Open Access Original Research Article

Fine Needle Aspiration Cytology in Lesions of Gall Bladder - Experience in a Primary Care Setting

Pradeep Tandon, Winie Gautam

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2017/31491

Aims: In certain regions of India, cancer of gall bladder (GBCa) is a common form of malignancy. In the Gangetic belt, its incidence is up to 10 times greater as compared to some other parts of the country. The aim of the present study is to study the diagnostic utility of guided fine needle aspiration cytology (FNAC) in patients of carcinoma of gall bladder. Whether use of this technique can help in segregating patients requiring palliative care only, was also analyzed. The demographic profile of these patients was also studied in a primary care setting.

Study Design: All patients referred with a gall bladder mass underwent guided fine needle aspiration procedure for purpose of establishing a morphological diagnosis. Ultrasonographic examination was used for cancer staging and delineating inoperable cases.

Place and Duration of Study: The study was conducted at Ama diagnostic centre, Lucknow, in collaboration with the department of Pathology, Integral Institute of Medical Sciences, Lucknow, India. The period of study is from August 2010 to March 2016.

Methodology: FNAC was performed under ultrasound guidance on all patients having a gall bladder mass. Clinical details of the patients were recorded and their demographic profile was studied.

Results: Forty five patients having a gall bladder mass underwent FNAC for diagnostic purposes. Adequate material was obtained in 44 patients. It was possible to provide a definite diagnosis in 38 cases (86.3% of cases). Adenocarcinoma NOS was the commonest diagnosis (86.8% of cases). Amongst patients with malignancy, 73.7% of cases were in advanced stage of the disease. Palliative care represents suitable treatment option in such patients in our clinical set up.

Conclusion: Utilizing guided FNAC, it was possible to provide a definite diagnosis of malignancy in 86.3% of cases. It was also possible to segregate patients requiring either definitive or palliative treatment.

Open Access Original Research Article

A Critical Appraisal of Hearing Impairment among Primary School Children in Port Harcourt, Nigeria

Odeh Josephine Enekole, Onotai Lucky Obukowho, Anochie Ifeoma

International Journal of TROPICAL DISEASE & Health, Page 1-17
DOI: 10.9734/IJTDH/2017/31019

Background: Hearing impairment is the most frequent sensory deficit in human populations affecting over 250 million people in the world. Undetected hearing impairment among primary school children has been linked with poor school performance, low self-esteem and thus poor psycho-social/intellectual development in the child. This paper determines the pattern and prevalence of hearing impairment in primary school children in Port Harcourt.

Methodology: This study was carried out in Port Harcourt. Primary school children of both public and private schools were recruited for this study from January 10th, 2010 to May 21st, 2010. At the schools, Pure Tone Audiometry (PTA) screening was carried out on the pupils whose parents gave informed consent. The data of each child screened was entered into the forms provided (Appendix i and ii) by the research assistants and crosschecked by the researchers.The data was then entered into the database of a software package designed for collection, completion and reporting, the EPI_INFO (version 6) statistical package for epidemiology. Data from the study was analyzed using the computer program EPI-INFO (VERSION 6) and SPSS11.0. The age and sex distribution of the study population; the social class; the prevalence of hearing impairment in relation to age, sex, social class and school type; the risk factors of hearing impairment and its relationship with school performance were determined from the data collected. These data were presented as charts, graphs and tables in simple proportions, and comparisons of sub groups carried out with chi square test. Statistical significance at 95% confidence interval was p value < 0.05.

Results: From 13 selected schools, a total of 802 pupils were screened, 461 (57.5%) were from public schools while 341(42.5%) were from private schools; giving a public to private school population ratio of 1.4:1 The number of pupils was almost equally distributed in all the age groups; 281 pupils (35.0%) were between 5-7 years whereas 253 pupils (31.6%) were > 10 years. There were 405 males (50.5%) and 397 (49.5%) females, giving a male: female ratio of 1.02:1.

Majority of the pupils were from social class III (268 pupils, 33.4%). The prevalence of hearing impairment in primary school children in Port Harcourt was found to be 29.4%. The prevalence of hearing impairment was higher in children in public schools (30.2%) than amongst those in private schools (28.4%). Of the 236 pupils with hearing impairment 76 pupils (52%) had Conductive Hearing Loss (CHL), 35 (24%) had Mixed Hearing loss (MHL) and 35 (24%) had Sensorineural Hearing Loss (SNHL). Of the 236 pupils with hearing loss, 128 (54.1%) had unilateral hearing loss while 108 (45.9%) had bilateral hearing loss.

Conclusion: The prevalence of hearing impairment in primary school children in Port Harcourt was found to be 29.4%. This was significantly higher among the older children and in females. Hearing impairment was more prevalent in children in public than private schools. Conductive hearing loss (CHL) was the commonest type of hearing impairment seen. Moreover, hearing impairment was significantly associated with poor school performance.

Open Access Original Research Article

Antenatal Care Attendance, Intermittent Preventive Treatment and Occurrence of Malaria Parasite Infection at Parturition in Abeokuta, Nigeria

A. S. Babalola, O. A. Idowu, S. O. Sam-Wobo, E. Fabusoro

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/IJTDH/2017/19207

The detrimental effect of malaria during and/or after pregnancy cannot be over emphasized, and lot of efforts had been put in place in order to reduce its scourge. Antenatal Care (ANC) is a major tool in improving maternal and foetal health. This study aims at evaluating the efficacy of ANC visit(s) against malaria infection at parturition with respect to ANC clinic attendance and Intermittent Preventive Treatment (IPT) uptake among parturients who seek delivery services in two secondary health facilities in Abeokuta. Blood samples from maternal and placenta were collected from 211 parturients. Blood films were prepared, stained with 10% giemsa staining technique and observed for malaria parasites under the microscope. Relevant maternal demographic characteristics were obtained from the parturients and Chi-square tests were conducted to measure relationships using SPSS version 16.0. Generally, a high turnout of ANC attendance (97.2%) was recorded among the parturients seeking delivery in Abeokuta Nigeria. However, about 60% of the respondent’s made above 3 ANC visits. Maternal age was a significant factor (p<0.05) affecting booking timing (early or late) and number of ANC visits made by the parturients. Furthermore, Late attendance as well as attending <4 ANC clinics are associated (p<0.05) with incomplete doses of IPT which in turn increases susceptibility to Pregnancy associated malaria in Abeokuta Ogun State. None usage of IPT, late ANC booking and receiving first dose of IPT towards the end or after second trimester are significant factors (p<0.05) associated with Pregnancy associated malaria. The full benefit of attached with ANC services could not be utilized as a result of late and inconsistent attendance practiced by the parturients during pregnancy and this could result in poor outcomes.

Open Access Original Research Article

Prognostic Value of Serum Estrogen, Cortisol, Calcium and Alkaline Phosphatase Activity in Pre and Postmenopausal HIV Women at Nnewi, Nigeria

R. Ukibe Nkiruka, N. Ukibe Solomon, C. Onyenekwe Charles, E. Ahaneku Joseph, N. Monago Ifeoma

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2017/27212

Background: Incidence of HIV infection is increasing fastest in women, and older age and some hormonal-deficient status may place them at higher risk for bone loss and fracture. The etiology of bone mineral loss in human immunodeficiency virus (HIV) infected patients is likely multifactorial, involving traditional risk factors such as low body weight, hypogonadism, as well as direct effects of chronic HIV infection and antiretroviral therapy.

Aims of Study: This study was designed to assess the prognostic value of Serum estrogen, cortisol, FSH, PTH, 25) OH Vit D, calcium and alkaline Phosphatase activity in pre and postmenopausal HIV infected women at NAUTH Nnewi, Nigeria.

Material and Methods: This was a cross-sectional study carried out from 2013 to 2014. A total of 80 female participants within the age bracket of 19-45(premenopausal) and 46-80 years (postmenopausal) were randomly recruited for the study. They were grouped into: (i) HIV-infected postmenopausal females (n=20). (ii) HIV- infected premenopausal females (n=20). (iii) Control postmenopausal females (n=20). (iv) Control premenopausal females (n=20). Blood samples were collected for determination of estrogen, FSH, PTH, 25OH Vitamin D and cortisol using Enzyme linked Immunosorbent Assay (ELISA) techniques. Serum levels of calcium and alkaline phosphatase activity were analyzed using spectrophotometric methods and CD4+ T-cell count using cyflow counter.

Results: The result showed that the mean serum alkaline phosphatase and cortisol levels were significantly higher while PTH and CD4+T-cell count were significantly lower in premenopausal HIV females when compared with the corresponding values in premenopausal control females (P=.05). The mean serum calcium, PTH, 25OH Vit D and CD4+ T- cell count were significantly lower while cortisol was significantly higher in postmenopausal HIV infected females compared to postmenopausal Control counterparts (P=.05). Serum estrogen and 25OH Vit D levels and CD4+ T-cell count were significantly higher while the mean serum calcium, FSH and PTH were significantly lower in premenopausal HIV when compared with postmenopausal HIV infected females (P=.05).

Conclusions: The present study shows alterations in both hormonal and biochemical indices of bone minerals in HIV infected women. This demonstrates significant derangement in bone health of pre and post-menopausal HIV-infected female subjects thereby increasing the risk of pathological bone fractures and can result in possible development of osteoporosis as the HIV infection progresses in these women. The clinical implication is discussed.

Open Access Original Research Article

Risk Factors of Otitis Media with Effusion among Preschool Children in Port Harcourt, Nigeria

Chibuike Nwosu, O. B. da Lilly-Tariah, Lucky Obukowho Onotai

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2017/31363

Background: Otitis media with effusion (OME) is the commonest cause of hearing loss in children worldwide. It has a lot of host related and environmental factors that influence it’s development. These factors had remained controversial from previous studies done, thus necessitating this research. The aim of this study was to determine the risk factors associated with OME among children within the age of one to six years.                                                                          

Methodology: This was a cross sectional study involving 226 preschool pupils selected by multi-staged sampling technique from ten (10) day-care and nursery schools from Port Harcourt metropolis, carried out between November 2014 and June 2015. Tympanometry was done on each participant and questionnaire was used to assess the risk factors associated with OME. Data was collected and analyzed using SPSS version-20.

Results: Among the 226 pupils, OME was diagnosed in 57 (25.2%) of the pupils. The pupils with upper respiratory tract infection (URTI), nasal allergy, upper respiratory obstruction and those who were in the prenursery age group showed significant association with OME.  However, on further analysis with logistic regression, only URTI and being in the prenursery age group were found to be significant predictors of OME.

Conclusion: This study had shown that URTI, nasal allergy, upper respiratory obstruction and the prenursery age group are important risk factors of OME, with URTI and the prenursery age group being predicting factors of the disease.