Samuel Akpan

Socio-cultural Factors Influencing Insecticide Treated Bed Net Utilization in a Malaria Endemic City in north-central Nigeria

Objective: To ascertain the socio-cultural factors influencing the rate of utilization of insecticide treated bed nets (ITNs) in a malaria endemic city of Makurdi, north central Nigeria. Methods: The study was cross-sectional in nature using systematic sampling method to identify households. Both quantitative and qualitative data was generated from adult women using structured and semi structured questionnaires, and focused group discussions (FGDs) to obtain information on rate and patterns of utilization of ITNs. Information such as age, educational level, marital status, awareness or otherwise of the existence of malaria, and factors influencing rate of ownership and utilization of ITNs were obtained. FGDs were used to obtain qualitative information on rate of utilization of ITNs not raptured in the questionnaires. Data obtained was analysed using Epi Info 6 statistical software. Results: Among the respondents interviewed, 97.0% (2013/2075) were aware of existence of malaria and 87.0% of these (1751/2013) would associate it with mosquitoes. The rate of ownership of any bed net, ITNs and untreated bed nets (UTNs) was 25.1%. 17.0% and 8.3%, respectively. Utilization of ITNs among children was 30.0% (112/373) and UTNs 12.9% (48/373). Positive contributors to ITNs utilization were literacy, enhanced economy, experience of marriage, and being gainfully employed (P＜0.05); while negative contributors were ignorance, poverty and some cultural beliefs and values. Conclusions: A mole synchronized advocacy should be carried out on the potential benefits of ITNs utilization and sustained. Also ITNs should be made available to the people of the community at minimal or no cost.

Giant Mucoepidermoid Carcinoma of the Parotid Gland: A Case Report and Review of Literature

Mucoepidermoid carcinoma is the most frequently encountered salivary gland carcinoma usually presenting as small, painless, asymptomatic mass. Presented is a 54-year-old male security personnel with a 5-year history of giant locally advanced, nodular, and ulcerated left sided facial tumour diagnosed as mucoepidermoid carcinoma on histology. Mucoepidermoid carcinoma can attain a grotesque dimension with management challenges. We present this case, as we have not encountered MEC as large as this and conclude that it should be considered as a differential diagnosis of facial tumours.

Antimicrobial susceptibility profile of community acquired and nosocomial isolates of Escherichia coli from clinical blood culture specimens at a Nigerian university teaching hospital

Objective: To ascertain the antibiotic susceptibility patterns of Escherichia coli recovered from blood culture specimens in Calabar, Nigeria. Methods: The study was retrospective in nature and was carried out at University of Calabar Teaching Hospital (UCTH) Calabar. Data generated from blood culture specimens over a five year period (Feb. 2004-Feb. 2009) was compiled, relevant information such as age, sex, organism recovered and antibiotic susceptibility patterns were obtained from patients records. Samples were collected, transported, stored and processed using standard laboratory procedures. Data obtained was analysed using Epi Info 6 statistical software. Results: Escherichia coli was responsible for 15.3% (31/203) of the blood infections being the third most common microorganism encountered. The community acquired (CA) isolates of the organism were significantly less resistant (P＜0.05), compared to the nosocomial (NC) isolates against ampicillin, cloxacillin, amoxicillin, tetracycline, co-trimoxazole, chloramphenicol and erythromycin. The sensitivity of both the NC and CA isolates of Escherichia coli to amikacin, augmentin, ofloxacin, ciprofloxacin, ceftazidime, cefuroxime, ceftriaxune and rifampicin was generally high (80-100%) with no significant difference (P＞0.05). Majority (＞95.0%) of the NC isolates of Escherichia coli were resistant to six of the antibiotics tested. Conclusions: Control mechanisms for hospital acquired infections should be stepped up so as to limit the spread of the highly resistant bacterial strains. Also the sale and consumption of antibiotics by the public need to be regulated.

Tuberculous Axillary Lymphadenopathy: A Case Report

Isolated axillary tuberculous lymphadenopathy is rare and described in patients without evidence of previous or ongoing tuberculosis anywhere in the body. Presented is a 26-year-old female with one-year history of axillary swelling, clinical examination and investigations revealed no evidence of tuberculosis elsewhere. Diagnosis was by histology. Tuberculosis should be considered in patients residing in endemic areas with axillary lympha denopathy.

Giant Cell Tumour of Soft Tissue of the Finger: A Case Report

Giant cell tumour of soft tissue resembling osseous giant cell tumour is a distinct and uncommon entity. Presented is a 52-year old man with a 3-year history of swelling located on the dorsum of the right middle finger diagnosed on histology as giant cell tumour of soft tissue. The need for high index of suspicion by physicians is emphasized, as giant cell tumour of soft tissue should be considered as differential diagnosis of finger lumps.

Giant Solitary Intramuscular Cystic Plexiform Neurofibroma of the Thigh: A Case Report and Literature Review

Objective: To report a rare occurrence of giant, solitary, cystic, intramuscular plexiform neurofibroma in the thigh. Case Report: A 45-year-old architect presented with a 5-year history of painless, progressively enlarging soft tissue mass in the right thigh, which was diagnosed on histology as cystic plexiform neurofibroma after excision biopsy. Conclusion: A plexiform neurofibroma should be considered in the differentials of a solitary cystic mass in the thigh even in the absence of usual manifestations of Neurofibromatosis.

Transmesenteric (Internal) Hernia with an Ileal Volvulus in Pregnancy: A Case Report and Literature Review

Abstract: Introduction: Transmesenteric hernia describes an internal abdominal herniation through an opening in the mesentery. It is a very rare finding especially in pregnant women. Case Report: We report a case of acute intestinal obstruction in a 30-year-old pregnant woman with a rare finding of transmesenteric hernia and gangrenous ileal volvulus at exploration. Despite a delay due to a precipitated labour and delivery successfully managed her. Conclusion: Clinicians when faced with similar features in a pregnant woman should consider transmesenteric hernia.