The epigastric heteropagus conjoined twins

Conjoined twins are rare and are classified as symmetrical or asymmetrical, in which a member, the host (autosite), is near normal and bears the parasite, which is incomplete, smaller, and fully dependent for growth on it. This form of conjoined twins is referred to as heteropagus and when attached to the epigastrium of the autosite is called epigastric heteropagus. Only 44 cases of epigastric heteropagus twins have been previously reported in the world literature. We hereby report the successful separation of a pair of heteropagus twins.     

Irritable bowel syndrome among patients attending General Outpatients' clinics in Jos, Nigeria

Irritable bowel syndrome (IBS) is a common disorder in the Western world. Its prevalence is yet to be fully determined in the African setting. This was a cross-sectional study of patients attending three General Outpatient clinics in Jos, Nigeria. Four hundred and eighteen randomly selected patients were interviewed using a structured questionnaire based on the Rome II diagnostic criteria for IBS. Excluded from the study were patients with established organic disease, memory problems, and pregnant women. Eighteen patients were excluded based on these criteria and 400 were analysed using Epi Info 2000 (Atlanta, Georgia, USA) statistical computer software. One hundred and thirty-two (33%) out of the 400 patients fulfilled the criteria for the diagnosis of IBS, the female to male ratio being 1.13 : 1. IBS was significantly associated with increasing age (P=0.03) and depression (P<0.001). The prevalence of IBS is high among patients attending primary care in the African setting with depression being the likely reason for seeking care.     

Comparative performance of HbA1c 6.5% for FPG ≥7.0 vs 2hr PG≥11.1 criteria for diagnosis of type 2 diabetes

Background

International expert committee on the use of HbA1c to diagnose diabetes mellitus in 2009 and World Health Organization (WHO) in 2011 has advocated the use of HbA1c to diagnose diabetes mellitus.

Objective

To determine and compare the relationship between the new cut off value of HbA1c with established criteria.

Methods

Thirty-one hypertensive subjects attending Lagos University Teaching Hospital were recruited for HbA1c and standard oral glucose tolerance test. Fasting plasma glucose (FPG) and two-hour plasma glucose (2hrpp) value of e”126mg/ dl and ≥200mg/dl were used as standard respectively for diagnosis of diabetes. The HbA1c of e”6.5% was used to diagnose diabetes. The performance and correlation of HbA1c with FPG and 2hrpp were calculated and results were compared.

Results

Mean age of the subjects was 53.97±6.27years. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), efficiency and correlation of FPG is 50%, 68%, 27%, 85%, 64% and 0.5 respectively while the sensitivity, specificity, PPV, NPV, efficiency and correlation of 2hrpp is 73.91%, 62.5%,85%, 41.66%, 70.97% and 0.73% respectively. There was a significant difference between FPG and 2hrpp interms of sensitivity, PPV and NPV.

Conclusion

The results of HbA1c with 2hrpp has better correlation, sensitivity, and PPV compared to HbA1c with FPG.     

Childhood circumcision: a planned approach

We prospectively reviewed 3824 boys circumcised during two circumcision festivities. The boys were circumcised in their respective houses under aseptic conditions by teams of nurses, midwives and surgical aids locally trained for that purpose. Complications were seen in 2.3% of the boys, the commonest being infection that was easily controlled by local wound care.     

Pattern of gout and its association with chronic kidney disease in Maiduguri,northeastern Nigeria

Clinical Rheumatology - Gout is considered uncommon among Black Africans. It is commoner in men and associated with obesity, hypertension, and chronic kidney disease (CKD). This study aims to...