Comparative Analysis of the Impact of Visual Impairment on Quality of Life of Patients Attending a Tertiary Hospital in South East, Nigeria.

BACKGROUND: Quality of life (QoL) is defined as an "individual's perception of their position in life in the context of the culture and value system in which they live and in relation to goals, expectations, standards, and concerns." Visual Impairment affects QoL because of the restrictions it imposes on everyday life activities. AIMS: This study aims to compare the QoL of visually impaired patients attending the Eye Clinic of Federal Medical Centre, Owerri with that of normally sighted persons. The findings will aid the formulation of policies guiding the management of visually impaired patients. PATIENTS AND METHODS: This was a hospital-based case-control study which recruited all consenting new patients with visual impairment, and age, and sex-matched controls who presented at the Eye Clinic, Federal Medical Centre, Imo State, Nigeria during the period of the study. Data was collected using a semi-structured closed-ended questionnaire, and the World Health Organization QoL-BREF and analyzed with the Statistical Package for Social Science version 22. RESULTS: Four hundred and two participants were recruited. Lower scores were recorded in all the quality of life (QoL) domains for the visually impaired compared with controls. The overall QoL and health status mean score for the visually impaired (61.10 ± 19.75) was significantly lower than that for the controls (70.90 ± 21.19) at P < 0.001. Severity of visual impairment at P < 0.001 significantly affected all the QoL domains for the visually impaired with the lowest score noted among the blind (58.21 ± 11.63) compared to controls (79.33 ± 11.74). Occupation and educational level significantly affected the QoL of the study group but not the controls. CONCLUSION: Visual impairment significantly reduces the QOL of patients. Policies targeted at enhancing the QoL of the visually impaired through rehabilitation and societal integration is recommended.

Knowledge, Attitudes, and Practices towards COVID-19 Transmission and Preventive Measures among Residents of Nigeria: A Population-Based Survey through Social Media.

BACKGROUND: COVID-19 was declared a pandemic by the World Health Organization (WHO) on 11th March 2020. Individuals with correct understanding about the risks and severity of the disease are more likely to respond positively and practice recommended preventive measures. OBJECTIVES: To assess the knowledge, attitudes, and practices towards COVID-19 transmission and preventive measures among residents of Nigeria. METHODS: The study was cross-sectional and involved 469 participants from 1st July to 31st August 2020. A 36-item questionnaire with Cronbach alpha of 0.753 was adapted and administered through an online survey tool. A snowball sampling approach was employed whereby the questionnaire link was distributed through social media networks including WhatsApp©, Facebook© and Instagram©. Data was analysed using SPSS 23 and a statistical significance level of 0.05 was used. Bivariate and multivariate analysis were employed to determine factors affecting the knowledge, attitude and practices towards COVID-19 transmission and prevention. RESULTS: The mean age of participants was 39±11.29years. Majority (54%) of the participants heard about COVID-19 through mass and social media. The study found that 71.6% of the participants had good knowledge, just 31.3% had a good attitude while 84.9% of them had good practices towards COVID-19 in Nigeria. The high rates of the knowledge and practices were driven by income, age, education and marital status. CONCLUSIONS: Majority of the study participants showed correct knowledge and adhered to recommended practices towards COVID- 19. However, there were gaps in the understanding of the underlying realities and beliefs in certain myths about COVID-19. Hence, interventions such as jingles and posters in various languages that would serve to correct the negative perceptions and myths about COVID-19 instituted through mass media and social media are recommended.

L'ARRIERE PLAN: Le COVID-19 a été déclaré pandémie par l'Organisation mondiale de la santé (OMS) le 11 mars 2020. Les personnes ayant une compréhension correcte des risques et de la gravité de la maladie sont plus susceptibles de réagir positivement et de pratiquer les mesures préventives recommandées. OBJECTIF: Évaluer les connaissances, les attitudes et les pratiques vis-à-vis de la transmission du COVID-19 et les mesures préventives parmi les résidents du Nigéria. MÉTHODES: L'étude était transversale et impliquait 469 participants du 1er juillet au 31 août 2020. Un questionnaire de 36 items avec Cronbach alpha de 0,753 a été adapté et administré via un outil d'enquête en ligne. Une approche d'échantillonnage en boule de neige a été utilisée dans laquelle le lien du questionnaire a été distribué via les réseaux de médias sociaux, notamment WhatsApp ©, Facebook © et Instagram ©. Les données ont été analysées à l'aide de SPSS 23 et un niveau de signification statistique de 0,05 a été utilisé. Des analyses bivariées et multivariées ont été utilisées pour déterminer les facteurs affectant les connaissances, l'attitude et les pratiques vis-à-vis de la transmission et de la prévention du COVID-19. RÉSULTATS: L'âge moyen des participants était de 39 ± 11,29 ans. La majorité (54%) des participants ont entendu parler du COVID-19 par le biais des médias de masse et sociaux. L'étude a révélé que 71,6% des participants avaient de bonnes connaissances, seulement 31,3% avaient une bonne attitude tandis que 84,9% d'entre eux avaient de bonnes pratiques à l'égard du COVID-19 au Nigéria. Les taux élevés de connaissances et de pratiques étaient attribuables au revenu, à l'âge, à l'éducation et à l'état matrimonial. CONCLUSIONS: La majorité des participants à l'étude ont montré des connaissances correctes et ont adhéré aux pratiques recommandées à l'égard du COVID-19. Cependant, il y avait des lacunes dans la compréhension des réalités et des croyances sous-jacentes à certains mythes sur le COVID-19. Par conséquent, des interventions telles que des jingles et des affiches dans diverses langues qui serviraient à corriger les perceptions négatives et les mythes sur le COVID-19 devraient être instituées par le biais des médias de masse et des médias sociaux. MOTS CLÉS: COVID-19, virus Corona, connaissances, attitude, pratiques, prévention, Nigéria.

ORTHODONTIC NEEDS OF PATIENTS WITH CLEFT LIP AND PALATE IN ENUGU, FIVE YEARS POST REPAIR.

BACKGROUND: Orthodontists play an integral role in the management of cleft lip and palate anomaly. This study looks at the frequency of anomalies amenable to orthodontics in patients who have had surgery and the effect of early or late surgical intervention. METHODOLOGY: Patients aged 0-5 years with cleft of the lip and/or palate who were operated on by the plastic surgeon at the Good Shepherd Specialist Hospital, Enugu between 1st July 2011 and 30th June 2014, were recalled after a minimum of five years post-surgery and examined to determine the absence or presence of dental anomalies, amenable to orthodontic treatment, which have arisen since surgical repair. Descriptive statistics and t-test were used for data analysis and significance was at 0.05. RESULTS: Thirty-one children were operated upon in the period under review. Seventeen had timely (three months or less) lip repair. Seven had timely palate repair (18 months or less). Thirteen patients were successfully recalled, 12 had cleft lip repair while one had cleft palate repair. Repair was timely in 10 (83.3%) of the 12 that had lip repair with a mean frequency of four dental anomalies, while the two (16.7%) that had late repair had a mean frequency of five dental anomalies and this was not statistically significant (P value=0.711). The only isolated cleft palate patient successfully recalled had a late repair. All 13 patients had at least four dental anomalies amenable to orthodontics. Hypoplastic maxilla were the most commonly occurring (eight patients, 61.54%) dental anomaly amenable to orthodontic treatment. None of the patients had a clinically visible supernumerary tooth. Out of 13 patients reviewed, sis were males with a mean frequency of four dental anomalies while seven were females, also with a mean frequency of four dental anomalies. This was not significant (P-value=0.553). CONCLUSION: There is need for the long term Orthodontic follow up of cleft lip and palate patients. The orthodontic management of dental anomaly should, therefore, be central in the planning and treatment of patients with cleft lip and palate.

Determinants and Rate of Self-Disclosure of Human Immunodeficiency Virus Sero-Status among People Living with Hiv/Aids Attending Antiretroviral Therapy Clinic of a Tertiary Hospital in North Central Nigeria.

BACKGROUND AND OBJECTIVE: Disclosure of human immuno-deficiency virus (HIV) sero-status is a difficult process that involves communication of information about a potentially stigmatizing and transmissible illness. Despite this, it is important for preventing HIV infection and mitigating its impacts. This study aimed to assess the rate and determinants of self-disclosure of HIV sero-status among people living with HIV/AIDS (PLHIV) attending an Antiretroviral Therapy (ART) Clinic in North Central Nigeria with a view to promoting self- disclosure as an intervention for secondary prevention of HIV/AIDS. METHODS: It was a cross-sectional study involving 325 consenting adults aged 18 to 65 years PLHIV attending ART clinic who were recruited using systematic random sampling method. Data collected from the participants include socio-demographic data and medical history. The rate and factors affecting self-disclosure of HIV sero-status were obtained by using a structured interviewer-administered questionnaire. Data was analysed using Statistical Package for Social Sciences (SPSS) version 20.0 Results: Most of the participants (66.2%) were females. 96% of the participants had disclosed their HIV sero-status. Self-disclosure of HIV sero-status had statistically significant association with age (c2 = 12.614; p = 0.027) and gender (c2 = 4.638; p = 0.031). CONCLUSION: Self-disclosure of HIV sero-status was high among the participants. Being female and within 15-44 year age group were statistically significant factors associated with disclosure of HIV sero-status. Multiple counselling sessions are needed to improve disclosure particularly in males and older PLHIV as self-disclosure of HIV sero-status is a process that requires ongoing support and encouragement.

Low Levels of some Nutritional Parameters of Pregnant Women in a Rural Community of South East Nigeria: Implications for the Attainment of the Millennium Developmental Goal

In developing countries; under nutrition is common; and this plays a crucial role in the pathogenesis of malaria and anemia. Indeed it has been associated with adverse pregnancy outcomes. Unfortunately; published evidence concerning the situation is lacking. Objectives: To evaluate some nutritional function indices of pregnant women in a rural Nigerian community. Subjects and Methods: This is a cross sectional study involving of 171 pregnant women from a rural area in South-eastern Nigeria. They included 72 and 99 women in their second and third trimesters respectively. The control group was of 60 women; matched in age; parity and socioeconomic conditions; non-pregnant; non-menstruating and non lactating apparently healthy women. The parameters measured by standard methods included serum iron; total proteins; albumin; globulin; packed cell volume and hemoglobin. Results: The results obtained from control group; second and third trimesters; recorded as Mean (SEM) were 134.60(3.12) ?g/L; 101.20(4.48) ?g/L and 91.87(3.42) ?g/L respectively for iron; 69.12(0.80) g/L; 63.60(0.71) g/L and 57.74(0.75) g/L for total proteins; 42.95(0.92) g/L; 35.74(1.00) g/L and 35.26(0.64) g/L for albumin; 26.77(1.00) g/L; 27.78(1.07) g/L and 22.93(0.88) g/L for globulin; 32.80(0.36); 27.92(0.37) and 27.73(0.34) for packed cell volume; and 11.25(0.11) g/L; 9.59(0.13) g/L and 9.57(0.14) g/L for hemoglobin respectively. These results showed that all the parameters decreased significantly in pregnancy (P0.001) except globulin that did not show immediate; significant decrease. Conclusion: There is a general decrease in the nutrition parameters studied among the pregnant women from our study area; indicating under-nutrition. Urgent measures should be taken to improve the nutritional status of rural dwellers especially the antioxidant micronutrients

A Retrospective Evaluation of the Class of Malocclusion amongst Orthodontic Patients at the University Of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria.

OBJECTIVES: The aim of this study was to evaluate the type of malocclusion amongst orthodontic patients in the UNTH. METHODS: A retrospective evaluation of patients who attended the Orthodontic unit of the University of Nigeria Teaching Hospital from January 2008 to January 2010 was carried out to determine the type of malocclusion. Demographic dat a of the patients and information on first molar relationship were obtained from the patient's record file. RESULTS: A total of 75 patients, 21 males (28%) and 54 females (72%) were seen. The age range of the patients studied was 6 to 63years with the most frequent age group being 6 to 15 years, consisting 52.1% of the total patients seen. Class 1 molar relationship was the most prevalent occurring in 60% of the cases. CONCLUSION: There were more females who attended the Orthodontic unit within this 2 year period. Class 1 malocclusion was the most common type of malocclusion.

Bicalutamide vs cyproterone acetate in preventing flare with LHRH analogue therapy for prostate cancer--a pilot study.

OBJECTIVE: To evaluate the efficacy of bicalutamide vs cyproterone acetate in preventing PSA flare (as a surrogate for tumour flare) for patients requiring luteinizing hormone-releasing hormone (LHRH) analogue therapy for prostate cancer. PATIENTS AND METHODS: In this pilot study, 40 men were randomized 1 : 1 to bicalutamide 50 mg o.d. or cyproterone acetate 100 mg t.i.d. 5 days prior to goserelin acetate and continued for 21 days thereafter. PSA, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone were obtained before treatment and on days 6, 8, 10, 16, 21 and 28. Primary end point was PSA. Hormone profile and clinical features including urinary symptoms and bone pain were secondary end points. RESULTS: Both groups were equally matched apart from serum creatinine and ALP. The speed and magnitude of the percentage change in median PSA from baseline was increased for the CPA group but there was no statistically significant difference in the two groups. Although those receiving bicalutamide all showed a testosterone peak, this remained within the normal range. No difference in the frequency of drug-specific adverse events was found. None of the patients died or developed cord compression during the study period. CONCLUSION: Bicalutamide is able to suppress the initial PSA surge as effectively as cyproterone acetate albeit slightly delayed. A statement whether bicalutamide is equally good at preventing clinical flare cannot be made and should be assessed in an appropriately powered study.

Contemporary update of cancer control after radical prostatectomy in the UK.

Despite a significant increase of the number of radical prostatectomies (RPs) to treat organ-confined prostate cancer, there is very limited documentation of its oncological outcome in the UK. Pathological stage distribution and changes of outcome have not been audited on a consistent basis. We present the results of a multicentre review of postoperative predictive variables and prostatic-specific antigen (PSA) recurrence after RP for clinically organ-confined disease. In all, 854 patient's notes were audited for staging parameters and follow-up data obtained. Patients with neoadjuvant and adjuvant treatment as well as patients with incomplete data and follow-up were excluded. Median follow-up was 52 months for the remaining 705 patients. The median PSA was 10 ng ml(-1). A large migration towards lower PSA and stage was seen. This translated into improved PSA survival rates. Overall Kaplan-Meier PSA recurrence-free survival probability at 1, 3, 5 and 8 years was 0.83, 0.69, 0.60 and 0.48, respectively. The 5-year PSA recurrence-free survival probability for PSA ranges <4, 4.1-10, 10.1-20 and >20 ng ml(-1) was 0.82, 0.73, 0.59 and 0.20, respectively (log rank, P<0.0001). PSA recurrence-free survival probabilities for pathological Gleason grade 2-4, 5 and 6, 7 and 8-10 at 5 years were 0.84, 0.66, 0.55 and 0.21, respectively (log rank, P<0.0001). Similarly, 5-year PSA recurrence-free survival probabilities for pathological stages T2a, T2b, T3a, T3b and T4 were 0.82, 0.78, 0.48, 0.23 and 0.12, respectively (log rank, P=0.0012). Oncological outcome after RP has improved over time in the UK. PSA recurrence-free survival estimates are less optimistic compared to quoted survival figures in the literature. Survival figures based on pathological stage and Gleason grade may serve to counsel patients postoperatively and to stratify patients better for adjuvant treatment.

Case selection for radical prostatectomy in the UK.

INTRODUCTION: Radical prostatectomy is an increasingly popular treatment option for clinically localised prostate cancer, yet PSA outcome figures are rare in the UK. This makes it difficult to establish appropriate criteria for case selection. We conducted an audit of PSA recurrence of 5 large centres in the south of England and investigated the use of pre-operative PSA to improve case selection and outcome. METHOD: 854 patients notes were audited for pre-operative staging parameters and follow-up data obtained. Patients with neoadjuvant and adjuvant treatment as well as patients with incomplete data and follow-up were excluded. RESULT: Median follow-up was 52 months for the remaining 663 patients. Median PSA was 10 ng/ml. A large improvement of PSA recurrence free survival rates was observed from 1988 to 1998 as a result of change in case selection and stage migration. Overall Kaplan-Meier PSA recurrence free survival probability at 1, 3, 5 and 8 years was 0.83, 0.69, 0.60 and 0.48, respectively. Five-year PSA recurrence free survival probability for PSA ranges <4 ng/ml, 4.1-10 ng/ml, 10.1-20 ng/ml and >20 ng/ml was 0.82, 0.73, 0.59 and 0.20, respectively (Wilcoxon, p < 0.0001). A simulation of biochemical recurrence free survival for patient cohorts with stepwise reduced inclusion PSAs suggests an improved outcome for patients with a pre-operative inclusion PSA of <12 ng/ml. Further reduction of the inclusion PSA does not improve outcome. CONCLUSION: Intermediate PSA recurrence free survival has improved over time in England. PSA recurrence free survival estimates are less optimistic compared to frequently quoted American figures. A reduced pre-operative PSA cut-off for case selection may be used to improve outcome.

Time trends in case selection, stage and prostate-specific antigen recurrence after radical prostatectomy: a multicentre audit.

OBJECTIVES: To report an audit of preoperative staging variables, case selection, stage migration and prostate-specific antigen (PSA) recurrence at five large centres in the south of England. To establish PSA outcome values after radical prostatectomy for clinically localized prostate cancer in the UK, and enable appropriate patient counselling. PATIENTS AND METHODS: The notes of 854 patients were audited for preoperative staging variables and follow-up data obtained. Patients with neoadjuvant and adjuvant treatment, and with incomplete data and follow-up, were excluded. RESULTS: The median follow-up was 52 months for the remaining 663 patients; the median PSA level was 10 ng/mL. There was a large migration towards lower PSA and stage; this translated into improved PSA survival rates. The overall Kaplan-Meier PSA recurrence-free survival probability at 1, 3, 5 and 8 years was 0.83, 0.69, 0.60 and 0.48, respectively. The 5-year PSA recurrence-free survival probabilities for PSA levels of < 4, 4.1-10, 10.1-20 and > 20 ng/mL were 0.82, 0.73, 0.59 and 0.20, respectively (Wilcoxon, P < 0.001). The PSA recurrence-free survival probabilities for biopsy Gleason grade 2-4, 5 and 6, 7 and 8-10 at 5 years were 0.70, 0.61, 0.55 and 0.21, respectively (Wilcoxon, P < 0.001). Similarly, the 5-year PSA recurrence-free survival probabilities for clinical stages T1a and 1b, T1c, T2a and T2b were 0.79, 0.62, 0.57 and 0.44, respectively (Wilcoxon, P = 0.0012). CONCLUSION: With better case selection the intermediate oncological outcome has improved over time in the UK. PSA recurrence-free survival estimates are less optimistic than the frequently quoted American values. The present values may be used to help in counselling British patients before radical prostatectomy.

Lymphoedema in urological cancer.

OBJECTIVES: To review the evidence underlying the diagnosis, pathology and treatment of lymphoedema of the lower extremities and genitalia from or following the treatment for urological cancer, and to suggest possible underlying pathophysiological mechanisms that may explain its development. METHODS: Reviews of the epidemiological, surgical, and scientific literature and personal experience of treatment of patients are used to build a picture of clinical setting and the physiological principles underlying lymphoedema of the leg. RESULTS: Lymphoedema of the leg and genitals results in serious morbidity for the patient. The incidence is largely unknown, but varies according to the type and location of tumours and may be up to 50% in advanced stages of penile carcinoma, or following its treatment. Although the aetiology of the condition is either iatrogenic, or associated with malignancy, the underlying pathophysiology is not well understood. CONCLUSIONS: Recent studies in breast cancer related lymphoedema point to underlying vascular as well as lymphatic problems, but the parallels with lower limb lymphoedema are not known.

A comparison of aspiration and sclerotherapy with laparoscopic de-roofing in the management of symptomatic simple renal cysts.

OBJECTIVES: To present the results of a minimally invasive treatment of symptomatic simple renal cysts, and to propose an algorithm for their management. PATIENTS AND METHODS: Seventeen patients presenting with suspected symptomatic simple renal cysts were referred for trial aspiration; 16 presented with loin pain and one with a flank mass. If the cyst and symptoms recurred after a temporary response, they were managed by re-aspiration with sclerotherapy using 95% ethanol, or by laparoscopic de-roofing of the cyst. RESULTS: Of the 17 patients referred, one failed to respond to aspiration and was excluded from further analysis. Three patients had sustained pain relief from simple aspiration alone, 13 required further treatment for symptom relapse, of whom six had aspiration and sclerotherapy, and seven had laparoscopic de-roofing. After a mean follow-up of 17 months, pain had recurred in all five patients originally presenting with pain and managed by sclerotherapy, and the patient who presented with a painless mass from a large cyst also developed pain after sclerotherapy. In contrast, the subsequent seven patients managed by laparoscopic treatment are pain-free at a mean follow-up of 17.7 months. CONCLUSION: Evaluation including a diagnostic aspiration is essential to diagnose a symptomatic cyst. When treatment is indicated, laparoscopic de-roofing appears to be more effective than sclerotherapy.

Prevalence of hypospadias abdominal and peno-scrotal abnormalities among primary school boys in a Nigeria community

Objectives To determine the prevalence of hypospadias; patent processus vaginalis; umbilical hernia; splenomegaly and cryptorchidism in primary school boys of a Nigerian community. Patients and Methods A community-based observational study using the cluster-sampling method was done. One thousand and ninety-six primary school boys aged between 5 and 13 years from five randomly selected schools in the administrative district of the Ogbaru Local Government Area (LGA) of Eastern Nigeria participated in this study; while in only 1080 boys some specific information on umbilical hernia was available. Each participant underwent a general; abdominal; groin and peno-scrotal physical examination. Results The prevalence of hypospadias was 1.1and this was equivalent to the incidence. The prevalence of a patent processus vaginalis was 1.0with an estimated incidence of 1.3. Cryptorchidism was present in 0.8and retractile testis in 3.2. The prevalence of umbilical hernia was 26and the splenomegaly rate was 7. Conclusion The incidence and prevalence of simple hypospadias was higher than previously suggested by a tertiary hospital-based report from Western Nigeria. Umbilical hernia was very common but apparently only few patients needed treatment. The incidence of a patent processus vaginalis was similar to that reported in other parts of the world; although surgical correction was delayed. Splenomegaly was common; not only due to endemic malaria; but also due to sickle-cell disease; with implications for the management of childhood trauma in this part of the world

Hand-assisted laparoscopic nephrectomy: complications related to the hand-port site.

OBJECTIVE: To evaluate the early results of hand-assisted radical nephrectomy and nephroureterectomy in our institution. PATIENTS AND METHODS: The records of 13 patients with malignant disease of the kidney who underwent hand-assisted laparoscopic radical nephrectomy and nephroureterectomy were reviewed retrospectively. Clinical outcomes were compared with a series of 16 patients who underwent similar procedures via a standard laparoscopic approach. RESULTS: There were three major hand-port wound complications in those who underwent hand-assisted procedures, while one other patient required conversion because of technical failure of the device. The operative duration, length of hospital stay, estimated blood loss, transfusion rate, analgesic requirement, conversion rates, and minor complications were similar between the hand-assisted and standard laparoscopy groups. CONCLUSION: There was little difference between hand-assisted and standard laparoscopy in operative duration or recovery, but there were problems with wound complications which may be related to the hand-assisted approach. We have consequently abandoned the technique in favour of a standard laparoscopic approach.

Characterization of urinary symptoms in patients with ureteral stents.

OBJECTIVES: To prospectively assess the prevalence and bother of various urinary tract symptoms caused by indwelling ureteral stents using validated questionnaires. METHODS: The study consisted of 60 patients with unilateral ureteral stents. Of these, 30 patients were asked to complete the International Prostate Symptoms Score questionnaire, with additional questions on dysuria, hematuria, and loin pain. The remaining 30 patients were asked to complete the International Continence Society questionnaire. These patients were also asked to complete frequency volume charts and undergo uroflowmetry studies. The questionnaires were completed with a stent in situ and 6 weeks after its removal. RESULTS: Forty-eight patients (36 men and 12 women, mean age 52.8 years) completed the study. A large proportion (80%) of patients reported one or more urinary symptoms. Analysis of the IPSS data revealed impaired global quality of life owing to these urinary symptoms. The responses to additional questions on dysuria and hematuria showed a statistically significant difference, but most International Prostate Symptoms Score questions did not. The results of the International Continence Society study identified storage symptoms, incontinence (60%), and bladder pain (80%) as important bothersome problems. The results of the frequency volume charts were in agreement with the storage symptoms. CONCLUSIONS: Patients with indwelling ureteral stents have a wide range of urinary symptoms that affect their quality of life. Storage symptoms, bladder pain, and hematuria pose a major bother. None of the existing questionnaires covered the entire range of symptoms. The results are useful in better understanding the urinary symptoms associated with stents and in providing patient counseling.

Prevalence and characteristics of cryptorchidism in a Nigerian district.

OBJECTIVE: To determine the prevalence and characteristics of cryptorchidism among primary schoolboys in a Nigerian district. SUBJECTS AND METHODS: The district selected had 35 primary schools with 23,342 pupils, consisting of 11,275 girls and 11,967 boys. Using a cluster-sampling technique, five primary schools were visited; 1096 boys (aged 5-13 years) participated in the study, giving a sampling ratio of 1:11. The boys underwent a clinical examination of the groin, scrotum and abdomen. RESULTS: Cryptorchidism was found in nine subjects, giving a prevalence rate of 0.82%. All the undescended testes were unilateral, of which five were right-sided. Eight of the testes were intracanalicular and one was at the external ring. There were no cases of orchidopexy. CONCLUSION: The prevalence of cryptorchidism among primary schoolboys in this district of Nigeria was high, at eight per 1000. Delayed diagnosis and treatment remains a problem because of the prevailing socio-economic factors. However, the incidence of cryptorchidism was similar to that reported in other parts of the world.

Ethanol-glycine irrigating fluid for transurethral resection of the prostate in practice.

OBJECTIVE: To evaluate the usefulness of a tracer of 1% ethanol in 1. 5% glycine in the early detection of irrigation fluid absorption during transurethral resection of the prostate (TURP). PATIENTS AND METHODS: Patients (120) undergoing TURP were irrigated with 1% ethanol in 1.5% glycine solution and their expired air tested for alcohol every 10 min during the procedure. RESULTS: In all, 112 patients were assessed; over half of the patients absorbed the irrigation fluid and they had a significantly lower postoperative serum sodium concentration (P < 0.002). Fourteen patients (12.5%) absorbed over 500 mL and two (1.8%) developed clinical features of the TUR syndrome. The experience of the surgeon, the weight of resected chips and the operative duration were not significantly predictive of absorption. CONCLUSION: A tracer amount of ethanol in the irrigant is reliable for detecting absorption. Irrigating fluid absorption was unpredictable, thus supporting the case for routine monitoring.

Distribution of ABO and RH genes in Nigeria.

Phenotype and gene frequencies of ABO and RH (D) systems were studied in 37,846 random blood donors in five zone of Nigeria (South West) (Yoruba)--Zone A, North West (Hausa-Fulani)--Zone B, Plateau (Birom)--Zone C, South East (Igbo)--Zone D and North East (Kanuri)--Zone E). We assessed the micro differences of genetic markers of ABO and RH blood groups between the ethnic groups in the ABO and RH blood group systems. Gene frequencies were ABO *O = 0.7068, ABO *A = 0.1490, ABO *B = 0.1443, RH *D = 0.8150 and results are similar to those earlier reported. Phenotype frequencies of the blood groups were in agreement with Hardy-Weinberg equilibrium expectations, except in two zones B and C where deviation was thought to be due to a high frequency of blood group AB.

Contraception in teenage Nigerian school girls.

Contraception is reviewed in 314 teenage Nigerian school girls comprising 128 students at secondary and 186 at tertiary levels of institution. Out of all the teenagers, 26.8% were sexually exposed, among whom there was a total pregnancy rate of 19.05%. The rate of sexual exposure was higher in teenagers from tertiary institutions, 38.7% compared with 9.4% from secondary institutions. However, the pregnancy rate was higher among the sexually exposed secondary school girls, 33% vs. 16.7% for tertiary school girls. The mean level of contraceptive awareness for the various methods of contraception was 38.2% for the entire survey group: 22.6% for the secondary school girls and 54.4% for the tertiary school girls. Mean true contraceptive usage (TCU) among sexually active students, on the other hand, was 17.7%: 5% and 16.5% for the secondary school girls and tertiary school girls, respectively. The source of information on contraception for the study group was highest from 'a friend' (37.3%) and from the 'newsprint' (36.9%) and was lowest from routine 'lectures and sex instructions' (9.2%). Twenty-five point five per cent of the entire study group, 43% of the secondary school girls and 13.4% of the tertiary school girls, had never had any information on contraception. Instruction on contraception, as part of the academic curricula at the primary, secondary and tertiary levels of education, would improve contraceptive knowledge and forestall the emotional and social problems resulting from unwanted teenage pregnancies.