Adamu Girei Bakari

Incidence of dog bite injuries and clinical rabies in a tertiary health care institution: A 10-year retrospective study

BACKGROUNDnIt is widely recognized that rabies is grossly under-reported even though it is a notifiable disease and a lack of accurate figures has rendered rabies a low public health and veterinary priority. This study aimed at determining the incidence of dog bite injuries and clinical rabies in a tertiary health care centre.nnnMATERIALS AND METHODSnCase records of patients managed at the accident and emergency unit of Ahmadu Bello University Teaching Hospital, Zaria, between June 2000 and May 2010 with diagnosis of dog bite and rabies were retrieved. Relevant clinical data were extracted using a structured questionnaire designed for the study.nnnRESULTSnEighty-one persons out of 24,683 consultations in the accident and emergency unit presented with dog bite injuries with two clinical cases of human rabies. Mean age of victims of dog bite injuries was 21.1 ± 14.3 years and the majority (55.6%) were children. Males were more affected than females with a male:female ratio of 4.8:1, lower limb/buttock injuries were significantly higher in children than adults, but the adults sustained significantly more severe (type III) injury. The majority of dog bite injuries were washed with soap and irrigated with water or saline and 87.7% of the victim of dog bite received postexposure anti-rabies vaccine.nnnCONCLUSIONnHospital incidence of dog bite injuries was low, but the use of postexposure prophylaxis was high.

Myasthenia gravis associated with autoimmune thyroid disease: A report of two patients

Myasthenia gravis (MG) is an acquired autoimmune disorder causing skeletal muscle fatigue and weakness. This is a report of one woman and her daughter presenting with myasthenia and gravis and Graves disease. It highlights possible hereditary component of this condition which has not been commonly reported in our setting.

Magnetic Resonance Imaging Determination of Normal Pituitary Gland Dimensions in Zaria, Northwest Nigerian Population

Objectives: To determine the dimensions of normal pituitary gland using T1-weighted magnetic resonance images (MRI) and to determine their relationship with age and sex. Materials and Methods: Cranial MRI scans of 100 individuals with clinically normal pituitary function (58 males and 42 females) and in the age range 14-82 years were reviewed in order to obtain volumetric measurements of the pituitary gland. The height, width, and depth of the pituitary were obtained from mid-sagittal and coronal planes, while the volume was calculated from these measured parameters. The data obtained were stratified based on age and sex for analysis. Statistical tests applied included Student′s t-test and Pearson correlation. A minimum level of statistical significance was set at P < 0.05. Results: The mean pituitary volumes were 334.1 ± 145.8 mm 3 and 328.1 ± 129.2 mm 3 while the mean pituitary heights were 6.45 ± 1.7 mm and 6.46 ± 1.57 mm in males and females, respectively. Although there was no statistically significant difference between pituitary height and pituitary volume in both sexes, they correlated negatively with increasing age (r = −202, P = 0.04 and r = −410, P = 0.000, respectively). Both parameters were highest in pubertal subjects and declined steadily with age, with a second peak occurring only for pituitary height in the sixth decade. The mean pituitary widths (9.08 ± 2.59 mm and 9.21 ± 1.86 mm) and depths (10.59 ± 1.71 mm and 10.49 ± 1.57 mm) in males and females, respectively, did not show remarkable changes with age and sex in the individuals studied. Conclusion: With this study, we have provided reference values in Nigerian population for the dimensions of normal pituitary gland, in order to facilitate assessment and diagnosis in patients with abnormalities of the hypothalamic-pituitary axis.

Low education and lack of spousal relationship are associated with dementia in older adults with diabetes mellitus in Nigeria: Dementia in diabetes mellitus

The relationship between dementia and type 2 diabetes mellitus (T2DM) in older adults is well established in the literature. However, there have been few studies on this relationship in older adults living in low‐ and middle‐income countries, and most demographic projections predict that older adult population will increase substantially in these regions by 2050.

Is glucose dysregulation an inflammatory process

Aim: To determine the relationship between glucose dysregulation and high-sensitive C-reactive protein (hsCRP). Settings and Design: Zaria is a major city located on the high plains of Northern Nigeria, 652.6 m above the sea level, some 950 km away from the coast. Its location is latitude 112°31” N and longitude 7°42” E. This was a cross-sectional observational study. Participants not previously known to have diabetes mellitus (DM) who satisfied the inclusion criteria were enrolled after cluster random sampling. The study was carried out over a period of 12 months. Materials and Methods: Four hundred apparently healthy participants were recruited through cluster sampling from their respective communities after due consent. Relevant biodata were documented, and appropriate examinations including anthropometric measurements were carried out. Plasma glucose and hsCRP levels were subsequently measured. Statistical Analysis Used: Microsoft excel was used for data entry while SPSS software version 19 was used for data analysis. Pearsons Correlation was used to test for association between plasma glucose levels and body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and hsCRP. Multiple logistic regression was used to determine whether BMI, WC, WHR, and hsCRP were significant determinants of glucose dysregulation. Significance level was considered P < 0.05. Results and Conclusions: BMI, WC, WHR, and hsCRP were shown to be significant determinants of glucose dysregulation. Therefore, a chronic low-grade inflammation may contribute to the etiopathogenesis of DM.

Community-acquired primary liver abscess due to klebsiella pneumoniae in a type 2 diabetic patient

Klebsiella pneumonia (KPLA) liver abscess is a cause of morbidity and mortality in especially diabetic patients. Early case reports have been from the Southeast Asia, also been found in other parts of the world. Diagnosis is usually by culture of hepatic aspirate and/or blood culture and treatment by drainage of abscess and administration of appropriate antibiotics. This is a case of KPLA in a 52-year old man treated and responded to antibiotics. KPLA is an entity that should be sought for especially in poorly controlled diabetic patients when they present with clinical features of liver abscess. Blood culture must always be done especially when aspiration or drainage proves difficult. Use of appropriate antibiotics alone may be successful in treating them if surgical drainage is unsuccessful.

Validity of new flow cytometric protocol in diagnosis of low-grade myelodysplastic syndromes

Background: Myelodysplastic syndromes (MDS) are the most common of myeloid malignancies, yet the morphological diagnosis is usually not straightforward especially in the low-grade forms. Immunophenotyping by Flow cytometry (FCM) is considered essential in the WHOs co-criteria for diagnosis of MDS. The Existing FCM Protocol utilizes a two-tube, two-colour approach to identify lineage specific cluster of differentiation (CD) markers, which is labour-intensive and time-consuming. A new FCM was recently developed and validated among Japanese cohorts. It utilizes a three-tube, five-colour approach and generates more information in the form of cardinal parameters. The aim of this study is to determine the diagnostic utility of the new protocol by comparing it with the existing protocol, in the diagnosis of low-grade MDS in our study population. Materials and Methods: We analyzed bone marrow samples of 30 subjects at Kings, London. They comprised of 27 patients who had a tentative diagnosis of MDS and three healthy bone marrow donors as controls. Immunophenotyping by FCM was performed using the Existing and New Protocols and the data obtained by the two different methods were compared. Cardinal parameters were generated in the new protocol, which are not applicable to the existing protocol. Results: There was no statistical difference between the data generated by the two protocols in the diagnosis of MDS. The sensitivity and specificity of the cardinal parameters of the new protocol appeared to be outstanding. Conclusion: It has been shown that the new multiplex FCM protocol for the diagnosis of MDS is relatively easy, cost effective and not inferior, compared to the Existing Protocol. However, small sample size has been identified as a limitation to the study and therefore a larger, multicenter study is recommended to assess this validation exercise.