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2019| Jan-Jun | Volume 8 | Issue 13
Online since
February 19, 2019
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ORIGINAL ARTICLES
Medicolegal analysis of sexual assault victims in Benin, Nigeria
Chukwuemeka Charles Nwafor, Wilson Oberaifo Akhiwu
Jan-Jun 2019, 8(13):10-17
DOI
:10.4103/nnjcr.nnjcr_18_17
Aim:
The aim of this study, done in a police clinic, was to understand sexual assault (SA) victim characteristics.
Subjects and Methods:
All SA cases seen at the Police Clinic, Benin City, Edo State, Nigeria, were retrospectively reviewed.
Results:
A total of 146 cases were seen involving 144 females and 2 males. Age group of 11–15 years was mostly affected (37%). The majority of SA victims (72.6%) had no sexual activity before the assault. In 95.9% of cases, no contraceptive was used. The perpetrators were known in 52.7% of cases, and most of them (20.5%) were cotenants. There was penovaginal penetration in 91.8% of situations, with verbal threats been the most common means of subjugation. About 76.9% of SA occurred during the daytime. The hymen in 56.2% of cases showed signs of fresh injury and, in 17.9% of cases, it was intact. Seminal acid phosphatase was seen in 29.6% of cases.
Conclusion:
SA victims should present very early so that adequate evidence will be collected. Modern diagnostic kits including DNA profiling are needed so that perpetrators can be convicted beyond doubt, while psychological care of victims should be included in medical care.
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CASE REPORTS
Subseptate uterus causing recurrent miscarriage
Onyekachi Okechukwu Moemenam, Chijioke Okeudo
Jan-Jun 2019, 8(13):40-42
DOI
:10.4103/nnjcr.nnjcr_2_18
Subseptate uterus is a variety of congenital uterine malformations that can result in recurrent pregnancy wastages. A high index of suspicion with the application of radiological imaging by experienced personnel will go a long way in achieving the early diagnosis of this uncommon condition. This was a case of 29-year-old Para 0
+4
who presented with recurrent miscarriages and was diagnosed of having subseptate uterus using histerosalpingogram, but she declined corrective surgery.
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ORIGINAL ARTICLES
Prevalence and sonographic patterns of uterine fibroids in Northern Nigeria
Yusuf Lawal, Ishaku Bala Yaro, Ayyuba Rabiu, Richard Emmanuel
Jan-Jun 2019, 8(13):24-29
DOI
:10.4103/nnjcr.nnjcr_4_18
Background:
Uterine fibroids are benign tumors which commonly affect women of reproductive age. Ultrasound scan is regarded as the commonly available method of diagnosing and growth monitoring of uterine fibroids.
Objectives:
To determine the prevalence of uterine fibroids, their sonographic pattern, and their association with body mass index (BMI) among patients undergoing pelvic ultrasound scan.
Methodology:
It was a descriptive cross-sectional study that was conducted among patients in Aminu Kano Teaching Hospital. Ethical approval was obtained from the hospital's Ethics Committee. Information such as sociodemographic characteristics was recorded in the questionnaire after obtaining informed consent. Mindray Digital Ultrasound Imaging System (Model DC6; Shenzhen Mindray Biomed Electronics, Shenzhen, China) was used for the study. The data obtained were analyzed using SPSS software version 20 (SPSS Inc., IL, Chicago, USA). A test of association was computed on the categorical variables using Fisher's exact test.
P
< 0.05 was considered statistically significant.
Results:
The prevalence of uterine fibroids was 12.1%. Age group of 36–40 years had the highest number of patients with fibroids (25 [29.8%]). Multiple fibroids of more than two nodules were the findings in almost half of the participants (41 [48.8%]). There was no statistically significant association between the number of fibroid nodules and parity
P
(Fishers') = 0.474 or BMI
P
(Fishers') = 0.181. Age group was statistically associated with the number of fibroid nodules
P
(Fishers') = 0.030.
Conclusion:
The prevalence of uterine fibroids in this study was high. Mixed echo pattern of fibroid nodules was the predominant finding in this study.
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Intimate partner violence among women attending a general practice clinic in Nigeria
Ehichoya D Oseyemwen, Ndudi K Oseyemwen, Bawo O James, Osahon Enabulele, Joseph Ajokpaniovo, Afolabi J Adewole, Leonard A Atsikidi, Oluwabunmi E Egharevba
Jan-Jun 2019, 8(13):1-9
DOI
:10.4103/nnjcr.nnjcr_10_18
Background:
There has been an increasing concern about the magnitude of violence against women, especially pregnant women in Nigeria. The long-term health impact of violence on the victims as well as the difficulty in directly associating violence with the health outcome of the victims is understudied in Nigeria. This study aimed to determine associations between physical health outcomes and intimate partner violence (IPV) in adult females attending a general practice clinic.
Methodology:
This was a cross-sectional descriptive study of 360 participants recruited using systematic sampling methods. A modified Abuse Assessment Screen tool was used to screen for IPV and the data were analyzed using version 21 of the Statistical Package for the Social Sciences (SPSS).
Results:
The prevalence of IPV in this study was 80%. Sexual abuse had the highest prevalence (56.4%), followed by physical and psychological abuse which had the prevalence of 46.7% and 31.9%, respectively. The common risk factors for IPV observed in this study included younger age of respondents, having a large family size, being employed, and partner's educational status. The common comorbidities found among the respondents experiencing IPV included hypertension, pelvic inflammatory disease, peptic acid disorders, osteoarthritis, and depressive illnesses. Alcohol use by partners was the most common perceived reason given by the respondents for their partners' perpetration of IPV.
Conclusion:
IPV as a part of violence against women remains very high and underreported in our society. The study showed a strong association between IPV and hypertension; this should be of interest to health-care practitioners and researchers.
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Dysmenorrhea and menstrual patterns among adolescent school girls in Kano
Ayyuba Rabiu, Idris Sulaiman Abubakar, Ibrahim Garba
Jan-Jun 2019, 8(13):30-34
DOI
:10.4103/nnjcr.nnjcr_3_18
Background:
Dysmenorrhea is a periodic cramping lower abdominal pain which occurs at menstruation. It could be primary when there is no organic basis and secondary when its due to underlying pelvic pathology. The primary dysmenorrhea frequently begins during adolescence. Abnormal menstrual patterns can also be encountered among adolescent.
Objective:
The objective of the study is to determine the rate of dysmenorrhea and menstrual patterns among adolescent school girls.
Methods:
It was a descriptive cross-sectional survey that was carried out among female adolescent girls in three secondary schools at Kano. Approval for the study was obtained from Kano State Ministry of Health. Consent/assent was obtained from all the participants/guardians. Information on dysmenorrhea and menstrual patterns was recorded on a pretested structured questionnaire. The data obtained were analyzed using SPSS Version 19, Statistics (SPSS Inc., IL, Chicago, USA).
P
< 0.05 was considered statistically significant.
Results:
The mean menstrual cycle ± standard deviation was 27.5 ± 8.76 days. Up to 52 (25%) of the adolescent girls have a 28-day menstrual cycle. The average duration of menstrual flow was 4.9 ± 1.51. The amount of blood flow was normal in 177 (81.6%), scanty/light in 21 (9.7%), and heavy in 19 (8.7%) of the adolescent school girls. The menstrual cycle was regular in 194 (89%) adolescent girls. The prevalence of dysmenorrhea and metrorrhagia was 42.5% and 12.5%, respectively.
Conclusion:
The prevalence of dysmenorrheal (42.5%) was high in the study. About one-quarter of the adolescent girls had a cycle length of 28 days. The average duration of flow was 4.9 ± 5.1 days with a normal amount of blood flow and regular menses in more than 80% of the adolescent school girls. There was a statistically significant association between heavy menstruation and dysmenorrhea (
P
< 0.005).
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Postincision wound infiltration with bupivacaine versus pethidine for postoperative pain relief following myomectomy under spinal anesthesia
Uche C Jaja, Fedrick E Amadasun, Idehen Osazuwa Hanson
Jan-Jun 2019, 8(13):18-23
DOI
:10.4103/nnjcr.nnjcr_27_18
Context:
Bupivacaine is commonly used agent for wound infiltration because of its local anesthetic effect. However, pethidine an opioid has both local anesthetic and systemic analgesic effect. The combined analgesic effect of pethidine may be superior to bupivacaine that has only a local anesthetic effect. Few studies have however supported the superiority of pethidine over bupivacaine for wound infiltration.
Aims:
The aim of this study is to evaluate the analgesic effect of pethidine in comparison with bupivacaine wound infiltration for postoperative pain control in nonparturients scheduled for myomectomy under spinal anesthesia.
Setting and Design:
This study is a prospective, randomized, double-blinded control trial of the analgesic efficacy of plain bupivacaine versus pethidine for patients scheduled for myomectomy under spinal anesthesia in a Tertiary Healthcare center in Nigeria.
Subjects and Methods:
Seventy-six American Society of Anesthesiologists 1 and 11 patients billed for myomectomy using spinal anesthesia were randomized into two groups. Group bupivacaine had wound infiltration with 50 mg isobaric bupivacaine at a concentration of 0.25%. Group pethidine had 1 mg/kg pethidine. In the ward, pain was assessed at various intervals at rest and on coughing using the numerical rating scale (NRS) pain assessment tool and the time of the first analgesic request.
Statistical Analysis:
NRS scores were presented as median with interquartile range, Continuous variables such as duration of analgesia and total analgesic consumption were analyzed using the unpaired Student's
t
-test.
Results:
The pethidine group had a longer time to first analgesic request, lower pain scores and a higher level of satisfaction.
Conclusion:
This study showed that postincision wound infiltration with pethidine at 1 mg/kg as a component in multimodal analgesia is more effective than 0.25% bupivacaine in the management of postmyomectomy pain.
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CASE REPORTS
Alobar holoprosencephaly in one of twin neonates
Bukunmi Michael Idowu
Jan-Jun 2019, 8(13):35-37
DOI
:10.4103/nnjcr.nnjcr_1_18
Holoprosencephaly (HPE) is a congenital structural anomaly of the forebrain which is often diagnosed prenatally, usually in singleton pregnancies. This is a case of alobar HPE affecting one of 19-day-old twin neonates which was only detected postnatally. The other twin was unaffected. The anomaly was not diagnosed in utero because a prenatal sonogram was not performed. This case is presented to reemphasize the need for thorough routine prenatal/obstetrics sonography. After birth, transfontanelle ultrasonography is a useful imaging modality for diagnosing this debilitating cerebral structural anomaly, but definitive classification requires cross-sectional brain imaging with computed tomography or magnetic resonance imaging.
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Perforation of the appendix due to intestinal schistosomiasis at a tertiary hospital in North Central Nigeria
Samuel Ali Sani, Monday G Yilkudi
Jan-Jun 2019, 8(13):38-39
DOI
:10.4103/nnjcr.nnjcr_25_18
In Nigeria, schistosomiasis is endemic and intestinal form affects the various internal organs. However, perforation of the appendix secondary to intestinal schistosomiasis is few. We report the case of a 35-year-old male with perforation of the appendix due to infestation with
Schistosoma mansoni
, following histopathological examination of the appendix after a laparotomy.
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LETTER TO THE EDITOR
Umbilical cord thrombosis, a cause of intrauterine fetal demise: A case study
Mahmood Dhahir Al-Mendalawi
Jan-Jun 2019, 8(13):43-43
DOI
:10.4103/nnjcr.nnjcr_26_18
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© New Nigerian Journal of Clinical Research | Published by Wolters Kluwer -
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Online since 8
th
Oct, 2014