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Article ; Online: The use of unripe pawpaw for wound bed preparation following radiation-induced sacral ulcer

Ezekiel Uchechukwu Nwankwo / Charles Chidiebele Maduba / Victor Ifeanyichukwu Modekwe / Ugochukwu Uzodimma Nnadozie

Nigerian Journal of Medicine, Vol 30, Iss 3, Pp 339-

A case report and review of literature

2021 Volume 341

Abstract: Radiation wounds are very difficult to manage due to poor vascular status, excessive matrix metalloproteinases, and abnormal myofibroblast function. Such wound beds do not adequately support conventional resurfacing as do nonradiate beds. We present a 46- ...

Abstract	Radiation wounds are very difficult to manage due to poor vascular status, excessive matrix metalloproteinases, and abnormal myofibroblast function. Such wound beds do not adequately support conventional resurfacing as do nonradiate beds. We present a 46-year-old female with a sacral radiation ulcer, which had earlier failed to support flap cover on two instances after bed preparation with conventional honey dressing and negative pressure dressing, but was subsequently successfully managed with unripe pawpaw wound bed preparation. A re-elevation of the right gluteal myocutaneous flap proved successful and satisfactory. The finding may have resulted from both enzymatic properties of unripe pawpaw and its ability to break the biofilms and to locally supply the ascorbic acid necessary for collagen synthesis and granulation tissue formation.
Keywords	case report ; radiation wounds ; unripe pawpaw ; wound bed preparation ; Medicine ; R
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Comparing hospital stay and patient satisfaction in a resource poor setting using conventional and locally adapted negative pressure wound dressing methods in management of leg ulcers with split skin grafts

Charles Chidiebele Maduba / Ugochukwu Uzodimma Nnadozie / Victor Ifeanyichukwu Modekwe / Ezekiel Uchechukwu Nwankwo

The Pan African Medical Journal, Vol 36, Iss

a comparative prospective study

2020 Volume 105

Abstract: INTRODUCTION: Chronic leg ulcers cause a prolonged hospital stay with devastating effects on the patients. Several modifiable factors are taken care of to reduce the duration of stay. A further measure to hasten wound bed preparation pre-grafting and to ... ...

Abstract	INTRODUCTION: Chronic leg ulcers cause a prolonged hospital stay with devastating effects on the patients. Several modifiable factors are taken care of to reduce the duration of stay. A further measure to hasten wound bed preparation pre-grafting and to hasten graft healing post-grafting is with negative pressure dressing. METHODS: sixty-two patients placed in two groups of 31 cases each. The wound beds were prepared with negative pressure apparatus locally adapted with suction machine for group A and with conventional gauze dressing using 5% povidone iodine soaks for group B. Grafted wound was also dressed similarly for the respective groups. Grafts were inspected on the 5th post-operative day and were determined with planimeter grid. Grafts were monitored until completely healed and patients were discharged. Satisfaction and length of stay were determined at discharge. RESULTS: the mean hospital stay pre-grafting and post-grafting were 12.2 (Â±8.64) days and 13.6 (Â±2.03) days respectively for the negative pressure dressing and 28.8 (Â±30.9) days and 21.8 (Â±21.97) days respectively for the traditional dressing group. These differences with p values of 0.038 for the pre-grafting stay and 0.006 for the post-grafting stay were statistically significant. The patients managed with negative pressure dressing also recorded greater satisfaction with the process and the outcome. CONCLUSION: negative pressure dressing contributes significantly to reducing the length of hospital stay in chronic leg ulcer both in wound bed preparation and in graft healing resulting to better patient satisfaction than in patients treated with conventional gauze dressing and 5% povidone iodine soaks.
Keywords	conventional gauze dressing ; length of stay ; negative pressure dressing ; patient satisfaction ; Medicine ; R
Subject code	360
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	The Pan African Medical Journal
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Analysis of machete cut fractures in Nigerian civilian trauma setting

Njoku Isaac Omoke / Omolade Ayoola Lasebikan / Francis Ndubuisi Ahaotu / Ugochukwu Uzodimma Nnadozie / Gregory Chinedu Nwigwe

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 8

Abstract: Abstract Machete cut fracture is an important component of morbidity associated with machete injuries although it is under reported. This was a retrospective study to assess machete cut fractures in patients seen in Federal Teaching Hospital Abakaliki ... ...

Abstract	Abstract Machete cut fracture is an important component of morbidity associated with machete injuries although it is under reported. This was a retrospective study to assess machete cut fractures in patients seen in Federal Teaching Hospital Abakaliki and National Orthopaedic Hospital Enugu from 2009 to 2018. There were 91 patients with 154 fractures, male- to- female ratio was 10:1 and mean age was 31.6 ± 14.6 years. The aetiological factors were assault (57, 62.6%), armed robbery (29, 31.9%) and accidental injury (5, 5.5%). The three top bones involved were ulna, metacarpal and finger-phalanx. Fracture was communited in (17, 11.0%), and Gustilo Anderson grade IIIC in (22, 14.3%). Injury to hospital arrival interval later than 6 h was common and correlated with prolonged length of hospital stay (p < 0.001). Anaemia, wound infection and hemorrhagic shock were the three top complications. Nine (5.8%) fractures ended in extremity amputation. Eleven (12.1%) patients left against medical advice, and 5 (5.5%) were transferred. Normal union in 98.3% of the fractures treated and followed up for a minimum of one year. Case fatality rate was 2.2%; none of the patient that died had pre hospital care, and hemorrhagic shock accounted for all the mortality. These call for appropriate injury preventive mechanisms, and improved rates of early presentation of patients to hospital, and pre hospital care.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Pattern of benign breast diseases in Abakaliki, South Eastern Nigeria, A 5 year retrospective study

Felix O Edegbe / Joseph Chukwuma Uzoigwe / Chinedu O Ndukwe / Anayo A Nwachukwu / Ngozi Immaculata Ugwu / Oluomachi C Nnachi / Uchechukwu N Agada / Ugochukwu Uzodimma Nnadozie

Nigerian Journal of Medicine, Vol 31, Iss 5, Pp 540-

2022 Volume 543

Abstract: Background: There is a rise in the trend of benign breast diseases (BBDs) currently; this is made possible through public awareness of the disease. Aim: To determine the pattern of BBDs in a 5-year retrospective study was the aim of this study. Materials ...

Abstract	Background: There is a rise in the trend of benign breast diseases (BBDs) currently; this is made possible through public awareness of the disease. Aim: To determine the pattern of BBDs in a 5-year retrospective study was the aim of this study. Materials and Methods: A 5-year retrospective study and all histopathologically proven BBDs from January 2015 to December 2020 were reviewed. Software, version 21 of the statistical package for the social sciences (SPSS) was used for data analysis. Results: Cases of BBDs diagnosed within the study period were 143 and were made up of 5 (3.5%) males and 138 (96.5%) females, with a ratio of 1: 28. Among the females, the most commonly affected age group was 21–30 years contributing 57.8% (80/138), followed by ≤20 years contributing 36.2% (50/138). Among males ≤20 years of age group are mostly affected and contributing 60% (3/5). Fibroadenoma accounted for 62.9% (90/143), followed by fibrocystic disease (FCD) contributing 16.8% (24/143). The less common breast diseases in this study were fat necrosis, lipoma, granulomatous mastitis, periductal mastitis, and cysticercosis accounting for 0.7% each. Conclusion: Fibroadenoma remains the most common BBD although higher than in the earlier study, followed by FCD in our centre. Females constituted most of the affected individuals (21–30 years). The practice of breast self-examination should be encouraged to detect and treat lumps which may be malignant early enough to reduce morbidity and mortality.
Keywords	benign breast disease ; fibroadenoma ; fibrocystic disease ; nigeria ; Medicine ; R
Subject code	590
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Correlates of patients´ satisfaction with antenatal care services in a tertiary hospital in Abakaliki, Ebonyi state, Nigeria

Chidebe Christian Anikwe / Chinedu Chukwuemeka Ifemelumma / Kenneth Chinedu Ekwedigwe / Cyril Chijioke Ikeoha / Ogah Emeka Onwe / Ugochukwu Uzodimma Nnadozie

The Pan African Medical Journal, Vol 37, Iss

2020 Volume 342

Abstract: INTRODUCTION: Antenatal care is a specialized pattern of care organized for pregnant women to improve their chances of a safe delivery. Assessment of patients´ perception of healthcare services is one of the ways of measuring the quality of healthcare as ...

Abstract	INTRODUCTION: Antenatal care is a specialized pattern of care organized for pregnant women to improve their chances of a safe delivery. Assessment of patients´ perception of healthcare services is one of the ways of measuring the quality of healthcare as satisfied patients are likely to come back for the services they need and to recommend the services to others. METHODS: this is a cross-sectional study. Two hundred and eighty-four booked antenatal attendees were randomly selected at the antenatal clinic of Federal Teaching Hospital, Abakaliki in November 2016 and interviewed using semi-structured questionnaire. Items in the questionnaire included sociodemographic and obstetric variables, assessment of amenities, total time spent, services and level of satisfaction. Data obtained were analyzed using Epi info TM 7.1.3.10 and presented with a simple percentage and chi-square. Main outcome measure: satisfaction with antenatal care. RESULTS: the mean age of the respondents was 28.2 ± 4.2 years, majority 130 (45.8%) were within the 25-29 age bracket. Most had tertiary education (146, 51.4%) and less than 10% are grand multipara. In general, 89.4% of the respondents were satisfied with the quality of antenatal care services. Majority of the respondents 170 (59.9%) were unsatisfied with the water supply while 128 (45.1%) were unsatisfied with cervical cancer prevention discussion during the health talk. The mean total time spent in the antenatal clinic was 4.1 hours ± 1.2 hours (range 2-7 hours). Being married and multiparous significantly affected satisfaction with the quality of antenatal care services as represented by P-value of 0.015 and 0.005 respectively. CONCLUSION: majority of pregnant women were satisfied with the care they received. Health providers should, however, improve the state of sanitary facilities and ensure the provision of adequate information on cervical cancer screening during health talks.
Keywords	antenatal care ; quality of care ; satisfaction ; abakaliki ; Medicine ; R
Subject code	360
Language	English
Publishing date	2020-12-01T00:00:00Z
Publisher	The Pan African Medical Journal
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Abdominoplasty for male truncal obesity

Ugochukwu Uzodimma Nnadozie / Gabriel Maduwuike Okorie / Charles Chidiebele Maduba / Njoku Isaac Omoke / Amaechi Ugbala / Emmanuel Uchendu / Collins Nwachi Ugwu

The Pan African Medical Journal, Vol 36, Iss

case report

2020 Volume 52

Abstract: Truncal obesity and its associated health risk is an enormous burden. The traditional surgical treatment modality is liposuction or lipoabdominoplasty. An uncommon mode of the treatment is the use of abdominoplasty alone or as a surgical component. The ... ...

Abstract	Truncal obesity and its associated health risk is an enormous burden. The traditional surgical treatment modality is liposuction or lipoabdominoplasty. An uncommon mode of the treatment is the use of abdominoplasty alone or as a surgical component. The aim of this report is to show a satisfactory outcome of abdominoplasty as the only surgical component in the management of severe truncal obesity in elderly male patient. We report a 75 year old Nigerian trader who had truncal obesity with gross abdominal asymmetry and cardiovascular and diabetes mellitus co-morbidities as well as bilateral knee osteoarthritis and social isolation due to truncal disfigurement. He was offered abdominoplasty as a sole surgical option for correction of anterior abdominal wall asymmetry. Apart from post operative wound complications and blood transfusion reactions, the patient had a good recovery and improved quality of life. Abdominoplasty is a rewarding treatment when used as a sole surgical option in centrally obese patients with anterior abdominal wall asymmetry and significant subcutaneous fat thickness.
Keywords	abdominoplasty ; elderly male ; truncal obesity ; quality of life ; Medicine ; R
Subject code	616
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	The Pan African Medical Journal
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Anterior abdominal wall reconstruction with mesh implants

Aloysius Ugwu-Olisa Ogbuanya / Ugochukwu Uzodimma Nnadozie / Livinus Nnanyerugo Onah / Stanley Nnamdi Chukwuemeka Anyanwu / Anastasia Amechi Mmeke

The Pan African Medical Journal, Vol 37, Iss

indications and limitations in a developing tropical economy

2020 Volume 57

Abstract: INTRODUCTION: The role of surgery in managing massive midline abdominal wall defects has continued to rise, leading to higher demand for more effective techniques in order to limit recurrences. There is paucity of data on this subject in Southeast ... ...

Abstract	INTRODUCTION: The role of surgery in managing massive midline abdominal wall defects has continued to rise, leading to higher demand for more effective techniques in order to limit recurrences. There is paucity of data on this subject in Southeast Nigeria. The aim of this study is to document the indications and challenges of treatment of complex, midline abdominal wall defects in our centre. METHODS: this was a cross-sectional study of adult patients with complex, midline abdominal wall defects managed with mesh implants over a five-year period. RESULTS: a total of 182 adult patients, predominantly females 160(87.9%), received mesh implants for complex abdominal wall defects. The common indications were incisional hernia 128(70.3%), abdominal wound dehiscence 16(8.8%) and divarication of recti 16(8.8%). About one-third 62(34.1%) of the patients required additional abdominoplasty procedure. Delay towards prompt surgical repair was noted in 168(92.3%) patients, notably due to financial constraints 32(17.6%) followed by comorbidities requiring serial assessments 24(13.2%). Superficial wound infection rate was 5.5% while deep (mesh) infection was noted in two (1.1%) patients. Recurrence and perioperative mortality rates were 1.1% and 1.6% respectively. Diabetes mellitus in obese female patients was an independent predictor of perioperative death (p=0.000). CONCLUSION: the most common indication for abdominal wall reconstruction in our environment is incisional hernia. The use of prosthetic meshes to repair complex abdominal wall defects is largely safe and effective in our practice, but timely reconstruction is commonly hampered by multi-faceted economic, clinical and pathological barriers.
Keywords	abdominal ; defect ; implant ; reconstruction ; ventral ; Medicine ; R
Subject code	610 ; 616
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	The Pan African Medical Journal
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Patterns of antimicrobial use in a specialized surgical hospital in Southeast Nigeria

Ugochukwu Uzodimma Nnadozie / Chukwuma David Umeokonkwo / Charles Chidiebele Maduba / Ifeanyichukwu I Onah / Dorothy Igwe-Okomiso / Iheuko S Ogbonnaya / Cosmas Kenan Onah / Patric Chukwuemeka Okoye / Ann Versporten / Herman Goossens

Nigerian Journal of Medicine, Vol 30, Iss 2, Pp 187-

Need for a standardized protocol of antimicrobial use in the tropics

2021 Volume 191

Abstract: Background: Antimicrobial resistance remains a growing global health menace. One of the key actions to curb this menace by the World Health Organization is antimicrobial stewardship (AMS). A prescription protocol is one of the cost-effective AMS ... ...

Abstract	Background: Antimicrobial resistance remains a growing global health menace. One of the key actions to curb this menace by the World Health Organization is antimicrobial stewardship (AMS). A prescription protocol is one of the cost-effective AMS interventions in surgery. This study determines the patterns of antimicrobial usage in a hospital specialized in orthopedic and plastic surgeries care in Nigeria. Methods: A cross-sectional survey was carried out at National Orthopaedic Hospital Enugu, a tertiary hospital specialized in orthopedic and plastic surgeries in Southeast Nigeria in May 2019. All the inpatients were included in the study. A standardized tool for point prevalence survey was used to collect data. Data were analyzed using Epi Info version 7.2.4. Results: A total of 127 inpatients participated in the survey with 387 antimicrobial encounters. The most common reasons for antimicrobial use were for the treatment of community-acquired infections (65.0%) and prophylaxis (29.4%). The decision for their use was made majorly on an empirical basis (92.4%). The reasons for antimicrobial prescriptions were documented in the majority (97.5%) of the cases and stop review dates in all (100%) of the prescriptions. Ceftriaxone (25.7%), tinidazole (21.9%), and metronidazole (14.6%) were the commonest antimicrobials prescribed among the patients. Conclusion: Orthopedic and plastic surgery practices require tailored prophylactic antibiotic regimens in the tropics due to peculiarities of both the specialties and the subregion. The claim that existing protocols in the temperate regions may apply in the tropics has been questioned due to the microbial profile on the tropics.
Keywords	antimicrobial protocol in surgery ; antimicrobial resistance ; antimicrobial stewardship ; prophylactic antibiotics ; Medicine ; R
Subject code	360
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Containing COVID-19 in Nigeria

Benedict Ndubueze Azuogu / Cosmas Kenan Onah / Emeka Onwe Ogah / Chinweoke Alfred Utulor / Osarhiemen Iyare / Azuka Stephen Adeke / Nkechi Elizabeth Ebere / Richard Ewah / Ugochukwu Uzodimma Nnadozie / Lawrence Ulu Ogbonnaya

Nigerian Journal of Medicine, Vol 30, Iss 3, Pp 293-

An appraisal of lockdown and surveillance at inter-state borders to control disease spread

2021 Volume 299

Abstract: Introduction: The outbreak of coronavirus disease 2019 (COVID-19) in Nigeria prompted decision-making at the various levels of governance. Ebonyi State Government in South-east Nigeria closed her borders with neighboring states as a preventive measure ... ...

Abstract	Introduction: The outbreak of coronavirus disease 2019 (COVID-19) in Nigeria prompted decision-making at the various levels of governance. Ebonyi State Government in South-east Nigeria closed her borders with neighboring states as a preventive measure for the spread of the pandemic. This study was an assessment of the effectiveness and challenges of border closure and surveillance activities in controlling the dispersion of the disease across states. Materials and Methods: The five major borders of Ebonyi State with her neighboring States of Enugu, Cross River, and Abia were visited. Information was collected about movement restrictions and surveillance at the borders using an observation checklist and key informant interviews. Data collected were analyzed using IBM-SPSS and thematic interpretation. Results: Commuters on essential duty were enforced to wear face masks, perform hand hygiene, and undergo screening for the symptoms of COVID-19 before entering the State. All the first 13 COVID-19 confirmed persons in the State were from those picked up as suspected cases by surveillance at the State borders. People who travelled hundreds of kilometers across several States were stopped from entering Ebonyi State. However, movement restriction at the borders was undermined by some security personnel who were bribed by commuters to allow them crossover during night hours. Conclusion: The lockdown and surveillance activities at the borders were effective in controlling the spread of COVID-19, but alternative routes of entry and corrupt act during odd hours constituted serious risks. Uniformity of movement restriction across all the states borders with vigilante groups manning inter-community boundaries may control the disease spread across regions.
Keywords	coronavirus disease 2019 surveillance ; infection control ; inter-state borders ; lockdown ; suspected cases ; Medicine ; R
Subject code	390 ; 940
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prevalence of anterior cruciate ligament injury among amateur footballers in Enugu, South-East Nigeria

Christian Chibuzor Ndubuisi / Ugochukwu Uzodimma Nnadozie / Emelie Moris Anekwu / Charles Chidiebele Maduba / Henry Chinedum Ekwedigwe / Petronilla Chidiebele Ojukwu / Canice Anyachukwu / Geraldine Ndubuisi

Nigerian Journal of Medicine, Vol 29, Iss 3, Pp 422-

The need for injury prevention programs

2020 Volume 427

Abstract: Background: Anterior cruciate ligament (ACL) injury is debilitating to any footballer. The injury is sustained in different ways during sporting events. There is need for injury prevention programs among the growing population of amateur footballers. Aim: ...

Abstract	Background: Anterior cruciate ligament (ACL) injury is debilitating to any footballer. The injury is sustained in different ways during sporting events. There is need for injury prevention programs among the growing population of amateur footballers. Aim: This study was carried out to determine the prevalence of ACL injury among Amateur footballers in Enugu, South-East Nigeria. Methodology: An observational study involving 825 of the registered amateur footballers in Enugu Metropolis. Oral interview and adapted knee pain evaluation form were used to screen for knee injuries and followed by Lachman and Pivot shift test to confirm ACL injury. Results: The mean age of the participants was 22.7 ± 3.1. The prevalence of ACL injury was 3.6% among the study population (8% for females and 3.5% for males), 56.6% among the participants with a history of knee injuries. Nearly 37.3% of the injuries occurred as a result of torsion/twist, which is a noncontact mechanism, 3.3% due to overuse, 13.3% due to contact/person, and 10.0% due to contact/friction. 70.0% of the injuries occurred during a training session, while 30.0% occurred during competition. Furthermore, 50.0% of athletes sought medical attention from traditional bone setters, 6.7% from physiotherapists, 10.0% from medical doctors, while 30.0% had self-medication. Conclusion: The prevalence of ACL injury among amateur footballers in Enugu, South-east Nigeria, falls within that obtained among athletes worldwide, with most of the injuries occurring from noncontact mechanisms during a training session. The prevalence is more in females than males.
Keywords	amateur footballers ; anterior cruciate ligament injury ; injury prevention ; nigeria ; Medicine ; R
Subject code	796
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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