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Chikani UN, Bisi-Onyemaechi AI, Onu JU, Nduagubam O, Mbanefo NR, Ohuche IO, Chime PU, T Onyia JO, Ogugua CF, Ugege MO. Dimensional approach to gender dysphoria in Nigeria: Association with socio-demographic and psycho-sexual variables. Niger J Clin Pract 2023; 26:1181-1191. [PMID: 37635615 DOI: 10.4103/njcp.njcp_124_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Background Recent changes across the world with respect to gender transitioning of children and adolescents have generated a bio-psycho-socio-cultural discourse among interest groups. Aim This study sought to examine gender dysphoric symptoms among adolescents and young persons in an African population, using a dimensional approach. Method A total of 747 primary/secondary school and university students aged 10-24 years were studied using the 27-item Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ-AA). Participants were divided into early, mid- and late adolescents. The composite and domain scores were calculated using the criteria described by Deogracias, and comparison of the median scores was done using Mann-Whitney U-test and Kruskal-Wallis test as appropriate. Dunnett's post-hoc test was used for pairwise comparisons. Results The prevalence of self-identified transgender and self-reported non-heterosexuals was 0.9% (95%CI: 0.36-1.92) and 18.6% (15.85-21.59), respectively. The participants as a group scored 4.56 out of a possible 5 on the gender dysphoria scale, indicating less gender dysphoric symptoms in this cohort. However, participants in mid- and late adolescents had significantly lower scores when compared with early adolescents (P = 0.009). Self-reported transgender had significantly lower scores in the social (P = 0.001) and socio-legal (P < 0.001) indicators of the scale. Conclusion The findings of this study, although, preliminary demonstrated less gender dysphoric symptoms in this cohort of Nigerian adolescents and young adults compared to the Western population. Nevertheless, some degree of GD was noticed, revealing that this condition is existent in our society.
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Affiliation(s)
- U N Chikani
- Department of Paediatrics, Division of Paediatric Endocrinology, University of Nigeria Teaching Hospital, Ituku-Ozalla Campus, Enugu, Nigeria
| | - A I Bisi-Onyemaechi
- Department of Paediatrics, Division of Paediatric Neurology, University of Nigeria Teaching Hospital Ituku-Ozalla Campus, Enugu, Nigeria
| | - J U Onu
- Department of Mental Health, Nnamdi Azikiwe University, Awka, Anambra State and Honorary Consultant Psychiatrist, Federal Neuropsychiatric Hospital, Enugu, Nigeria
| | - O Nduagubam
- Department of Paediatrics, Enugu State Teaching Hospital, College of Medicine, Parklane, Enugu, Nigeria
| | - N R Mbanefo
- Department of Paediatrics, Division of Nephrology, University of Nigeria Teaching Hospital, Ituku- Ozalla Campus, Enugu, Nigeria
| | - I O Ohuche
- Department of Paediatrics, Division of Paediatric Endocrinology, University of Nigeria Teaching Hospital, Ituku-Ozalla Campus, Enugu, Nigeria
| | - P U Chime
- Department of Paediatrics, Division of Pulmonology, University of Nigeria Teaching Hospital, Ituku-Ozalla Campus, Enugu, Nigeria
| | - J O T Onyia
- Department of Paediatrics, Division of Gastroenterology, University of Nigeria, Ituku Ozalla Campus, Enugu, Nigeria
| | - C F Ogugua
- Department of Paediatrics, Division of Endocrinology, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria
| | - M O Ugege
- Department of Paediatrics, College of Health Sciences, Usman Danfodiyo University/Usman Danfodiyo University Teaching, Hospital (UDUTH), Sokoto, Nigeria
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Mbanefo NR, Igbokwe OO, Iloh ON, Chikani UN, Bisi-Onyemaechi AI, Muoneke VU, Okafor HU, Uwaezuoke SN, Odetunde OI. Percutaneous kidney biopsy and the histopathologic patterns of kidney diseases in children: An observational descriptive study at a South-East Nigerian tertiary hospital. Niger J Clin Pract 2023; 26:795-801. [PMID: 37470655 DOI: 10.4103/njcp.njcp_855_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Background Kidney biopsy remains the best standard for kidney tissue analysis. Although percutaneous kidney biopsy is an invasive procedure, it is an indispensable part of interventional nephrology for accurate diagnosis, selection of appropriate therapy protocol, and prognostication of kidney diseases in children. With improvement in expertise among pediatric nephrologists, data on procedure outcomes are now being documented. Aim: We aimed to describe the outcomes in a 5-year practice of kidney biopsy at the pediatric nephrology unit in a southeast Nigerian tertiary hospital. Patients and Methods An observational descriptive study conducted on the kidney biopsy performed in our facility from 2017 to 2022. The focus was on the patients' clinical profile, indications for biopsy, the adopted procedure, and the histopathologic findings. Results A total of 69 patients had kidney biopsy, 40 (58.0%) were males, while 29 (42.0%) were females. Sixty-four (92.7%) patients had the procedure at the age of >10 years, while five (7.2%) at the age of <7 years. The patients' prebiopsy mean systolic and diastolic blood pressures were 111.20 ± 16.93 and 74.64 ± 12.69 mmHg, respectively. Their estimated glomerular filtration rate (eGFR) was 119.27 ± 52.78 ml/min/1.73 m2. The most frequent indication was steroid resistance (39/69, 56.5%). Focal segmental glomerulosclerosis was the commonest histopathologic finding (38/69, 55.0%). Conclusion Outcomes of percutaneous kidney biopsy at a Nigerian tertiary hospital are adjudged successful. The histopathologic patterns highlight FSGS as the major cause of steroid resistance in childhood nephrotic syndrome in this clime.
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Affiliation(s)
- N R Mbanefo
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - O O Igbokwe
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - O N Iloh
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - U N Chikani
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - A I Bisi-Onyemaechi
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - V U Muoneke
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - H U Okafor
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - S N Uwaezuoke
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - O I Odetunde
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
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Ugege MO, Chikani UN, Yusuf T, Amodu-Sanni M, Ibitoye PK, Abdul Rahman MB. Abnormal blood glucose and the relationship with clinical outcome in acutely ill children admitted to the emergency unit of a Nigerian Tertiary Hospital. Niger J Clin Pract 2021; 24:205-212. [PMID: 33605910 DOI: 10.4103/njcp.njcp_353_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Dysglycemia (hyper- or hypoglycemia) is frequently seen in acutely ill children and may be associated with poor outcome. Objective To determine and compare clinical characteristics and outcomes of children admitted for acute illnesses presenting with euglycemia and dysglycemia. A prospective cohort study was conducted in Emergency Pediatric Unit (EPU), of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Subjects and Methods Children aged ≤15 years, admitted for acute illnesses were enrolled consecutively for a 6-month period. An Accu-Chek Active glucometer was used to check blood glucose of subjects at admission, and based on the result; subjects were categorized as either euglycemic or dysglycemic. The clinical characteristics and outcomes (discharged or died) were compared in the two groups. Statistical analysis involved Chi square test and logistic regression. Results The median age of 376 subjects was 24 months (range: 1-156 months). Forty-four subjects (11.7%) had dysglycemia, consisting of 36 (9.6%) with hyperglycemia, and 8 (2.1%) with hypoglycemia, whereas 332 (88.3%) had euglycemia. The clinical characteristics associated with hyperglycemia were presence of fever (p = 0.001), and convulsion (p = 0.04), whereas hypoglycemia; coma and hepatomegaly (p = 0.01). Forty subjects (40/376, 10.6%) died. The proportion of those that died in the dysglycemic group (10/44, 22.7%) was significantly higher than that in the euglycemic group (30/332, 9%) (p = 0.006). Subjects who had hyperglycemia were 2.6 times less likely to survive (OR = 2.64, 95% CI: 1.02--6.79, P = 0.05) compared to their euglycemic counterparts. Hypoglycemia was not significantly associated with death outcome (p = 0.13). Conclusion Dysglycemia, particularly hyperglycemia, was significantly associated with increased mortality in acutely ill children. We recommend routine bedside glucose estimation for all acutely ill children at admission to the emergency unit, to detect dysglycemia, treat hypoglycemia promptly, monitor closely, and treat aggressively the underlying conditions in children with hyperglycemia to prevent attendant high mortality.
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Affiliation(s)
- M O Ugege
- Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - U N Chikani
- Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - T Yusuf
- Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - M Amodu-Sanni
- Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - P K Ibitoye
- Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - M B Abdul Rahman
- Department of Chemical Pathology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
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Ekenze SO, Chikani UN, Ezomike UO, Okafor DC. Outcome of feminizing genital reconstruction in female sex assigned disorder of sex development in a low-income country. J Pediatr Urol 2019; 15:244-250. [PMID: 30926253 DOI: 10.1016/j.jpurol.2019.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 02/27/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND In patients with disorders of sex development (DSD), surgical/medical treatments are undertaken after sex assignment to ensure congruent bodily appearance and function. Genital reconstruction in these patients can be daunting with varied outcome. Understanding these outcomes is imperative, more especially in a developing country where added challenges exist. OBJECTIVE This study evaluates the outcome of genital surgery in patients with DSD assigned female sex. METHODS A retrospective analysis of 25 cases of female sex assigned DSD managed in two tertiary centers in southeast Nigeria was performed. Data of these cases were collected from the case notes, discharge summaries, and theater records. IBM SPSS Statistics Data Editor, version 21, was used for data entry and analysis. RESULTS The patients presented at median age of 12 months (range 2 days-30 years), with 15 (60%) cases reared as female and 10 (40%) reared as male before presentation. The predominant phenotype was phallus with empty fused/unfused labioscrotum and urethra opening in the labioscrotum or perineum in 21 (84%) patients. Evaluation revealed features suggestive of 46XX DSD in 21 (84%) patients, ovotesticular DSD in two (8%), and androgen insensitivity in two (8%). A total of 10 cases required sex reassignment after evaluation. Overall, 24 of the 25 cases had feminizing genital procedures. After a median follow-up period of 2 years (range 2 months-8 years), six (25%) cases developed procedure-related complications, three (12.5%) had social maladjustment, and two (8.3%) patients reported features of gender dysphoria. DISCUSSION The procedures of feminizing genitoplasty in this study did not differ from the established procedure. However, as a result of challenges of delayed presentation, inadequate early management, sociocultural factors, and a lack of facilities for full evaluation, some cases may require sex reassignment and more daunting reconstructive procedures. This may give rise to less than optimal outcome. The study was limited by the retrospective nature, small number of cases, and the short duration of follow-up of the cases. CONCLUSION Feminizing genital procedures for DSD in our setting may be associated with procedure-related complications and non-surgical complications. Improving surgical technique and addressing the challenges of delayed presentation and fixation on male gender may improve overall outcome.
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Affiliation(s)
- S O Ekenze
- Sub-Department of Paediatric Surgery, College of Medicine, University of Nigeria, Enugu Campus, Nigeria.
| | - U N Chikani
- Endocrine Unit, Department of Paediatrics, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
| | - U O Ezomike
- Sub-Department of Paediatric Surgery, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
| | - D C Okafor
- Paediatric Surgery Unit, Federal Teaching Hospital, Abakaliki, Nigeria
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Chikani UN, Ibekwe MU, Oguonu T, Mungai L, Bisi-Onyemaechi AI, Ugege OM, Ogbonna IF, de Beaufort C. Steroid-induced impairment of glucose tolerance: Prevalence among pediatric patients on long-term steroid use in Nigeria. Pediatr Diabetes 2017; 18:942-946. [PMID: 28261934 DOI: 10.1111/pedi.12514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 12/15/2016] [Accepted: 02/02/2017] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Glucocorticoid (referred to from here on as simply steroid) is used for effective treatment of various inflammatory disorders since its discovery in 1940s. However, these useful drugs cause important side effects, such as impairment of glucose tolerance. We sought to determine the prevalence of steroid-induced impairment of glucose tolerance in pediatric patients on long-term steroid use. MATERIALS AND METHODS A cross-sectional, descriptive and hospital-based study. Consenting subjects who met the inclusion criteria were screened with random glucometer measurements repeated twice. An average of both readings obtained from the initial measurement of their random blood glucose (RBG) and a repeat during the next clinic visit was taken as the RBG. RESULTS Hundred patients were studied, 66 males/34 females. Subjects with nephrotic syndrome were 61 while 39 had asthma. Mean age of 10.13 years (range: 0.5-18 years); mean body mass index (BMI): 18.2 kg/m2 (range: 6.6 to 26.30 kg/m2 ). The subjects with nephrotic syndrome were on oral prednisolone while the asthmatics were on inhaled fluticasone, budesonide and oral methylprednisolone. Mean (range) duration of steroid use was 9.74 (0.5-72) months. Mean (range) RBG was 3.49 (3.3-7.5) mmol/L. None of the subjects showed abnormal RBG. However, the RBG was further categorized into low, moderate and high normal RBG. A positive correlation between longer duration of steroid use as well as high doses of both oral and inhaled steroids, and high normal RBG existed (P = .015). No statistically significant relationship existed between body mass index (BMI) percentile and RBG (P = .437). CONCLUSION Low to moderate doses of oral and inhaled steroids should be used when indicated as they are associated with lesser risk of impairment of glucose tolerance in the pediatric population.
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Affiliation(s)
- U N Chikani
- Department of Paediatrics, University of Nigeria, Nsukka, Enugu, Nigeria
| | - M U Ibekwe
- Department of Paediatrics, Federal Teaching Hospital, Abakaliki, Nigeria
| | - T Oguonu
- Department of Paediatrics, University of Nigeria, Nsukka, Enugu, Nigeria
| | - L Mungai
- Department of Paediatrics, University of Nairobi, Nairobi, Kenya
| | | | - O M Ugege
- Department of Paediatrics, Usman Danfodio University, Sokoto, Nigeria
| | - I F Ogbonna
- Department of Paediatrics, Abia State University, Okigwe, Nigeria
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Chikani MC, Mezue W, Okorie E, Mbachu C, Ndubisi C, Chikani UN. Subdural empyema: Clinical presentations and management options for an uncommon neurosurgical emergency in a developing country. Niger J Clin Pract 2017; 20:1221-1225. [DOI: 10.4103/njcp.njcp_340_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chikani UN, Ibekwe MU, Chinawa JM, Adimora GN. Testicular volume of healthy term neonates: Determination of normative values among Igbo babies in South-Eastern Nigeria. Niger J Clin Pract 2016; 19:85-90. [PMID: 26755224 DOI: 10.4103/1119-3077.173704] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Testicular volume (TV) in neonates has some predictive values of clinical importance. Establishing the normal values of TV among term newborn males of every population is important as differences exist among different populations. Much is not known on TV among Igbo newborns. AIM The aim of this study was to determine the normative values of TV in apparently healthy term Igbo newborn males in Enugu, South-Eastern Nigeria and its relationship with gestational age (GA), birth weight (BW), and birth length (BL). SUBJECTS AND METHODS This was a hospital-based, cross-sectional and descriptive study. Eight hundred and eleven apparently healthy term Igbo male neonates within the first 3 days of life were studied. The TV was measured with Prader Orchidometer (ZKL-135-H), ESP Model. Smoothed centiles (3-97th percentile values) for TV by GA were determined. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0 (Chicago). P < 0.05 were regarded as statistically significant. RESULTS The mean TV was 1.74 ± 0.62 ml ranging from 1 to 3 ml. The TV increased with increasing GA (P = 0.00). Pearson's correlation test between TV and birth length (r = 0.301, P = 0.001), as well as with BW (r = 0.247, P = 0.001) were significant. A linear regression demonstrated correlation between TV and birth length (P = 0.0001, r2 = 0.091). CONCLUSION The mean TV among male Igbo newborn is 1.74 ± 0.62 ml. Also, the first smoothed percentile values for TV by GA for Nigerian Igbo babies is created.
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Affiliation(s)
| | - M U Ibekwe
- Department of Paediatrics, Ebonyi State University, Abakaliki, Ebonyi, Nigeria
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