Impact of smoking on nasal mucociliary clearance time in Kano metropolis, Nigeria.

Background: Mucociliary clearance is an important defense mechanism in human upper and lower respiratory airways. Impairment of this process by certain conditions such as cigarette smoking can predispose to chronic infection and neoplasm of the nose and paranasal sinuses. Methods: This was a cross-sectional study conducted in Kano metropolis, Nigeria. Eligible adults were enrolled, a saccharine test was conducted, and the nasal mucociliary clearance time was assessed. Analysis of the result was carried out using Statistical Product and Service Solutions version 23.0. Results: There were 225 participants categorized into 75 active smokers (33.3%), 74 passive smokers (32.9%), and 76 nonsmokers (33.8%, living in a smoking-free zone). The age range of the participants was between 18 and 50 years, with a mean age of (31.2 ± 5.6) years. All participants were males. There were 139 (61.8%) of Hausa-Fulani ethnic group, 24 (10.7%) Yoruba, 18 (8.0%) Igbo, and 44 (19.5%) other ethnic groups. Findings in this study showed that the average mucociliary clearance time among active smokers was prolonged ([15.25 ± 6.20] min) compared to passive ([11.41 ± 4.25] min) and nonsmokers ([9.17 ± 2.76] min) respectively, with a statistical significance (F = 33.59, P < 0.001). Binary logistic regression revealed that the number of cigarettes smoked per day was an independent predictor of prolonged mucociliary clearance time (P = 0.008, odds ratio = 0.44, 95% confidence interval = 0.24-0.80). Conclusion: Active cigarette smoking is associated with prolonged nasal mucociliary clearance time. The number of cigarette sticks smoked per day was found to be an independent predictor of prolonged mucociliary clearance time.

Helicobacter pylori antibiotic sensitivity pattern in dyspeptic patients in Kano, Nigeria.

BACKGROUND: Despite the high prevalence of Helicobacter pylori infection in Nigeria, in the North-West there are no studies on the antibiotic sensitivity pattern of this organism. This study aims to determine the antibiotic sensitivity pattern of this bacterium as well as bridge the gap in knowledge. METHODS: The study was cross-sectional in design. Questionnaires were administered in dyspeptic patients to obtain the relevant data. Two sets of gastric biopsy specimens were taken during upper gastrointestinal (GI) endoscopy. One set was sent to the histopathology laboratory for assessment and H. pylori identification, while the other set for culture was minced and plated on Columbia blood agar media (Oxoid Ltd, England) incubated at 37°C in an anaerobic jar containing CampyGen (Oxoid Ltd) to provide the required micro-aerobic environment. The disc diffusion method was used in determining the sensitivity pattern of isolates. Pre-treatment and post-treatment stool samples were collected from each patient for a H. pylori faecal antigen test to assess eradication rate. RESULTS: The sensitivity of H. pylori to amoxicillin was 9.2%, and 100% for both clarithromycin and levofloxacin. Tetracycline, metronidazole, cefuroxime, tinidazole and ciprofloxacin were 100% resitant. The prevalence of H. pylori at histology was 81.7%. Only 101 subjects had a positive H. pylori stool antigen test. CONCLUSION: This study showed a high amoxicillin resistance; however, there is high sensitivity (100%) to clarithromycin and levofloxacin. We recommended that levofloxacin be adopted in preference to amoxicillin as part of triple therapy in Nigeria.

Metallic foreign body in esophagus: are multiple radiographs necessary?

BACKGROUND: Multiple X-rays required for confirmation and localization of ingested metallic foreign body preoperatively predisposes children to increased radiation exposure. This study aims to highlight the current necessity or otherwise of these X-ray requests. MATERIALS AND METHODS: This is a retrospective study of patients with ingested metallic foreign bodies over a five-year period in a tertiary health institution. Case notes and X-ray requests were studied. RESULTS: Of 39 cases of foreign body in esophagus, 29 (74.4%) were metallic and the coin accounted for 79.3% of all metallic foreign bodies. There were 20 males to 9 females and 28 children aged 2 months to 11 years to one adult. There were 62 pre-extraction X-rays consisting of 29 (46.8%) initial confirmatory films and 33 (53.2%) repeat films for localization of the foreign body. There were 10 post-extraction films for postoperative complications. CONCLUSION: More than half of the X-ray films were unnecessary and the radiation exposure was avoidable if alternative methods of localization of the foreign body such as the handheld metal detector were available.

Analysis of 348 consecutive cases of primary postpartum haemorrhage at a tertiary hospital in Nigeria.

A retrospective analysis of 348 cases of primary postpartum haemorrhage (PPH) that occurred at the University of Ilorin Teaching Hospital, Ilorin, Nigeria between 1 January 1993 and 31 December 1996 was carried out. The incidence of PPH was 4.5%. Booking status of the patients had no relation with occurrence of PPH in this study (P>0.05). The risk of PPH in advanced maternal age (over 35 years) and grandmultiparity (para 5 and over) was twofold higher than low maternal age (<25 years) and low parity (para 0-1), P<0.05, respectively. The incidence of PPH was higher in deliveries conducted by midwives than doctors (P<0.05). Anaemic patients (PCV< or =30%) were more at risk than non-anaemic patients (P<0.05). Uterine atony, 183 (53.8%) was the most common cause of PPH and a combination of uterotonic agents and uterine massage were effective in controlling PPH in 171 (49.1%) of the cases. Seven (2.0%) patients required hysterectomy. One-third of the patients had a blood transfusion. To reduce the incidence of PPH, we recommend that doctors should supervise the delivery of parturients at risk of PPH and advocate health education against high parity.

The role of ultrasound in obstetrics.

Ultrasound contributes immensely to obstetrics and its application and use is now widespread. The clinical applications and uses of ultrasound include confirmation of pregnancy and multiple gestation, estimation of gestational age, localisation of placenta and monitoring of foetal wellbeing. The others are evaluation of caesarean section scar integrity and post partum haemorrhage. Ultrasound is also useful in prenatal diagnosis and foetal therapy. The major limitation of ultrasound is the fact that it is not useful in air/gaseous containing media. Ultrasound is safe and there is no known adverse effect for now on mother, foetus or operator at the intensity used for present obstetric examination. Overdependence and abuse of ultrasound remains a problem and it should be emphasised that ultrasound is to complement and not a substitute to clinical judgement.