Chronic myeloid leukemia (CML) is one of the myeloproliferative disorders accounting for 15–20% o... more Chronic myeloid leukemia (CML) is one of the myeloproliferative disorders accounting for 15–20% of adult leukemia. Priapism is a rare initial presentation of CML occurring in 1–2% of cases. It is a urologic emergency requiring urgent multidisciplinary management as delay in initiating treatment may lead to erectile dysfunction. Combined treatment modalities are usually employed in its management including surgery, chemotherapy, therapeutic leukapheresis, and local intracavernous therapy. We report an 18-year-old male who presented with a 12-day history of priapism. Further evaluation with peripheral blood film revealed CML in chronic phase with ischemic prolonged priapism. At presentation patient refused consent for surgical intervention and subsequently had cytoreductive therapy with oral hydroxyurea. He achieved complete detumescence after 4 weeks of cytoreduction and by the 5th month during follow-up, he developed erectile dysfunction.
Both Ventricular Septal Defect (VSD) and Acute Lymphoblastic Leukaemia (ALL) are relatively commo... more Both Ventricular Septal Defect (VSD) and Acute Lymphoblastic Leukaemia (ALL) are relatively common in childhood. While the former is congenital, the latter is usually acquired. Diagnosis and thorough profiling of patient with ALL remains a great challenge in most resource poor settings including our hospital. Despite the high prevalence of these conditions in our environment, there is no previously reported case of the two coexisting in an individual based on our literature search. We report a ten-year old boy in whom ALL unmasked the diagnosis of VSD and non-availability of diagnostic facilities prevented exploring any possible pathogenetic relationship between the two conditions in case of its existence.
BACKGROUND Safe, timely red blood cell transfusion saves lives and chronic transfusion therapy (C... more BACKGROUND Safe, timely red blood cell transfusion saves lives and chronic transfusion therapy (CTT) prevents or limits morbidities such as stroke, therefore improving quality of life of patients with sickle cell disease (SCD). METHODS This questionnaire-based study assessed the ability of sickle cell centers in Nigeria to provide safe blood to patients with SCD between March and August 2014. RESULTS Out of the 73 hospitals contacted, responses were obtained from 31. Twenty four (78%) hospitals were unable to transfuse patients regularly due to blood scarcity. Packed red blood cells were available in 14 (45%), while only one provided leukocyte-depletion. Most centers assessed donor risk and screened for HIV in 30 (97%), hepatitis B in 31(100%) and hepatitis C in 27 (87%) hospitals. Extended phenotyping and alloantibody screening were not available in any center. A quarter of the hospitals could monitor iron overload, but only using serum ferritin. Access to iron chelators was limited and expensive. Seventeen (55%) tertiary hospitals offered CTT by top-up or manual exchange transfusion; previous stroke was the most common indication. CONCLUSION Current efforts of Nigerian public hospitals to provide safe blood and CTT fall short of best practice. Provision of apheresis machines, improvement of voluntary non-remunerated donor drive, screening for red cell antigens and antibodies, and availability of iron chelators would significantly improve SCD care in Nigeria.
Antipsychotic medications have been used primarily to manage psychosis, schizophrenia and affecti... more Antipsychotic medications have been used primarily to manage psychosis, schizophrenia and affective disorders.. In a cross sectional retrospective study the prescribing pattern of antipsychotic drugs was studied using 625 prescriptions from case notes of patients seen in the in-patient unit of the Federal Neuropsychiatric Hospital Kware, from January-December 2009.Data was collected on a prescribing indicator form and analyzed using descriptive statistics .A mean age of 31.4 was recorded, and 70.1% of the patients are males. A total of 2566 drugs were prescribed with an average of 4.1 drugs per prescription. Typical antipsychotics, antidepressants, anticonvulsants, anticholinergics and sedative hypnotics accounted for 41.8%, 4.3%, 2.8%, 25.6%, and 15.8% of the total prescriptions respectively. Substance abuse was ranked as the second highest disorder (16.4%).Percentage antibiotic per prescription was 0.94% and number of medicines per prescription was 4.1.Poly pharmacy was employed i...
Background: Hepatitis B virus is known to be endemic in Africa. The seroepidemiological studies o... more Background: Hepatitis B virus is known to be endemic in Africa. The seroepidemiological studies of HBV have shown that infection commonly occurs in childhood in Africa resulting in an increased tendency to chronicity. This cross-sectional study was undertaken to determine the seroprevalence of hepatitis B surface antigen among pediatric patients with homozygous hemoglobin S. Materials and Methods: Three hundred sickle cell anemia children aged 6 months-15 years (both in steady state and in crises) attending the SCA clinic and on admission in emergency pediatrics unit and pediatrics medical ward, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, were screened for hepatitis B infection using HBsAg as marker of infection. The sensitive enzyme linked immunosorbent assay method was used for detection of the marker. Three hundred children with minor illness attending pediatrics outpatient department and on admission in EPU/PMW for various treatment in the same hospital served as gender- and age-marched controls cohorts. Results: The sero-prevalence of HBsAg seropositivity for hepatitis B virus infection among SCA children was 17.3% (52/300) compared to 10.7% (32/300) of the control ( P = 0.0875). The peak prevalence age group for HBV infection among SCA children was in the age group 1.1-5.0 years (6%) compared to 10.1-15.0 years (4.7%) in the control. Risk factors for HBV infection such as blood transfusion, traditional scarification/circumcision/uvulectomy, and tattooing did not significantly affect the prevalence of HBV infection in both SCA children and controls. Conclusion: Hepatitis B infection is common in Sokoto. The need for strict adherence to HBV immunization and further community-based studies on the risk factors are recommended.
Chronic myeloid leukemia (CML) is one of the myeloproliferative disorders accounting for 15–20% o... more Chronic myeloid leukemia (CML) is one of the myeloproliferative disorders accounting for 15–20% of adult leukemia. Priapism is a rare initial presentation of CML occurring in 1–2% of cases. It is a urologic emergency requiring urgent multidisciplinary management as delay in initiating treatment may lead to erectile dysfunction. Combined treatment modalities are usually employed in its management including surgery, chemotherapy, therapeutic leukapheresis, and local intracavernous therapy. We report an 18-year-old male who presented with a 12-day history of priapism. Further evaluation with peripheral blood film revealed CML in chronic phase with ischemic prolonged priapism. At presentation patient refused consent for surgical intervention and subsequently had cytoreductive therapy with oral hydroxyurea. He achieved complete detumescence after 4 weeks of cytoreduction and by the 5th month during follow-up, he developed erectile dysfunction.
Both Ventricular Septal Defect (VSD) and Acute Lymphoblastic Leukaemia (ALL) are relatively commo... more Both Ventricular Septal Defect (VSD) and Acute Lymphoblastic Leukaemia (ALL) are relatively common in childhood. While the former is congenital, the latter is usually acquired. Diagnosis and thorough profiling of patient with ALL remains a great challenge in most resource poor settings including our hospital. Despite the high prevalence of these conditions in our environment, there is no previously reported case of the two coexisting in an individual based on our literature search. We report a ten-year old boy in whom ALL unmasked the diagnosis of VSD and non-availability of diagnostic facilities prevented exploring any possible pathogenetic relationship between the two conditions in case of its existence.
BACKGROUND Safe, timely red blood cell transfusion saves lives and chronic transfusion therapy (C... more BACKGROUND Safe, timely red blood cell transfusion saves lives and chronic transfusion therapy (CTT) prevents or limits morbidities such as stroke, therefore improving quality of life of patients with sickle cell disease (SCD). METHODS This questionnaire-based study assessed the ability of sickle cell centers in Nigeria to provide safe blood to patients with SCD between March and August 2014. RESULTS Out of the 73 hospitals contacted, responses were obtained from 31. Twenty four (78%) hospitals were unable to transfuse patients regularly due to blood scarcity. Packed red blood cells were available in 14 (45%), while only one provided leukocyte-depletion. Most centers assessed donor risk and screened for HIV in 30 (97%), hepatitis B in 31(100%) and hepatitis C in 27 (87%) hospitals. Extended phenotyping and alloantibody screening were not available in any center. A quarter of the hospitals could monitor iron overload, but only using serum ferritin. Access to iron chelators was limited and expensive. Seventeen (55%) tertiary hospitals offered CTT by top-up or manual exchange transfusion; previous stroke was the most common indication. CONCLUSION Current efforts of Nigerian public hospitals to provide safe blood and CTT fall short of best practice. Provision of apheresis machines, improvement of voluntary non-remunerated donor drive, screening for red cell antigens and antibodies, and availability of iron chelators would significantly improve SCD care in Nigeria.
Antipsychotic medications have been used primarily to manage psychosis, schizophrenia and affecti... more Antipsychotic medications have been used primarily to manage psychosis, schizophrenia and affective disorders.. In a cross sectional retrospective study the prescribing pattern of antipsychotic drugs was studied using 625 prescriptions from case notes of patients seen in the in-patient unit of the Federal Neuropsychiatric Hospital Kware, from January-December 2009.Data was collected on a prescribing indicator form and analyzed using descriptive statistics .A mean age of 31.4 was recorded, and 70.1% of the patients are males. A total of 2566 drugs were prescribed with an average of 4.1 drugs per prescription. Typical antipsychotics, antidepressants, anticonvulsants, anticholinergics and sedative hypnotics accounted for 41.8%, 4.3%, 2.8%, 25.6%, and 15.8% of the total prescriptions respectively. Substance abuse was ranked as the second highest disorder (16.4%).Percentage antibiotic per prescription was 0.94% and number of medicines per prescription was 4.1.Poly pharmacy was employed i...
Background: Hepatitis B virus is known to be endemic in Africa. The seroepidemiological studies o... more Background: Hepatitis B virus is known to be endemic in Africa. The seroepidemiological studies of HBV have shown that infection commonly occurs in childhood in Africa resulting in an increased tendency to chronicity. This cross-sectional study was undertaken to determine the seroprevalence of hepatitis B surface antigen among pediatric patients with homozygous hemoglobin S. Materials and Methods: Three hundred sickle cell anemia children aged 6 months-15 years (both in steady state and in crises) attending the SCA clinic and on admission in emergency pediatrics unit and pediatrics medical ward, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, were screened for hepatitis B infection using HBsAg as marker of infection. The sensitive enzyme linked immunosorbent assay method was used for detection of the marker. Three hundred children with minor illness attending pediatrics outpatient department and on admission in EPU/PMW for various treatment in the same hospital served as gender- and age-marched controls cohorts. Results: The sero-prevalence of HBsAg seropositivity for hepatitis B virus infection among SCA children was 17.3% (52/300) compared to 10.7% (32/300) of the control ( P = 0.0875). The peak prevalence age group for HBV infection among SCA children was in the age group 1.1-5.0 years (6%) compared to 10.1-15.0 years (4.7%) in the control. Risk factors for HBV infection such as blood transfusion, traditional scarification/circumcision/uvulectomy, and tattooing did not significantly affect the prevalence of HBV infection in both SCA children and controls. Conclusion: Hepatitis B infection is common in Sokoto. The need for strict adherence to HBV immunization and further community-based studies on the risk factors are recommended.
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