Journal of Health Sciences and Practice

Incomplete Situs Inversus Presenting as a Case of Neonatal Intestinal Obstruction

Wed, 25 Jun 2025 00:00:00 -0600

BACKGROUND

Situs inversus totalis is a rare congenital abnormality characterized by a mirror-image transposition of both the abdominal and the thoracic organs.

Laterality is achieved established early in development, and any failure in that process might lead to a wide variety of positional derangements which may be partial or complete. Situs solitus describes the normal anatomy, situs inversus is the complete reversal, and situs ambiguous is used for any other abnormality of left-right development and shift.

Complete situs inversus is a very rare anomaly is characterized with the total inversion of all abdominal and thoracic organs. During the normal embryonic development, laterality (left-right-sidedness) is controlled by a group of signal molecules and genes. Any disturbance in the establishment of normal anatomical left-right asymmetry during this period results in left-right axis disorder which may express as complete situs inversus, incomplete situs inversus or situs
ambiguous.

AIM: To present a case of situs inversus ambiguous which presented as neonatal intestinal obstruction.

METHODOLOGY: The index case would be reported here as a presented from admission to mortality.

KEY WORDS: Incomplete, situs inversus, presenting, a case, neonatal, intestinal, obstruction.

Assessment of Fructosamine and Corrected Fructosamine as A Screening Test for Gestational Diabetes Mellitus

Wed, 25 Jun 2025 00:00:00 -0600

ABSTRACT

Background: The prevalence of Gestational Diabetes Mellitus (GDM) is on the increase. Screening with Oral Glucose Tolerance Test (OGTT) is time consuming. Fructosamine offers an alternative in its simplicity and can be assayed anytime of the day compared to OGTT. This study aimed to evaluate serum fructosamine and corrected fructosamine usefulness in detecting GDM.

Method: This was a cross sectional study which included 160 pregnant women. recruited from the antenatal clinic of Federal Medical Centre, Makurdi. Plasma glucose, serum fructosamine and serum total protein assays were assessed. Diagnosis of GDM was made using World Health Organization (WHO) 2013 diagnostic criteria.

Results: Majority of the participants 130 (81.3%) were normoglycaemic while those with GDM were 25 (15.6%) and Diabetes in Pregnancy (DIP) were 5 (3.1%). The mean (SD) fructosamine was higher in women with GDM [223.6 (17.6) µmol/L] compared to women without GDM [217.9 (15.0) µmol/L], however, this difference was not statistically significant, p= 0.091. Also, the mean (SD) corrected fructosamine was slightly higher in women with GDM [254.9 (19.1) µmol/L] compared to women without GDM [251.2 (22.3) µmol/L]. This difference was also not statistically significant, p= 0.435 Receiver Operator Characteristics of Fructosamine and Corrected Fructosamine to detect GDM, the Area under the curve (AUC) for fructosamine and corrected fructosamine were 0.584 and 0.594 respectively. Suggesting that they may not be good markers for detecting milder forms of hyperglycaemia.

Conclusion: Serum fructosamine and corrected fructosamine have limited use as a screening tool for GDM based on the WHO 2013 diagnostic criteria.

Key Words: Gestational Diabetes Mellitus, Hyperglycaemia in pregnancy, Diabetes in pregnancy, Fructosamine,

Evaluation of Cephalic Index and Students’ Performance among Hausa Children in Azare North Eastern Nigeria

Wed, 25 Jun 2025 00:00:00 -0600

Background: One of the most frequently used parameters for studying of racial differences amongst the populace is cephalometry. There is paucity of baseline information in the North Eastern part of Nigeria on population classification using cephalic index. Objective: Our aim was to assess the cephalic index and correlated with performance. Method: Cross sectional study was performed on 200 male secondary school students selected randomly for the study. Demographic data was collected through self administered questionnaire, the head and breath were measured using a spreading caliper from standard body landmarks to determine the cephalic index, and an Intelligent Quotient (IQ) test was administered to test the students’ performance. Descriptive statistics and Pearson’s Correlation performed using SPSS version 22, and the results were expressed as a mean ±SEM with statistical significant set at p< 0.05. Results: The results indicated a significant correlation between the cephalic index and IQ test performance (r value = Dolicocephalic (<74) 12.24 ± 0.04; Mesocephalic (75 – 79) 14.73 ± 0.47 and Brachycephalic (80 – 85) 18.50 ± 0.05, values were significant (p < 0.05). The two variables were related by the simple linear regression (SLR) equation as y= 62.91 + 0.5*x. On the other hand, there was no significant relationship between age and cephalic index as well as age and IQ (p< 0.05). Conclusion: Our finding established a relationship between cephalic index and students’ performance among children of Hausa ethnic group in Azare, Nigeria. However, further study needs to be carried out to have comprehensive information relating to cephalic index and student’s performance, particularly in the North Eastern part of Nigeria.

Randomized Controlled Study Comparing Diathermy and Scalpel Incisions for Elective Midline Abdominal Access in Jos University Teaching Hospital

Wed, 25 Jun 2025 00:00:00 -0600

Introduction: Surgeons have traditionally made skin incisions with the scalpel. The introduction of diathermy for coagulation of bleeding vessels, cutting and fulguration of soft tissue has been used as an alternative to the scalpel for making skin incisions. Comparative studies have shown varying outcomes, and there are limited studies carried out in the Nigerian context. The objectives of this study were to compare wound outcomes and complication rates following the use of cutting mode diathermy and scalpel skin incisions for elective midline laparotomy.

Methods: In this prospective, hospital based, randomized controlled non-inferiority study, consenting patients undergoing elective open laparotomy were randomized into interventions of diathermy incision or scalpel incision using sealed envelopes with intraoperative allotment disclosure. Participants, care givers and outcome assessors were blinded to group allotment. Demographic characteristics and wound outcomes including incision time, incision blood loss, post-operative pain, and complications (infection, haematoma, and wound dehiscence) were observed and recorded. Primary end point was 30-day post-operative follow up. Data were analysed using the Fisher’s exact and independent sample t-test, with results represented in tables and figures.

Results: Forty-two of 50 enrolled patients (84%) attained the primary end point and were included in the final analysis with 21 patients analysed in the diathermy (Group A) and scalpel incisions (Group B). The two groups did not differ significantly with respect to age (p = 0.725), BMI (p = 0.904), wound length (cm) (p = 0.065), wound depth (cm) (p = 0.334), and wound area (cm²) (p = 0.985). The use of diathermy for skin incision for intraperitoneal access was significantly faster than the use of scalpel (p <0.001). The total skin incision wound blood loss was significantly less in the diathermy group compared to the scalpel group (p < 0.000) as well as the wound blood loos per unit wound area (p = 0.002). There was no significant difference in post-operative wound pain assessed using the Visual Analogue Scale on Day 1 (p = 0.270), Day 2 (p = 0.592), and Day 3 (p = 0.770). The post-operative wound complication rate did not differ significantly between the two groups (p = 1.000).

Conclusion: The use of diathermy incision for access in midline laparotomy significantly reduced wound incision time and incision blood loss compared to that of the scalpel incision. However, there was no significant difference in post-operative wound pain and complication rate between the two groups.

Key words: Diathermy, Scalpel, Laparotomy, Incision.

Assessment of Emotional Intelligence in Health Care Delivery among Nurses in Olabisi Onabanjo University Teaching Hospital

Wed, 25 Jun 2025 00:00:00 -0600

Background: Emotional intelligence (EI) plays a crucial role in healthcare, particularly in nursing, where it enhances communication, teamwork, and compassionate patient care. Despite the growing global interest in EI, limited research has been conducted in Nigeria on its impact among nurses.

Objectives: This study aims to assess the knowledge of emotional intelligence among nurses in Olabisi Onabanjo University Teaching Hospital (OOUTH), evaluate their self-perception of EI, and determine its influence on healthcare delivery. The research seeks to highlight the importance of EI in nursing education and practice to enhance the quality of patient care.

Methodology: A descriptive cross-sectional study was conducted using a structured questionnaire administered to 165 randomly selected nurses across various departments at OOUTH. Data were analyzed using descriptive and inferential statistics with SPSS version 23.0, with significance set at p<0.05.

Results: Findings revealed that 100% of the respondents had a high level of knowledge of EI, with a mean score of 11.2±0.6. Additionally, 90% of nurses acknowledged a strong influence of EI on healthcare delivery (mean score = 30.1±5.8). Furthermore, 82.7% exhibited a high level of self-perception of EI, particularly in self-awareness, stress management, and empathy. Nurses who demonstrated higher EI were better able to handle workplace challenges and provide patient-centered care.

Conclusion: The study underscores the critical role of emotional intelligence in nursing practice and healthcare delivery. Integrating EI training into professional development programs can enhance nurses' ability to manage emotions, interact effectively with colleagues, and deliver compassionate patient care. Regular assessment and reinforcement of EI competencies should be incorporated into nursing education to improve overall healthcare outcomes.

Management of Facial Fractures in a Teaching Hospital North-west Nigeria: Our Methods and Challenges

olatunde oluleke omisakin — Wed, 25 Jun 2025 00:00:00 -0600

Background: Oral and maxillofacial region are made of several bones which are connected to each other and are affected by direct or indirect impact to the facial structures causing diverse types of facial bone fractures. There are several challenges that are encountered in the management of these fractures. This study reviewed etiology, demography, fracture patterns and management of facial bone fractures.

Materials and Methods: This was a retrospective study of facial fractures that were treated at the Barau Dikko Teaching hospital, Nigeria. The study period span from January, 2010 to December, 2023. Information was collected from the theatre register, clinic register, accident and emergency register and radiology register. The information collected includes patient demography, etiology of fracture, fracture patterns, treatment received, complications of the fractures and challenges in the management.

Results: Patients with facial bones fracture that received treatment in our Centre were 114 during the period of study. Males were more affected than females by a ratio of 5.3: 1. The age ranged from 6 years to 70 years, the mean age is 38 years SD ±18.76 Most injuries were due to road traffic accidents (n= 62, 54.39%), then missiles (gunshot & bomb blast) (n=20, 17.55%), fall from height (n=13, 11.40%), interpersonal violence (n=11, 9.65%), sport injuries (n=6, 5.26%), industrial accident (n= 2, 1.75%). The commonest site of fracture was the mandible, other common sites were maxillae (Leforte 1, 11 and 11I), zygomatic arch, nasal and frontal bone. Reduction and immobilization was the treatment for facial bone fractures. Limitation of mouth opening, gag occlusion, anterior and lateral overbites, loss of teeth, altered arch and weight loss were some of the complications encountered.

Conclusion: The commonest cause of facial bones fractures was road traffic accident, therefore all efforts must be made to reduce this trend, by obeying traffic rules and regulations. Adult males were the most affected. Most of the maxillofacial fractures in this study were treated by closed reduction and immobilization.

Keywords: Facial, fracture, management, mandible, trauma.

Penile Pathomorphologic Entities Seen at A Tertiary Health Facility

Wed, 25 Jun 2025 00:00:00 -0600

Introduction: The human penis is a cylindrical cucumberlike external organ that “stands tall,” defining the phenotypic male. The diseases of the penis are rife and may impact heavily on psychosocial well-being of a man. The aim of this research is to study the clinical and histologic patterns of all penile biopsies received at a Nigerian tertiary hospital over a 10years period.

Methodology: The work was a descriptive study of all histologically diagnosed cases of penile pathologies seen at the Jos University Teaching Hospital between 1st January 2003 and December 31st, 2022. The age, clinical characteristics (site and symptoms) and histological diagnosis were obtained from the records. The data obtained was entered into Microsoft excel and then exported into Statistical Product and Service Solutions (SPSS) 2016, and presented on frequency tables as proportions, simple frequencies, percentages, range, and measures of central tendencies.

Result: There were 14 histologically diagnosed cases of penile pathologies during the period of the study. The age range was 1-71years, with the mean age, median age and modal ages of 28.64+23.11years, 24.5years and 25.0years respectively. Table 1. The commonest diagnostic entity was verrucae (condyloma acuminata) accounting for 6(42.9%) cases while Neurofibroma was the least with 1 (7.1%) case. The symptoms of a mass, itching, pain, and ulceration were seen in these patients. The presence of a mass was the symptom with the highest frequency while ulceration had the least frequency. All cases seen were circumcised males.

Conclusion: This study showed that most penile diseases in our environment are due to pathologies related to sexually transmitted infections with the HPVs, the condyloma acuminata and squamous cell carcinoma. The rarity of disorders of the penis could be attributable to circumcision and therefore vaccination against the HPV should be encouraged in a massive scale to complement prevention of development of the disease.

Sexual Behaviour and Health Risks among Unmarried Adolescent Girls in Nigerian IDP Camps: A Pilot Study

Wed, 25 Jun 2025 00:00:00 -0600

Background: Internal displacement (ID) places women and especially unmarried adolescent girls in heightened vulnerability of sexual exploitation and other forms of gender-based violence. In the wake of increasing displacement due to violent conflict in Nigerian communities, we evaluated the sexual behaviour and associated determinants among unmarried adolescents in Internally Displaced Persons (IDP) camps in North central, Nigeria.

Methods: This was a descriptive cross-sectional design, using a structured questionnaire to survey 75 older adolescent girls aged 15–19 years living in six IDP camps across Abuja, Benue, and Plateau States. Data was analysed using the Statistical Product and Service Solution (SPSS) version 23.0, using Chi-square tests and logistic regression to identify predictors of sexual initiation among the respondents. p<0.05 was considered significant.

Results: Among respondents, 42.7% of participants had initiated sexual intercourse, with a mean (SD) age of debut at 16.6 ±1.5years. Over half (53.1%) of these instances occurred after displacement and 81.3% of these were unprotected intercourse. Older adolescents (aged 17–19 years) and those not currently attending school were more likely to have initiated sexual activity (p < 0.001).

Conclusion: A significant proportion of internally displaced female adolescents have initiated sexual activity, majority of which are unprotected. This study highlights the need to strengthen sexual and reproductive health services among displaced populations.

Hysteroscopic Findings and Interventions at A Private Fertility Centre

Wed, 25 Jun 2025 00:00:00 -0600

Background-Hysteroscopy is the gold standard modality in assessing and treating intrauterine abnormalities that may affect fertility.

Objectives- To review the indications, findings, type of hysteroscopic surgeries and complications of hysteroscopy.

Methods- This study was conducted over a two year period. The data for 341 consecutive women were collected and reviewed. Statistical analysis was done using Microsoft Excel.

Results- In this review 336(98.8%) of hysteroscopies were done for the evaluation and treatment of women with infertility. Intrauterine adhesions (IUA) were the most common findings at hysteroscopy, 80(23.5%) had IUA alone and 13(3.8%) of the women had IUA coexisting with other intrauterine abnormalities. Endometrial polyp was the second most common abnormality seen alone (55(16.1%)) or in combination with other intrauterine abnormalities (10(3.8%). Hysteroscopic adhesiolysis was done in 93(38.3%) women followed by polypectomy with a frequency of 68(28.2%). There were 5(1.5%) women who had complications, 3(0.9%) of the women had uterine perforation.

Conclusion- Evaluation and treatment of infertility was the commonest indication for hysteroscopy. Intrauterine adhesions were the commonest findings at hysteroscopy. Intrauterine adhesiolysis was the most frequently performed operative procedure. The most common complication encountered was uterine perforation.

Key words- Hysteroscopy, Indications, Findings, Complications, Laser, Infertility, Intrauterine adhesions, Uterine perforation

Stroke in Children with Sickle Cell Disease: Prevalence, Pattern of Presentation and Outcomes in Jos, Nigeria

Wed, 25 Jun 2025 00:00:00 -0600

Background: Stroke is a severe complication in children with sickle cell disease (SCD), leading to persistent disabilities and a markedly reduced quality of life. Most research on paediatric stroke in Nigerian children with SCD originates from low-altitude southern regions, leaving gaps regarding higher-altitude areas like Jos, Plateau State. This is important, as cerebral blood flow velocity has been shown to be influenced by altitude. We investigated the prevalence, presentation, and outcomes of stroke in children with SCD in Jos.

Methods: A descriptive, retrospective study was conducted at Jos University Teaching Hospital from January 2018 to December 2022 using data from the paediatric haematology registry and hospital records. Records of children under 18 years were thoroughly reviewed for demographic details, stroke history, presentation, and outcomes. Stroke was diagnosed per WHO criteria, and analyses were performed using SPSS version 23.0.

Results: Of 778 eligible children with SCD, 42 experienced stroke, yielding a prevalence of 5.4%. The mean age at first stroke was 7.7 ± 3.4 years, with 57.1% occurring in the 5–9-year group. Males comprised 57.1% of cases, and 57.1% belonged to the middle socioeconomic class. Clinically, all children exhibited limb weakness; hemiplegia was seen in 92.9% and aphasia in 42.9%. Concerningly, only 26.2% presented within 24 hours of symptom onset, and 40.5% had recurrent strokes.

Conclusion: This study reveals a significant burden of paediatric stroke in Nigerian children with SCD. High recurrence rates, consistently delayed presentations, and limited imaging highlight the urgent need for early transcranial Doppler screening, improved preventive measures, and better healthcare access to reduce the stroke burden.

Six-minute Walk test in Nigeria- Applicability and Usefulness: A Review of Current Literature.

Shadrack D. Chungyang, Ganiyu A. Amusa — Wed, 25 Jun 2025 00:00:00 -0600

Background

The Six-minute Walk Test (6MWT) is a relatively widely applied simple, valid and reliable field exercise test used to determine the exercise capacity, factors limiting exercise performance and often the response to an intervention. It is still relatively unpopular in Nigeria despite its usefulness in the complete evaluation and care of cardiorespiratory patients.

Objectives

This review aims to increase awareness, applicability and usefulness of this simple field walk test for the complete evaluation of patients with cardiorespiratory conditions in Nigeria.

Methods

The available literature on the topic from PubMed, Medline, Google Scholar and other relevant internet sites were accessed, reviewed and inferences made.

Conclusion/Recommendation

The applicability and usefulness of the 6MWT in the complete evaluation and care of patients with cardiorespiratory conditions in Nigeria remains scanty. Awareness of this simple test can boost its application in Nigeria and across the world.

Keywords:

Word count : Abstract: 190; Main body: 3,080

Visual Impairment Among Children with Epilepsy at a Tertiary Hospital in Nigeria.

Wed, 25 Jun 2025 00:00:00 -0600

Background

Visual impairment (VI) may be one of the least reported neurologic comorbidities among children with epilepsy. But its impact on the child’s development and quality of life makes it of public health importance. This study describes the prevalence of VI, clinical and schooling factors associated with VI among children with epilepsy (CWE) being managed at the Jos University Teaching Hospital (JUTH).

Methods: A cross-sectional comparative study of CWE and their age, sex matched controls. Eligible children diagnosed with epilepsy and being managed at the JUTH were consecutively recruited after obtaining signed informed consent from their caregivers. Their sociodemographic data, clinical and schooling histories were obtained from the caregivers. Vision was assessed using the American Academy of Paediatrics guideline for visual systems assessment in infants, children and young adults by paediatricians and categorized using the International Center for Disease control version 11 (ICD11) guidelines. Result of the findings were compared with that of age and sex matched controls recruited from neighbouring schools and the community.

Results

A total of 200 children were recruited for the study; 100 CWE and 100 controls aged between 1-18 years with a male to female ratio of 1.2:1. The prevalence of VI among CWE (5.0%) was significantly higher than the prevalence (2.0%) among the controls (p < 0.001). Vision loss in both groups was in the moderate VI category. No association was found between patients’ clinical parameter and VI. Similarly, although the CWE had significantly poorer schooling history compared to the control group (p < 0.001), no statistically significant relationship was found between VI and schooling history (p = 0.363) or school performance (p = 0.130) of CWE.

Conclusion

VI is more common among CWE at the JUTH compared to the controls but no significant association was found between VI and clinical parameters, schooling history or school performance of CWE. An interdisciplinary approach involving caregivers, teachers, paediatricians and ophthalmologist is required to enhance early detection and management of VI associated with childhood epilepsy.

Key words:Visual impairment, epilepsy, school

Inputting Community Educators as Advocates of Hepatitis B Screening Uptake Among Women of Reproductive Age in Jos North Communities, Plateau State

Mary John Duguru, Agbo, H.A , Odoh F, Isandu O — Wed, 25 Jun 2025 00:00:00 -0600

Abstract

Hepatitis B is one of the common viral hepatitis affecting persons that may not have been previously vaccinated with the antigen. It is easily prevented through a three dose schedule of vaccination with the antigen, but unfortunately despite the accrued benefits of prevention through vaccination, there is a growing apathy towards early detection (screening) and vaccination of adults especially of women in the reproductive age group.

Women of reproductive age is a good target if adequate control of Hepatitis B spread is be to achieved. Thus, the role of the community educators may be considered very crucial and timely in scaling up the willingness to screen for Hepatitis B in our communities.

Study objective

The influence of community educators on Hepatitis B virus screening and vaccine uptake among adult females was assessed.

Materials and Methods

The study was carried out over a period of 6 weeks. Six community educators (CE) residing in selected communities in Jos North Local Government Area of Plateau State were the research assistants, 2 in each of the selected communities. Consent was first obtained after the research was explained to the participants. The research was conducted over 6 weeks, in the first week, eligible participants were mobilized, information were obtained by interviewer-administered questionnaire after consent to participate was obtained. Information were obtained on socio-demographic characteristics, virus status and willingness to conduct a screening test. They were then encouraged, given a recorded information tag and linked to the nearest PHC for a viral screening and vaccine uptake. A feedback assessment at the PHCs was conducted over the research duration after one weekly reminder calls to participants whose information were not obtained at the PHCs.

Results

Two hundred and thirty-four adult females were the participants; one hundred and twenty-one (51.7%) completed secondary school education. One hundred and seventy-one were between ages 18-30 years while the higher ages more than 30 years formed 26.9% of the participants. One hundred and eighty-nine were married (80.8%); 139, (59.4%) had no knowledge of their Hepatitis B status; of the 95 (40.6%) that knew, 27(11.5%) had immunization against the virus while 68 (29.1%) has had no immunization despite the previous negative Hepatitis B status. Most of them were however willing to have a routine screening for Hepatitis B while 18 (7.7%) were not sure they will subject themselves for screening for fear of the unknown. Uptake were good in all the selected communities A, B and C (66.7%, 62.2% and 84.8%) respectively.

Conclusion

The community educators played a significant role in improving Hepatitis B screening and vaccine uptake in three selected communities in Jos North, Plateau State.

Major Omphalocele

Dido Dung, Shitta AH, Chirdan LB, Uba AF — Wed, 25 Jun 2025 00:00:00 -0600

Background

Major omphalocele are a source of neonatal morbidity and mortality.Primary surgicalclosure is the ideal management in developed nations with advanced neonatal care but floaded with dismal results in poorly equipped centers. The conservative care by the use of escharotic agents is ideal for this centers. Topical wound care with Honey has demonstrated safety and shown impressive outcome. The aim is to show our experience in the care of major omphalocele with topical use of Honey as escharotic agent.

Material and methods

This is a 10 year retrospective study of neonates admitted into the Special Baby Care Unit of Jos University Teaching Hospital clinically diagnosed with unruptured major omphalocele from January 2008 to June 2018. The wounds were dressed daily with gauze soaked in 10-20 mls of Honey. The wound was observed for the presence of infection,rupture,mean durations of complete separation of the eschar and complete epithelialization(healing). The age at presentation,gender and weight were assessed.

Result

A total of 36 neonates were treated. There were 17(42.2%)males and 19(52.8%)females (M:F=1:1.1) with a mean age of presentation of 54.28 hours(S.D 67.007). The mean weight was 3.025Kg(S.D 0.4150). Risk of sepsis was present in 9(25%) and associated sepsis was present in 14(38.9%). Associated congenital malformations were detected in 11(30.6%). Eleven(30.6%) developed complications with sepsis for 81.8% of the total complications. Ten(27.8%) died before assessing for eschar separation. Sepsis and prematurity accounted for majority of the cause of death. The mean duration of eschar separation was 31.9 days(S.D 10.566). The mean duration of complete epithelialization(healing) was 12.19 weeks(S.D 1.059). Gender, age at presentation,risk of sepsis,associated sepsis at presentation and associated congenital malformation did not demonstrate significant association with either eschar separation nor complete epithelializatin. One patienthad rupture of the omphalocele sac.

Conclusion

Honey is a safe and effective escharotic agent in the conservative management of major omphalocele. The procedure is easy,simple, practical,less expensive, not requiring equipment and can be used in limited resource cemters.