Distal symmetrical polyneuropathy detected by vibration perception threshold among adults with and without diabetes attending a general outpatient clinic in Ilorin, Nigeria

The aim of this study is to compare the prevalence, severity, and symptoms of Distal Symmetrical Polyneuropathy (DSP) among adult patients with diabetes and those without diabetes in a primary care clinic. It was a cross-sectional comparative study involving 72 adults of between 40-60 years of age living with diabetes and 72 age-matched adults without diabetes. DSP was assessed with a biothesiometer device, and data analysis was performed using the SPSS Version 21 statistical software. The overall prevalence of neuropathy among the participants was 68.1% for those living with diabetes and 38.9% for the other group. Furthermore, 22.3% of the diabetes group had severe neuropathy compared with 8.3% of the other group. These differences were found to be statistically significant with p=0.001 (df = 2, X2 = 14.07). We reported higher prevalence and severity of DSP in those living with diabetes. We also found significant association between high VPT (≥25V) and presence of neuropathic symptoms thereby enhancing the use of the biothesiometer device in the diagnosis of adults with DSP in the primary care setting.

Body mass index, blood pressure, and cognitive impairment among type 2 diabetic patients in a primary care setting, North-Central Nigeria

The long-term effects of certain clinical factors on cognition cannot be overemphasized. The morbidity of Cognitive Impairment (CI) in patients with type 2 diabetes has been found to increase when associated with some clinical factors. The main objective of this study was to determine the relationship between CI and Body Mass Index (BMI) as well as CI and Blood Pressure (BP), among type 2 diabetic patients attending the primary care unit of a tertiary hospital. It was a descriptive hospital-based crosssectional study. Ethical approval was obtained from the Ethical Review Committee of the University of Ilorin Teaching Hospital (UITH) before the commencement of the study. Data was collected from 274 adult type 2 diabetic patients attending the Family Medicine clinics of the hospital, from March through May 2017. Interviewer-administered structured and semi-structured questionnaires were used to obtain information from the respondents. The Mini-Mental State Examination (MMSE) was used to assess CI among respondents. The BMI and BP of participants were obtained following standard procedure. Data was collated and analyzed using the Statistical Package for Social Sciences version 21 (SPSS- 21). The elderly constituted a higher proportion of participants 55.4%. Respondents were mainly females (70.8%), married (78.8%), and educated (78.1%). The clinical factor that had a statistically significant association with CI was the BMI of participants with a chi-square value (χ2) of 11.139 and a p-value of 0.048. Blood pressure had no statistically significant association with CI (χ2 of 5.181 and p-value of 0.159). CI is common in our clinics with a prevalence of 27% seen in this study. BMI had a statistically significant association with CI while BP was not. Hence, maintaining a normal weight may help in controlling CI. Physicians in primary care should routinely screen type 2 diabetic patients for CI as well as control risk factors for it.

Clinical and haematological determinants of outcome among children with cerebral malaria in a tertiary centre in Nigeria

Background: Many clinical and haematological changes occur as a result of severe malaria, of which cerebral malaria (CM) is a common entity. These changes affect virtually all organs and systems of the body. We identify various clinical and haematological determinants of outcome in CM so as to institute proactive management of such children.Methods: All children who met World Health Organization (WHO) diagnostic criteria for CM over 8 month-period were prospectively studied. The presenting symptoms and its duration, detailed physical examination and laboratory parameters were obtained. Logistic regression was employed to determine the prognostic significance of various clinical and laboratory parameters. Outcome indicators were full recovery, alive with neurological sequelae or death of the children. Results: Of the 892 children admitted into the Children Emergency Unit (CEU) over the study period, 50 (5.6%) had CM with M: F ratio of 1:1 and age range of 6 months to 12 years. Sixty percent were aged less than 5 years. The defining symptoms were fever (100%), coma (100%) and convulsion (98%). Forty-one (82%) patients survived, while nine (18%) died. Of the 41 survivors, 30 (73.2%) recovered fully, while 11 (26.8%) had neurological deficits at discharge. Identified clinical and laboratory predictors of mortality and neurological sequelae in CM included Blantyre coma score of 0-2(p = 0.018) prolonged coma recovery time > 26 hours (p = 0.026), abnormal breathing pattern (p = 0.0124), absent corneal reflex (p = 0.012), absent pupillary reflex (p = 0.012), depressed tendon reflex (p = 0.028), hyperreflexia (p =0.014), retinal haemorrhage (p =0.001), duration of admission (p=0.000), hyper parasitaemia (p=0.001), hypoglycemia (p= 0.014) and leucocytosis (p = 0.008). Independent determinants of immediate post-recovery neurological deficits and death were hyper-parasitaemia (OR = 8.657, p = 0.017.) and leucocytosis (OR = 1.090; p = 0.035 Conclusion: CM is a potentially reversible encephalopathy associated with high mortality and sequelae. Affected children with the above listed clinical / haematological parameters especially hyperparasitemia and leucocytosis should be given proactive management to improve the outcome.

Effect of the COVID-19 pandemic on blood donations and transfusions in Nigeria ­ A multi-facility study of 34 tertiary hospitals

Background: The coronavirus disease 2019 (COVID-19) pandemic affected blood supplies globally. Mobile blood drive campaigns halted, and voluntary blood donations reduced, challenging available blood supplies. Furthermore, fears of virus transmission led to deferrals of elective surgeries and non-urgent clinical procedures with noticeable declines in blood donations and transfusions. Aims: We aimed to assess the effect of the COVID-19 pandemic on the number of blood donations and transfusions across the country by blood product type across various hospital departments. Materials and Methods: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 34 tertiary hospitals in Nigeria, comparing January to July 2019 (pre-COVID-19) to January to July 2020 (peri-COVID-19). Data were collected from the country's web-based software District Health Information System, Version 2 (DHIS2). Results: A 17.1% decline in numbers of blood donations was observed over the study period, especially in April 2020 (44.3%), a 21.7% decline in numbers of blood transfusions, especially in April 2020 (44.3%). The largest declines in transfusion were noted in surgery department for fresh frozen plasma (80.1%) [p = 0.012] and accident and emergency department transfusion of platelets (78.3%) [p = 0.005]. The least decline of statistical significance was observed in internal medicine transfusions of whole blood (19.6%) [p = 0.011]. Conclusions: The COVID-19 pandemic significantly affected the numbers of blood donations and transfusions in Nigeria. Strengthening blood services to provide various blood components and secure safe blood supplies during public health emergencies is therefore critical.

Prevalence and Risk Factors Associated with Diabetes Mellitus in Public Secondary Schools Teachers in Ekiti State

Background: Diabetes Mellitus is a non-communicable disease and a leading cause of morbidity and mortality in the world. The estimated prevalence of diabetes in Africa is 1% in rural areas and ranges from 5% to 7% in urban sub-Saharan Africa. 3 Nigeria is the most populous country in African and she contributes about one sixth of the Africa's diabetic population. This study is aimed at determining the prevalence of diabetes mellitus and accessing its risk factors among public secondary school teachers in Ekiti State. Methodology: This survey is a cross-sectional study carried out among 357 public school teachers in Ekiti State using a multi stage sampling technique. Data was gathered using a semi structured questionnaire and Accu Check Glucometer machine for Fasting Blood Sugar. Analysis was done using SPSS version 23 and level of significance was taken as P = 0.05. Result: Mean age was 42.9±9.2 years. Prevalence of Diabetes Mellitus was 5.6%. Family history (15%), Alcohol intake (14.0%) and smoking (11.2%) were major risk factors in the respondents. Poor vision is the main complication being experienced by the respondents (40.3%). Predictors of Diabetes Mellitus as found by this study include increasing age (starting from above 40years), cigarette smoking, alcohol intake and positive family history. Conclusion: Prevalence of Diabetes Mellitus is high compared to what it was before. Alcohol intake, smoking and family history were major risk factors while poor vision is the commonest complication. It is recommended that all efforts must be made to put in mechanism that will halt this undesired progression through control of risk factors.

Assessment of Willingness to pay for Community-Based Health Insurance among Artisans in a selected Community of Ekiti State, Southwest Nigeria

Background: Community-based health insurance (CBHI) has emerged as a more efficient and equitable approach to healthcare financing. It was designed to ensure that sufficient resources are made available for members to access effective healthcare. This study assessed the willingness to pay (WTP) for CBHI among artisans in a town in Ekiti State, South West Nigeria. Methods: This was a cross-sectional survey conducted among 416 artisans in a town in Ekiti State. A semi-structured interviewer-administered questionnaire was designed and used for data collection on sociodemographic data and WTP for CBHIS. Data entry and analysis was done using IBM SPSS software version 25.0. Results: The mean age and standard deviation of the respondents was 29.7±10.9 years with male to female ratio of 1:1.4. Most of the respondents were willing to pay (86.3%) and willing to enroll other household members (73.6%) in the CBHI. A large percentage (44.3%) of those willing to pay were ready to pay between ₦1,000-₦5,000 (US$2.63­US$13.16) per year while 39.6% preferred frequency of payment to be annually. Positive predictors of WTP for CBHI were age groups ≥50 years and 40-49 years than <20 years (AOR:13.270, 95%CI: 1.597-110.267; AOR:142.996, 95%CI: 10.689-1913.009). Females than males (AOR:9.155, 95%CI: 3.680-22.775), tertiary level of education than no formal of education (AOR:23.420, 95%CI: 1.648-850.921), no children than ≥5 children (AOR:20.099, 95%CI: 2.705-149.364), earn ≥₦30,000 (US$78.95) than <₦30,000 (AOR:2.248, 95%CI: 1.278-6.499). often and somethings fall ill than seldom fall ill (AOR:6.505, 95%CI: 1.623-26.065; AOR:4.889, 95%CI: 1.674-14.279) Conclusion: WTP for CBHI was high among the artisans, however, there is a variation across the amount and frequency of payment. Therefore, policy that is flexible enough to allow artisans enroll and pay a premium that is affordable, at an acceptable frequency, should be formulated by the Government.

Socio-demographic and clinico-pathologic pattern of patients with colorectal cancers seen in Ahmadu Bello University teaching Hospital, Zaria

Introduction: Colorectal cancer is a major cause of morbidity and mortality in the world. It accounts for 10.2% of cancer incidence globally, with a mortality of 9.2%. It ranks third in terms of incidence but second in terms of mortality. Colorectal cancer is not uniformly common throughout the world. Its incidence is increasing in developing countries, probably due to the acquisition of western lifestyle.Aim: The aim of this study was to determine the sociodemographic and clinicopathological pattern of patients with colorectal cancer seen in the Department of Surgery, Radiotherapy, and Oncology Centre, Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, over a 10-year period.Materials and Methods: In this retrospective study, data were collected from the case files and treatment cards of 122 patients with colorectal cancer managed at the Surgical, Radiotherapy, and Oncology Department of ABUTH, Zaria, from January 2006 to December 2015. Data items analyzed included age, sex, residential area, occupation, duration of symptoms, presenting complaints, subsite, histological type, grade, and stage. All analyses were performed by SPSS version 20.Results: An annual incidence of 12.2 cases/annum was seen. Seventy (57.4%) were male and 52 (42.6%) were female. Male:female ratio was 1.3:1 and the age range was between 12 years and 78 years, majority were between 31 and 40 years (24.6%), with a mean age of 42.4 years and median age of 41 years. It was found to be more common among the urban dwellers, with the public/civil servants being the most affected (36.0%). The duration of presenting complain ranged from 3 weeks to 10 years, most patients presenting at 7­10 months with more than one symptom. Bleeding per rectum was the most common symptom seen in 20%. Adenocarcinoma was the predominant histology seen in 73% (n = 89) and 28.7% were well differentiated. The rectum was the most common subsite, while left-sided lesions (20%) were more common than right-sided lesions (17%). About 18% (n = 22) had distant metastasis.Conclusion: The study showed that colorectal cancer was more common among the younger age group, with a slight male preponderance. They were mostly urban dwellers and civil/public servants. The most common presenting symptom was bleeding per rectum and majority of the cases presented at an advanced stage. Early detection through public health education, screening programs, affordable and effective treatment, and follow-up will help reverse this trend.Conclusion: The study showed that colorectal cancer was more common among the younger age group, with a slight male preponderance. They were mostly urban dwellers and civil/public servants. Bleeding per rectum being the most common complaint, majority of the cases presented at an advanced stage. Early detection through public health education, screening programs, affordable and effective treatment, and follow-up will help reverse this trend

Socio-demographic and clinico-pathologic pattern of patients with colorectal cancers seen in Ahmadu Bello University Teaching Hospital, Zaria

Introduction: Colorectal cancer is a major cause of morbidity and mortality in the world. It accounts for 10.2% of cancer incidence globally, with a mortality of 9.2%. It ranks third in terms of incidence but second in terms of mortality. Colorectal cancer is not uniformly common throughout the world. Its incidence is increasing in developing countries, probably due to the acquisition of western lifestyle.Aim: The aim of this study was to determine the sociodemographic and clinicopathological pattern of patients with colorectal cancer seen in the Department of Surgery, Radiotherapy, and Oncology Centre, Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, over a 10-year period.Materials and Methods: In this retrospective study, data were collected from the case files and treatment cards of 122 patients with colorectal cancer managed at the Surgical, Radiotherapy, and Oncology Department of ABUTH, Zaria, from January 2006 to December 2015. Data items analyzed included age, sex, residential area, occupation, duration of symptoms, presenting complaints, subsite, histological type, grade, and stage. All analyses were performed by SPSS version 20.Results: An annual incidence of 12.2 cases/annum was seen. Seventy (57.4%) were male and 52 (42.6%) were female. Male:female ratio was 1.3:1 and the age range was between 12 years and 78 years, majority were between 31 and 40 years (24.6%), with a mean age of 42.4 years and median age of 41 years. It was found to be more common among the urban dwellers, with the public/civil servants being the most affected (36.0%). The duration of presenting complain ranged from 3 weeks to 10 years, most patients presenting at 7­10 months with more than one symptom. Bleeding per rectum was the most common symptom seen in 20%. Adenocarcinoma was the predominant histology seen in 73% (n = 89) and 28.7% were well differentiated. The rectum was the most common subsite, while left-sided lesions (20%) were more common than right-sided lesions (17%). About 18% (n = 22) had distant metastasis.Conclusion: The study showed that colorectal cancer was more common among the younger age group, with a slight male preponderance. They were mostly urban dwellers and civil/public servants. The most common presenting symptom was bleeding per rectum and majority of the cases presented at an advanced stage. Early detection through public health education, screening programs, affordable and effective treatment, and follow-up will help reverse this trend.Conclusion: The study showed that colorectal cancer was more common among the younger age group, with a slight male preponderance. They were mostly urban dwellers and civil/public servants. Bleeding per rectum being the most common complaint, majority of the cases presented at an advanced stage. Early detection through public health education, screening programs, affordable and effective treatment, and follow-up will help reverse this trend

Endoscopic management of ureteric stones: our initial experience

The aim of this study is to present our initial experience with intracorporeal pneumatic ureterolithotripsy highlighting the pattern of patients' clinical presentation, techniques, and limitation of the procedure.Materials and Methods:This is a retrospective study of cases of ureteric stones managed over a period of 18 months in a private hospital. Data obtained include patients' sociodemography, clinical presentation, stone burden, procedural technique, complication, and need for a secondary procedure. Data were analyzed using the Statistical Package for the Social Sciences version 21.Results:The total number of patients managed was 20 with an age range of 28­75 years and a mean of 48.2 ± 12.4 years. Majority of them, i.e., 11 (55%) were middle aged. Female gender was more predominant, 11 (55%). Flank pain was the most common mode of presentation. Right-sided stone occurred in 9 (45%), left sided in 7 (35%), and bilateral in 4 (20%). Stone location was in the upper ureter in 4 (16.7%), mid-ureter in 7 (29.2%), and lower ureter in 13 (54.2%). The stone size ranged from 6 to 18 mm with a mean of 9.7 ± 2.5 mm. Four patients (20%) required initial bilateral ureteric stenting before definitive procedure to allow for recovery from sepsis and/or nephropathy. All patients had double-J stenting and were discharged 2 days after the procedure. The procedure was successful in 19 (95%) with 100% stone clearance rate and complete resolution of symptom without any complication. One patient (5%) had a very hard upper ureteric stone which retropulsed into the renal pelvis requiring open nephrolithotomy.Conclusion:Endoscopic treatment of ureteric stone with intracorporeal pneumatic lithotripsy is a safe and effective treatment modality. It is, however, limited in the management of hard upper ureteric stone, especially those that are close to the pelviureteric junction due to the risk of retropulsion of the stone into the kidney

Indications and outcome of tracheostomy in Ilorin, North Central Nigeria: 10 years review

Background: The study aims to highlight common indications as well as outcome of treatment among patients with tracheostomy in Ilorin, North-Central Nigeria. Methods: A review of clinical records of all patients with tracheostomy over a period of ten years (2002-2011), using the Theatre, Ward, ICU and the emergency register after approval from the ethical review committee. Data retrieved included; demographic profile, primary diagnosis, indication for tracheostomy, surgical technique, hospital admission and care outcome of management. All information retrieved input and analysed using an SPSS version 17.0 and data analyzed descriptively. Results: Seventy-six patients had complete data for analysis, age range from 1-89yrs, and mean age of 41.9yrs. There are 48males and 28 females with M:F ratio of 1.6:1. Majority of the patients were in the 3rd­5th decade. About 47.4% had temporary tracheostomy. The commonest indication for tracheostomy is upper airway obstruction secondary to aerodigestive tract tumors in 60.5%, then trauma in 26.3%. The complications are higher among the under tens'. Out of the 36 temporary tracheostomy only 18 were successfully decannulated. The mean hospital stay was 22±2days. Overall 15% mortality was recorded. Conclusion: Common reason for tracheostomy is essentially same earlier documentation in developing countries, common among males, emergency type still most common, neoplasm, prolonged intubation and trauma are the commonest indications, its complication is still high among the under tens'. The outcome is good with 15% mortality due to the primary disease and not from tracheostomy

Estimation of staute from toe lengths: an evaluation of the Hausa population in Nigeria using linear modeling

Background: Statue determination has remained a basic requirement in determining human identity and ethnicity. Usually in situations when whole anatomical structures are unavailable, forensic expert would be expected to rely on smaller structures such as the phalanges, patella ribs and other fragmentary bones. Aim: The present study evaluates toe anthropometry and its usability as predictors of the stature of the Hausa ethnic group in Nigeria. Methods: Six hundred and sixty four (664) subjects comprising of equal percentage of adult males and females were included in the study group. Toe lengths of both feet (coded as big toe or first toe [1T] to the fifth toes [5T]) were measured using a digital Vernier calliper with accuracy of 0.01mm while stature was taken using a stadiometer with accuracy of 0.1m. SPSS (IBM®) t-test was to evaluate gender difference in the measured dimensions; while SPSS and XLSTAT (2015) Automatic & Generalized Linear Modelling were used to determine the predictability of stature from the toe lengths. The significance level was set at 95% as P ≤ 0.05 was considered significant. Results: The automatic (multiple) regression analysis showed that the males displayed significantly higher mean values than the females for all measured parameters (P<0.001). The general population regression formulae were derived and only three (3) variables (R2T, R5T and L3T) significant contributors to the models for stature prediction for the general Gp (R2=0.385, F[3, 660]=137.68, P<0.001) and female F (R2=0.137, F[3, 328]=17.367, P<0.001) population, while only the L.1T could predict male M stature (R2=0.139, F[1, 330] = 54.489, P<0.001). Single regression gender-specific formulae were derived for the measurements that provided significant R2 values. Conclusion: This study suggested that estimation of a stature of Hausa ethnic group could be made possible by using specific toe measurements. However, lengths of toe may not be so reliable in the estimation of stature, but could be used for sex discrimination in forensic investigation

A Cross-sectional Survey of the Willingness of Tertiary Hospital Staff to Donate Blood in Sagamu, Nigeria

Background: Available donor blood rarely meets the demand in sub-Saharan Africa due to obstacles to blood donation. Willingness to donate blood is adjudged an important step to the actual practice of donating blood.Objective: To assess the willingness of the members of staff of the hospital to donate blood and determine factors affecting their willingness or otherwise.Methods: This was a descriptive cross-sectional study. A proportional allocation of participants was carried out at the various departments in the hospital using self-administered questionnaire. Results: Overall, 183 (73%) of the 246 respondents expressed willingness to donate blood, 111(45%) of whom have been asked to donate blood in the past. Only 91(37%) had donated blood in the past. Significantly higher proportion of health staff showed the willingness to donate blood generally and voluntarily compared to non-health staff. Significantly higher proportion of respondents with tertiary education showed the willingness to donate blood. Two hundred and eighteen (88.8%) were willing to donate blood to help the patient in need while fear of exposure to HIV infection, needle prick and dizziness constituted the major factors discouraging blood donation (19.9%, 18.7% and 18.3% respectively.Conclusion: Willingness to donate blood was mostly based on the primordial motivation of helping the patient in need which does not translate to blood donation. There is a need to improve awareness and advocacy on blood donation among hospital staff and the general population

Antibiotic Resistance Profile and Phenotypic Detection of Beta-Lactamase-producers among Gram-negative Bacteria Isolated from the Gut of Household Cockroaches in and around University of Ibadan

Background: Cockroaches are carriers of numerous microorganisms. However, there is paucity of information on their role as potential reservoir for beta-lactamase producers.Objectives: This research determined the antibiotics susceptibility profile of Beta-lactamase producing Gram-negative bacteria isolated from the gut of household cockroaches in selected locations in and around University of Ibadan, Oyo state.Materials and Methods: Thirty Cockroaches from different locations in and around University of Ibadan were collected between June 2015 and March, 2016, and their intestinal homogenates cultured on different selective media for the isolation of bacteria. The isolates were identified using a combination of biochemical tests and 16S rRNA sequencing. Antibiotic susceptibility testing was done using the disc-diffusion technique and phenotypic detection of extended-spectrum beta-lactamase (ESBL), AmpC-beta-lactamase (AmpC) and Metallo-beta-lactamase (MBL) production was done using double-disc synergy, cefoxitin/cloxacillin and imipenem/EDTA double-disc methods respectively.Results: A total number of 58 bacteria belonging to nine genera; Pseudomonas, Proteus, Klebsiella, Salmonella, Enterobacter, Escherichia, Serratia, Shigella and Raoultella were isolated. Higher percentage of the isolates exhibited resistance to erythromycin (90%), azithromycin (87.5%), amoxicillin (84.5%), ampicillin (74.1%), amoxicillin-clavulanic acid (74.1%), cefoxitin (67.2%) and chloramphenicol (54%), while lower percentage showed resistance to aztreonam (25%), ertapenem (13%), cefotaxime (8.6%), ceftazidime (10.3%), cefepime (5.2%), ciprofloxacin (3.5%), gentamicin (5.2%) and imipenem (0%). MDR phenotype was recorded among 82% of the isolates, 17.2% were positive for ESBL, 12% for AmpC and 13.8% for MBL production.Conclusion: This study identified household cockroaches Periplaneta americana, as a potential reservoir for MDR and beta-lactamase-producing isolates

Bioactive constituents and antibacterial screening of two nigerian plant extracts against selected clinical bacteria

Background: The growing desires to combat antibiotic resistance among pathogenic bacteria necessitate the need to search for new antimicrobials agents from other sources such as plants.Objectives: The present study investigated the antibacterial activities and bioactive components of Nymphaea lotus and Spondias mombin against selected clinical bacteria.Material and Methods: Extracts of N. lotus and S. mombin were prepared by 72 hours maceration in 70% methanol. The antimicrobial susceptibility testing (AST) of Escherichia coli, Klebsiella pneumoniae, Enterobacter aerogenes, Salmonella typhi, Staphylococcus aureus, Citrobacter freundi and, Klebsiella oxytoca against the two extracts was carried out by disk diffusion method while minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) was by agar-well dilution and broth dilution method, respectively. The bioactive compounds of the plants were identified by Gas Chromatography-Mass Spectrometry (GC-MS) analysis.Results: Extracts of N. lotus showed better antimicrobial activities than S. mombin against all the clinical bacterial isolates with an MIC range of 3.13 ­ >12.5mg/mL compared to S. mombin with MIC range of 6.25 ­ >12.5mg/mL. The GC-MS results revealed the presence of 21 and 25 compounds for N. lotus and S. mombin respectively. Benzoic acid derivatives were in abundance in both plants with approximately 71.5% and 82.1% in N. lotus and S. mombin respectively.Conclusions: The findings from this study provided further evidence on their ethno-botanical claims and additional information on the potentials of the studied plants as effective medicinal plants with antimicrobial activity against clinical bacteria. This highlights the need for continuous exploration of medicinal plants for novel compounds with better antimicrobial property as option for the treatment of resistant bacterial infection

Prevalence of dermatophytosis among primary school children in Oke-Oyi community of Kwara state

Background: Dermatophytic infections have been known to impact negatively on health and well-being of children. This study was undertaken to determine the prevalence; clinical types as well as the etiologic organisms of dermatophyte infection among primary school children aged 5-16 years in Oke-Oyi community in Kwara state. Materials and Methods: A 4-months descriptive cross-sectional survey was carried out among 602 children aged 5-16 years in Oke-Oyi community; in Kwara state. Results: The prevalence of clinically suspected dermatophytoses lesion was 29.9(180/602). Dermatophyte accounted for 5.0(30/602) on Sabouraud dextrose agar culture; while non-dermatophyte molds represent majority of isolate i.e.; 15.4(93/602). Tinea capitis is the commonest clinical type; followed by Tinea coporis and then Tinea pedis. Multiple infections are noted in nine respondents. Three species of dermatophytes belonging to only two of the three genera of dermatophytes were responsible for human infection in the area studied; of which Trichophyton mentagrophyte is the commonest; followed by Microsporum audouinii and Trichophyton verucossum. Among the non-dermatophytes; Aspergillus fumigatus and Candida albicans predominate. Conclusion: This study demonstrates that the prevalence of dermatophytoses in the school studied was significant. Control efforts should target this vulnerable group to reduce its prevalence

A survey of facial nerve dessection techniques in benign parotid surgery among maxillofacial and ear, nose, and throat surgeons in Nigeria

Objective: The aim of the present study is to identify the facial nerve dissection technique routinely used during parotidectomy for benign parotid tumors by Nigerian Oral and Maxillofacial (OMF) and Ear; Nose; and Throat (ENT) Surgeons. Materials and Methods: A questionnaire-based study was conducted among Oral and Maxillofacial and Ear; Nose; and Throat Surgeons in Nigeria; on their experience with antegrade and retrograde facial nerve dissection techniques in parotid surgery. The respondents were asked to indicate their choice of dissection techniques in revision parotidectomy; limited superficial parotidectomy; and in obese patients with large tumors. They were also asked to indicate if they routinely used perioperative facial nerve monitoring devices in parotid surgery for benign tumors. Result: About half (47.5) of them routinely used the antegrade technique; while only a few (12.5) used the retrograde technique. A large number of them (40); however; used a combination of antegrade and retrograde routinely. Technical ease was the main reason for the choice of technique. The antegrade technique was the technique of choice by most respondents for revision parotidectomy (60) and limited superficial parotidectomy (62). However; the retrograde approach was the technique of choice by most of them (47) in case of parotidectomy in obese patients with large tumors. The routine use of perioperative facial nerve monitoring devices is an uncommon practice among OMF and ENT surgeons in Nigeria. Conclusions: The antegrade approach for facial nerve dissection is the most common technique used in parotid surgery by Nigerian OMF and ENT surgeons. Nigerian surgeons need to consider the retrograde approach in selected cases of parotid surgery especially for localized tumors that are amenable to limited superficial parotidectomy. Inclusion of perioperative facial nerve monitoring devices is also advocated

Knowledge of Human Immunodeficiency Virus Post-Exposure Prophylaxis among Doctors in a Nigerian Tertiary Hospital

Background: The mainstay of prevention of occupationally-acquired HIV infection is compliance with universal precautions. Appropriate post-exposure prophylaxis is an integral part of prevention; control and workplace safety. This study was undertaken to assess the level of knowledge of post-exposure prophylaxis (PEP) against human immunodeficiency virus (HIV) among doctors in Federal Medical Centre; Gombe; Nigeria. Materials and Methods: Ethical committee approval for the conduct of the study was obtained. Questionnaires were served to all cadres of doctors from house officers to consultants; it was completed and returned on anonymous basis. Results: Sixty six (88.0) of the 75 distributed questionnaires were returned completed and formed the basis of further analysis. The overall knowledge level of post-exposure prophylaxis against human immunodeficiency virus infection was very low. About 62.1are aware of the existence of PEP policy in the hospital. The level of knowledge concerning the high-risk fluid and three drugs used in PEP is high. Over 90are not aware of the risk of sero-conversion following significant needle-sticks injury and mucous membrane exposure. The study also revealed poor knowledge concerning actions to be taken; how soon to commence the PEP treatment and the duration of medication following needle stick injury. More than 50of the surveyed doctors had experienced significant exposure to potentially infective materials and none reported or sought PEP advice. Conclusion: There is the need to educate the doctors and other health workers about the PEP guideline policy; what to do in the event of injury; whom to contact and the importance of seeking urgent advice following injury or exposure

Clinico-Pathological Pattern of Nasopharyngeal Carcinoma in Ilorin, Nigeria

Nasopharyngeal carcinoma is an uncommon tumour in Nigeria but the burden of the disease in terms of morbidity and mortality is very high. The aim of the study was to document the clinic-pathological characteristics of nasopharyngeal carcinoma in Ilorin, North central Nigeria. This was a retrospective review of all patients seen in ENT department, University of Ilorin Teaching Hospital with the diagnosis of nasopharyngeal carcinoma between January 1st 1999 and December 31st,2008. The patient's biodata, clinical presentation and histopathological findings are presented. The histopathological diagnosis was in accordance with the 1991 WHO classification. A total of 30 patients with histologically confirmed nasopharyngeal carcinoma seen during the study period accounted for 2% of the total cancers recorded in Ilorin cancer registry. There were 20 males and 10 females with a mean age of 48.7 ± 15.9 years. The commonest presenting complaint was cervical lymphadenopathy in 96.7% of patients followed by epistaxis (66.7%) and hearing loss (66.7%). Identifiable risk factors included regular intake of ungutted salted smoked fish (76.7%) and tobacco use (23.3%) with some having both risk factors. Histologically, undifferentiated carcinoma was the commonest (70%) followed by welldifferentiated keratinizing squamous cell carcinoma (20%) and differentiated nonkeratinizing squamous cell carcinoma (10%).Undifferentiated carcinoma was the commonest type of nasopharyngeal carcinoma reported from this study especially among males in the 4th and 5th decades of life. Identifiable risk factors included consumption of ungutted salted smoked fish with tobaccon usage. Early diagnosis with effective referral system and easy access to radiotherapy would improve the survival outcome in patients with the disease

A etiological profile of nasal trauma in Ilorin North-Central Nigeria

The nose being the most prominent part of the face is easily traumatized in facial injuries and these has been found to be common among the Caucasians compared to the Africans and Asians. The aim is to ighlight the Aetiological profile of nasal trauma in Ilorin orth-central Nigeria. Method: A prospective study was carried out at the University of Ilorin Teaching Hospital Ilorin; Ilorin; north central Nigeria over a period of one and half years of all trauma cases seen at the A/E department of the hospital and those with nasal trauma were further studied. The data retrieved include demographic data; clinical presentation; and timing of presentation; examination findings; intervention offered and the outcome. Data were entered into SPSS 11.0 and analyzed descriptively. Results : A total of one hundred and six (106) patients with nasal trauma were seen during the study period with a prevalence rate of 7. The age range 6months to 65years with the majority of the patients in the age range 21-34 years (35.8). The Male to female ratio was 1.7:1.0 and most patients were students ( 28.3); followed by the traders ( 22.6) the least were children (8.5).Road traffic injury (RTI) constituted the highest cause of the nasal trauma ( 57.5);assaults (17);falls from heights ( 8.5) and others were 17.Majority of the patients presented within 1-6hours of occurrence of the injury (61.3) and only 24.5presented less than an hour of the incidence. The common forms of presentation were epistaxis (40.6); nasal lacerations and epistaxis (25.5) and nasal fractures in only 10.4.Involvement of both the passengers and the pedestrians was (57.5) and most of them; 44.3had surgical intervention and 40.6had conservative treatment with a mortality rate of 0.9. Conclusions: The prevalence of nasal trauma is 7with RTI being the commonest cause in nearly two thirds of cases and cases of assaults only accounted for 17.The commonest forms of presentation were epistaxis;nasal lacerations and nasal fractures in that order and most of them were surgically treated. Measures should be adopted to reduce incidence of RTI; with regulations enforced to protect pedestrians most of whom were the victims of these injuries