Pyramid Journal of Medicine 2020-01-28T15:08:40+00:00 Emanuela Fusinato Open Journal Systems <p>The <strong>Pyramid Journal of Medicine</strong> (PJM) is an online Open Access, peer-reviewed scholarly journal in the broad field of clinical and bio-medical sciences.</p> <p>The journal aims to publish in all areas of clinical practice including, but not limited to, Internal Medicine, Pediatrics, Obstetrics and Gynecology, Surgery and their sub-specialties. Also included are issues related to public health, health economics, medical geography, medical sociology, health policy, global health, bio-medical engineering, translational medicine and topics of general interest to biomedical sciences. The journal will accept manuscripts in form of <em>Original Articles</em>, <em>Case Reports</em>, <em>Case Series</em>, <em>Mini Reviews</em>, <em>Reviews</em>, <em>Short Communications</em>, <em>Perspectives Systematic Reviews</em>, <em>Meta-Analysis</em>, <em>Book Reviews</em> and <em>Letter to the Editor</em> in all aspects of clinical sciences and bio-medical sciences.</p> Knowledge of obstetric danger signs among pregnant women attending antenatal clinic in Murtala Muhammad Specialist Hospital, Kano, Nigeria 2020-01-28T15:08:40+00:00 Ayyuba Rabiu Habiba Isah Ladu <p>Knowledge of obstetric danger sign promotes active preparation and decision making for delivery by pregnant women and their families. It assists in decision making for seeking health care in case of complications. This study was aimed at determining the knowledge of obstetric danger signs among pregnant women attending antenatal clinic in Murtala Muhammad specialist hospital Kano. It was a cross sectional survey among 394 pregnant women attending antenatal clinic. Information on knowledge of obstetric danger signs were recorded on a questionnaire. The data were analyzed using SPSS version 19 Computer Software (IBM SPSS Statistics Inc., IL, Chicago USA). Quantitative variables were summarized using measures of central tendency and measures of variability. Qualitative variables were summarized using frequencies and percentages. A P value of ≤0.05 was considered statistically significant. The mean age ±SD was 26.9±6.21 years. The mean gestational age at booking was 29.7±7.22 weeks. Two hundred and eightysix (77.1%) Pregnant women were aware that unforeseen problems related to pregnancy can occur during any pregnancy that can endanger the life of the woman. These problems include bleeding 176 (61.6%) and convulsion 96 (33.6%). Should any of those problems occur, a woman should preferably visit government hospital 366 (92.9%). Concerning danger signs of pregnancy, the respondents mentioned that a health worker advised them at least once, about danger signs of serious health problems during pregnancy, child birth or soon after 228 (63.3%). The study findings generally revealed that there was awareness of obstetrics danger signs. Vaginal bleeding was the commonest obstetric danger sign known. Knowledge of obstetric danger signs was statistically associated with parity and age group.</p> 2019-07-01T13:44:24+00:00 ##submission.copyrightStatement## Sero-prevalence and risk factors of HIV/AIDS among long distance commercial drivers in Kano State, Nigeria 2020-01-28T15:08:38+00:00 Usman Sunusi Usman Yusuf Abdu Misau Abubakar Muhammad Kurfi Umar Lawal Bello Ibrahim Adam Abdullahi <p>Migration and mobility have contributed significantly in the spread of Human- Immunodeficiency Virus (HIV) globally: more especially among transport corridors. Identifying risk factors of HIV among long distance drivers (LDDs) could provide strategies for more effective preventive intervention. This was a cross-sectional descriptive study design that used multistage sampling technique to select four hundred and thirty-four study participants. An interviewer-administered questionnaire was used to collect information and blood for HIV testing. The mean and standard deviation of age of the respondents were 42.3±11.2 years. The sero-prevalence of HIV was 12.5% (95%CI: 8.8-16.3%). On adjusting for confounding effect using logistic regression analysis, the risk factors for HIV were marital status of single [AOR=4.25; (95%CI: 1.97- 9.31)] and separated [AOR=6.07; (95%CI: 5.26-16.45)], monthly income [&gt;100,000.00 AOR=6.11; (95%CI: 1.53-41.97)] and history of extramarital sex [AOR=4.01; (95% CI: 6.07- 10.43)]. Establishment of clinic for treatment of sexually transmitted diseases in a strategic location, scaling up of condom distribution, and effective behavioural change communication were recommended in order to reduce the risk of acquiring HIV infection.</p> 2019-07-04T08:07:26+00:00 ##submission.copyrightStatement## Sinonasal diseases in Nigerian primary school children 2020-01-28T15:08:35+00:00 Waheed Atilade Adegbiji Abdul Akeem Adebayo Aluko <p>This study aimed at determining the prevalence, pattern, sociodemographic features and effect on the quality of life of sinonasal diseases among the primary school children. This community-based descriptive cross-sectional study of school children with sinonasal diseases was carried out between October 2017 and March 2018 in Ibadan-Nigeria, using multistage sampling technique. Data was taken using a pretested, interviewers assisted questionnaire and statistically analyzed using SPSS IBM version 23.0. The prevalence of sinonasal diseases was 21.7% (n=964). Age range was 5-13 years; the mean age was 8.5±2.7. There were 52.6% males and male to female ratio was 1:1. Common sinonasal diseases were allergic rhinitis (37.8%), chronic rhinosinusitis (19.6%), nasal trauma (15.3%), acute rhinosinusitis (11.0%) and foreign body impaction (5.74%). Bilateral sinonasal diseases occurred in 82.3%. Right and left sinonasal diseases accounted for 10.0% and 7.7% respectively. Major presenting complaints were rhinorrhea (73.2%), excessive sneezing (36.4%), nasal blockage/stuffiness (32.5%) and itching (29.7%).Associated complications of sinonasal diseases were mainly orbital complications in 30.1%, pharyngitis in 12.9%, pneumonia in 8.6% and otitis media in 6.7%. Commonly affected qualities of life were fatigue (16.3%), sleep disturbance (12.4%), changes in mood (10.5%) and isolation (8.6%). The prevalence of sinonasal diseases in primary school children was 21.7%. At presentation the majority of the pupils had associated complications and affectation of the quality of life.</p> 2019-07-04T16:20:54+00:00 ##submission.copyrightStatement## Idiopathic orbital inflammation: An unusual presentation of benign essential blepharospasm 2020-01-28T15:08:39+00:00 Aliyu Ibrahim Musbahu Sani Kurawa Shuaibu Abdulsalam Yusuf Lawal <p>A case of a 48-year-old man with recurrent twitching of the right eye associated with the drooping of the upper eyelid, ipsilateral periorbital headache and blurring of vision aggravated by direct exposure to strong sunlight. Eye examination revealed intermittent twitching of the right upper eyelid, mild restriction of range of motion (downward gaze) and difficulty reading small prints (presbyopia). Computed tomographic scan showed thickened right superior rectus muscle and tendons. Based on the clinical and neuroimaging abnormalities a diagnosis of right orbital myositic inflammation was made. Patient was given high dose oral corticosteroids and remarkable improvement in his symptoms was recorded after 6 weeks of treatment.</p> 2019-07-01T13:55:15+00:00 ##submission.copyrightStatement## Delayed presentation of congenital diaphragmatic hernia masquerading as pulmonary tuberculosis in a 4-year-old girl 2020-01-28T15:08:38+00:00 Abdullahi Salisu Shaaibu Aliyu Mohammed El-Habeeb Idris Mohammed Mustapha Abdulsalam Usman Danjaji <p>Diaphragmatic hernias are defined as congenital or acquired defect in the diaphragm. It is said to be the most common intra-thoracic fetal anomaly with an incidence of 1 in 2200 to 3000 live births and male to female ratio of 2:1.The unusual and misleading presentation of this condition which would cause an unnecessary delay in diagnosis and all the attendant consequences (such as intestinal obstruction) is hereby presented. The role of plain chest Xray which is cheap and readily available in salvaging the confusing clinical scenario has been emphasized. Late presenting CDH should be factored in the differential diagnosis of any child with chronic cough. Delay in diagnosis increases chances of complication such as chronic lung diseases and gastro-esophageal reflux, later in adulthood.</p> 2019-07-02T08:40:56+00:00 ##submission.copyrightStatement## Ischemic colitis in a known sickle cell disease patient 2020-01-28T15:08:37+00:00 Abdu Hamisu Dambatta <p>Patients affected with sickle cell disease (SCD) suffer from recurrent vascular occlusions that lead to ischemia and distal tissue infarction in multiple organs. These vascular occlusions manifest as sickle cell pain crises. Abdominal pain is common in sickle cell pain crises. It is attributed to vasoocclusion or infarction in the mesenteric vasculature. Progression to significant ischemic damage of the intestine is rare in sickle cell disease. The objective was to show the rare case of ischemic colitis in SCD patient. The patient’s images (plain abdominal x rays and barium enema images) and case file were reviewed and summarized. The subject matter of ischemic colitis in a known SCD was reviewed in the literature. The index case was discussed and compared with literature. We report an 18-year-old known SCD patient diagnosed since childhood but not regular on medication and follow up. The patient presented to SCD clinic of Aminu Kano Teaching Hospital (AKTH), Kano with 2-year history of recurrent blood stained and watery stool associated with abdominal pain and low-grade fever. There was history of easy fatigability and multiple blood transfusions in the past. Other systemic reviews were unremarkable. This man is the only sickle cell anemic child among 9 other siblings of the family, and on presentation, a second-year student of a junior secondary school. Examination revealed a stunted young man, mild pale with a tinge of jaundice. Abdominal examination revealed hepatomegaly 4 cm below the costal margin. The spleen was not enlarged. Other systemic reviews were unremarkable. Latest hemoglobin was 5.7 g/dL. Renal and the liver function tests were normal. Stool microscopy did not isolate ova, cyst or protozoa. Barium enema was then requested and showed loss of haustration and cobblestone appearance involving the entire colon. Fine mucosal granulations were also noted in the rectum. Diagnosis of colitis most probably ischemic was made. The patient was commenced on analgesics and antibiotics including azithromycin and metronidazole and made significant improvement. Ischemic colitis in SCD may still be encountered in practice despite its rarity.</p> 2019-07-04T08:24:23+00:00 ##submission.copyrightStatement## Symptomatic giant cavernous hemangioma of the liver in a 42-year-old man 2020-01-28T15:08:36+00:00 Abdu Hamisu Dambatta <p>Most cases of liver hemangioma are asymptomatic and discovered incidentally on liver ultrasound or computed tomography scan. Giant cavernous hemangioma (GCH) are however clinically distinct from smaller asymptomatic ones and may be confused with primary or metastatic malignancy. Symptomatic GCH of the liver are rare. The aim of the study was to show the rare case of symptomatic giant cavernous hemangioma of the liver which may be confuse with primary or metastatic malignancy. The patient’s images (abdominal ultrasound and computed tomography scans) and case file were reviewed and summarized. The subject matter of giant cavernous hemangioma was reviewed in the literature. The index case was discussed and compared with literature. We report a 42-year-old man who presented with a 2-year history of right upper abdominal pain and 6-month history of chest pain. No history of jaundice, body swelling or previous history of blood transfusion. No history of smoking or alcohol consumption. The patient is a known diabetic. Abdominal ultrasound scan showed hepatomegaly with a huge well defined oval shaped mixed echogenic mass lesion with lobulated margins occupying 4th and 5th segments of liver, measuring 84.9×111 mm in size suggestive of adenoma. The remaining hepatic parenchyma was normal. No intrahepatic biliary dilatation was seen. Initial histological examination revealed adenoma. Repeat histology done later however revealed hepatitis. Abdominal CT scan was later carried out and showed hepatomegaly but with no discernible mass lesion on precontrast images. Contrast enhanced images however, showed a fairly rounded mass lesion with peripheral enhancement and delayed filling-in at the venous phase, seen in the superior aspect of the right lobe extending to the dome. The intrahepatic vasculature and biliary ducts are not dilated. A diagnosis of cavernous hemangioma was made based on criteria of delayed (centripetal) filling-in. The patient however was lost to follow up. Hepatic hemangioma can be giant and symptomatic and despite its rarity, may still be encountered in practice.</p> 2019-07-04T08:41:04+00:00 ##submission.copyrightStatement## Extramedullary plasmacytoma of the nasopharynx: A case report and review of literature 2020-01-28T15:08:35+00:00 Abdul Akeem Adebayo Aluko Ghazali Hasheem Adamu Auwal <p>Plasmocytoma is a monoclonal neoplasm derived from progenitor B lymphocyte lineage. It rarely occurs as solitary plasmacytoma in 5-10% of all plasma cell tumors. Extramedullary plasmacytoma is even rarer, accounting for 3% of solitary plasmacytoma. Extramedullary plasmacytoma of the nasopharynx was found to be the cause of emergency presentation with upper airway obstruction and dysphagia in a 50 years old man. The patient had an emergency tracheostomy and feeding gastrostomy. Tumor biopsy and histology confirmed plasmacytoma. He was treated with chemoradiation without prior surgical excision and he had satisfactory improvement. This report highlights that a high index of suspicion is needed for early diagnosis and prompt treatment.</p> 2019-07-04T16:28:49+00:00 ##submission.copyrightStatement##