Serial pathologic fractures of five long bones on four separate occasions in a patient with primary hyperparathyroidism, challenges of management in a developing country: a case report.

Multiple pathologic fractures secondary to parathyroid adenoma is rarely recognized and reported in the tropics. Inadequate evaluation causes worsened disability and increased psychological stress. We present a 27-year-old Nigerian male student with recurrent unexplained pathological fractures of the long bones. Primary Hyperparathyroidism was later diagnosed and he benefited from a unilateral parathyroidectomy. Primary hyperparathyroidism secondary to parathyroid adenoma is difficult to diagnose and needs a high index of suspicion. Surgery and good post-operative biochemical control of serum calcium produce satisfying outcomes.

Awareness and use of insecticide treated nets among women attending ante-natal clinic in a northern state of Nigeria.

OBJECTIVE: To determine the awareness, accessibility and use of ITN by pregnant women attending ante-natal clinic (ANC) at the Primary Health Care (PHC) level considering the Government commitment of ensuring that at least 60% of pregnant women benefit from ITN by year 2010. METHODS: This descriptive cross sectional study was carried out in all 78 PHC centres in the state. Four hundred and fifty-five (455) pregnant women that consented to the study where interviewed during their ANC sessions using semi-structured questionnaires. Data entry and analysis was done on a micro computer; frequency tables and cross tabulations of important variables were done; and Chi-square test was used for the test of significance. RESULTS: About one-third 164 (36%) of the respondents were aware of ITN in malaria prevention, but less than a third 124 (27%) had ever used it and only 88 (19%) were currently using it, while 104 (23%) of the total respondents had a member of their household using ITN. Some of the difficulties encountered or experienced by respondents currently using ITN were scarcity of new nets, difficulty in getting chemicals for re-treatment of nets, non availability of quality ITN for sale. Three hundred and thirty-one (73%) respondents have never used ITN before because of lack of awareness 136 (41%), price of ITN is too costly 26 (8%) and non-availability of ITN for purchase 67 (20%). Respondents' age, educational level, parity and source of information or awareness on ITN have no significant influence on ITN use (P > 0.05); however, the frequency of malaria attack among respondents using ITN was lower than those not using it and this was significant (P > 0.0043). CONCLUSION: Awareness and utilization of ITN among pregnant women and their household members is still low despite Government policy of free ITN for vulnerable groups and subsidized nets for other people. There is need to focus on creating demand for ITNs through all available health information channels including social marketing.