Nigerian Journal of Medicine

Background: Thyroid disease and type 2 diabetes mellitus (T2DM) are interconnected endocrine disorders with a bidirectional relationship. T2DM patients may present with various thyroid abnormalities, such as gland enlargement and nodule formation, warranting noninvasive assessment through ultrasound scanning. Aim: This cross‑sectional study aimed to evaluate thyroid gland volume (TGV) in adult patients with T2DM using ultrasound imaging in Kano. Materials and Methods: A total of 160 participants were randomly selected and underwent sonographic scans of the thyroid gland using a medical ultrasound machine with a 7.5 MHz linear probe. Thyroid volumes were recorded, and demographic information was collected. Statistical analysis was performed using the SPSS software version 29, with significance set at P < 0.05. Results: The mean TGV ± standard deviation was 5.8 ± 3.1 cm3. Females exhibited a statistically higher TGV (6.1 ± 3.4 cm3) compared to males (5.6 ± 2.8 cm3). There was no significant difference in TGV among patients with different diabetes control habits. The mean volume of the right lobe (3.1 ± 1.8 cm3) was significantly greater than that of the left lobe (2.7 ± 1.6 cm3). TGV correlated positively with T2DM duration, age, weight, and body mass index. Conclusion: This study provides valuable insights into the TGV among patients with T2DM in Kano. The findings indicate a positive correlation between TGV and T2DM duration and demonstrate gender and laterality differences. Ultrasound‑based assessment of thyroid volume can be a valuable tool in monitoring thyroid health in T2DM patients and may aid in the early detection and management of thyroid abnormalities.

Oromandibular dystonia (OMD) is a rare focal neurological disorder associated with impaired masticatory function, dysphagia, dysphonia, and involuntary abnormal movements of the mandible of varying severity. The peripheral-induced variant among other factors is a common aetiological factor of secondary dystonias, associated with constellations of clinical features and presents with differing responses to various treatment therapies. To report a case of oromandibular dystonia and to add to the body of literature. The case report is of a 33-year-old male who presented with complaints pain on speaking and from the temporomandibular joint area for 8 months which adversely affected patient’s work, social life and psychological well-being. Examination revealed retraction and repetitive but uncoordinated pattern of labial, cheek and masticatory muscular movement on mouth opening and closing. Diagnosis of oromandibular dystonia was made on clinical grounds. Patient was managed with a combination of medications by the oral physician, and physical therapy, which led to a significant improvement in the control of muscle contractions within 5 weeks. OMD though a rare neuromuscular condition can present to the dentist, and effective assessment, diagnosis and collaboration with relevant specialities are key to improved outcome.

Background: The adolescent period is a unique and crucial period of growth and development, in which the child transits from childhood to adulthood. It is characterised by several changes, both physiological and psychological, in preparation for adulthood. Thus, their health needs and health challenges differ from that of other children. Hence, the need to pay special attention to them and provide health and social support tailored toward their needs. Aim: This study aimed to determine the pattern of cases that presented to the Adolescent and Social Pediatrics Unit (ASP) of the Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA) over a three-year period. Materials and Methods: This was a retrospective study done to determine the pattern of cases seen at the Adolescent and Social Paediatrics Unit of the Alex Ekwueme Federal University Teaching Hospital, Abakaliki, between 2017 and 2019. Case files of all patients seen within the study period were retrieved, and all were included in the study. Relevant information such as age, gender, social class, diagnosis for both adolescent and nonadolescent age groups, treatment modalities, clinical subspecialties involved in management, and the outcome were retrieved. Data were entered and analysed using SPSS version 25, and results were presented as ratios, means, and proportions, whereas comparisons were made with the Chi‑square test or Fisher’s exact were applicable. P < 0.005 was considered statistically significant. Results: A total of 220 clients were seen over the given period. The adolescents were 148 (67.3%), whereas nonadolescents were 72 (32.7%). Among the adolescents, common diagnoses include sexual assault (24.3%), acne (8.1%), Pelvic Inflammatory Disease (PID)/sexually transmitted infection (STI) (8.1%), HIV (8.1%), somatisation disorder (6.8%), suicide attempts (5.4%), oppositional deviant disorders (4.1%), and conduct disorder (2.7%). In nonadolescents, common diagnoses include sepsis (30.6%), Severe Acute Malnutrition (SAM) (30.6%), and malaria (11.1%). There was a significant difference between the adolescents and nonadolescents with respect to diagnosis (P < 0.001), treatment modalities (P < 0.001), type of care received (P < 0.001), and outcome (P = 0.002). Conclusion: The study has portrayed that the common medical conditions seen among adolescents include sexual assault, acne, HIV, PID/STI, and somatisation. This will be useful in developing health‑care services and program geared toward adolescent health.

Background: Type 2 diabetes mellitus (T2DM) is frequently associated with hypertension (HTN), adding significantly to its overall morbidity and mortality. Aim: This study aimed to investigate the relationship between insulin resistance (IR) and blood pressure and other factors associated with both conditions. Patients, Materials and Methods: A case–control study of 180 subjects consisting of 60 with T2DM and HTN, 60 with T2DM and normal blood pressure, and 60 without T2DM or HTN (control). Sociodemographic, anthropometric, and clinical parameters were obtained from each subject and control. IR was derived from homeostasis model assessment (HOMA)‑IR index calculated from fasting blood glucose and insulin. Results: The mean age of subjects with T2DM and HTN was 49.58 ± 10.50 years, that of subjects with T2DM and normotension was 48.50 ± 10.44 years, while that of controls was 48.85 ± 10.15 years. IR (HOMA‑IR ≥2) was found in 96.7% of subjects with T2DM and HTN, 88.3% of those with T2DM and normotension, and 1.7% of subjects with neither of both conditions. Central obesity (Waist circumference “WC”), overweight, and obesity (BMI) significantly related to IR in subjects with T2DM and HTN (p = 0.020, 0.021 and 0.016 respectively) while only WC and obesity (BMI) significantly related to IR in subjects with T2DM and normotension (p = 0.001 and 0.036 respectively). Conclusions: There is a high prevalence of IR in T2DM subjects which is heightened by the presence of HTN.

Background: Aging is an unavoidable process that is connected with several health issues, including presbycusis, a degenerative disease of the cochlear hair cells and central auditory pathways with a resultant reduction in hearing acuity. In developing countries like Nigeria, little attention is given to the elderly population with possible underreporting of presbycusis, hence the need for this study. Aim: The aim of this study was to investigate hearing loss, the type, and associated risk factors among the elderly attending a geriatric clinic in South‑west Nigeria. Patients, Materials and Methods: It was a cross‑sectional study of patients aged 60 years and above in a geriatric centre. All consented participants were given a structured questionnaire to collect important data such as demographics, history of hearing loss, family history of hearing loss, risk factors, and so on. Ear examinations, otoscopy, pure‑tone audiometry, distortion‑product otoacoustic emissions, and tympanometry were also performed on all patients. Results: Ninety‑five participants, comprising 33 males and 62 females, were recruited, and their ages ranged from 60 to 89 years (74.5 ± 7.6 years). The mean pure‑tone average was 42.2 dB ± 17.4 and 39.21 dB ± 17.4 in the right and left ears, respectively. About 80% of them have a hearing threshold above 15 dB, with 13 (13.7%) being conductive hearing loss, 48 (50.6%) sensorineural hearing loss, and 15 (15.8) mixed hearing loss. Presbycusis was diagnosed in 37 (38.9%) participants. There was a significant correlation between the pure‑tone average and distortion‑product otoacoustic emissions results in both ears of the participants (P = 0.0001). Tympanograms were abnormal in 21 (22%) right ears and 27 (28%) left ears. Conclusion: Hearing loss is highly prevalent among the elderly, with presbycusis being the most common type. Periodic hearing screening for the elderly is hereby recommended.