M Okoh, JE Enabulele

Garbati MA, Mubi BM, Gali RM, Jidda BU, Mshelia DS

Background: Most publications on disturbance of thyroid function among patients with drug resistant tuberculosis (DR-TB) have focused mainly on the effects of treatment with second line drugs. Some patients with newly diagnosed DR-TB are likely to have disturbed thyroid function at baseline. These groups of patients need to be actively looked out for in order to institute appropriate therapy to prevent further deterioration.

Methods: This is a prospective review of thyroid function on patients newly diagnosed with RifampicinResistant TB/Multidrug resistant TB (RR-TB/MDR-TB) who underwent baseline thyroid function test (TSH, T3 and T4) at the University of Maiduguri Teaching Hospital (UMTH) between January 2016 and December 2018.

Results: Sixty-two patients were diagnosed with RR-TB, 58% of them were females, with ages ranging between 16 and 70 years. Forty-seven (75.8%) were aged between 20 and 49 years. The baseline results showed that 77.4% were euthyroid, while 16.1% had one form of thyroid disorder or another; Nonthyroidal illnesses (NTIs) were reported in 6.5% of the study population. Of the 16.1% of results that indicated presence of thyroid disorders, 60% were hyperthyroid, 10% had subclinical hyperthyroidism, 20% subclinical hypothyroidism and only 10% were hypothyroid.

Conclusion: Determination of baseline thyroid function in newly diagnosed patients with DR-TB is vital to identify patients with baseline thyroid dysfunction. This will guide proper intervention before commencing second line anti-TB medications that are known to affect thyroid function. Follow-up thyroid function tests, especially among those with hyperthyroidism will show the effect of thionamide therapy and whether they progress to develop any alterations in the reported parameters.

Background: Bacterial infections are the most common cause of postoperative endophthalmitis with gram positive bacteria accounting for most cases. The flora of the eyelids and conjunctiva are the most frequent source of infection. Knowledge of the conjunctival bacterial flora is therefore important to provide an informed choice of appropriate antibiotics for postoperative prophylaxis in patients undergoing cataract surgery or other intraocular surgeries.

Objectives: To determine the bacterial normal flora of the conjunctiva and their antibiotic sensitivity with a view to determine the appropriate choice of prophylactic postoperative antibiotic in patients undergoing cataract surgery in Maiduguri.

Materials and Methods: This was a prospective cross-sectional study conducted on adult patients scheduled for cataract surgery at the University of Maiduguri Teaching Hospital and the State eye hospital Maiduguri from February 2018 to October 2018. Surgery was either small incision cataract surgery (SICS) or extra capsular cataract surgery (ECCE) with lens implantation. The sample included one hundred eyes of one hundred patients

Results: A total of 95 eyes of 95 patients was analysed. The patients were between the ages of 18-85 years with a mean age of 58.11+- 12.3 years, with a male to female ratio of 1.1:1. Positive bacterial cultures were found in 31 (32.6%) of the patients and negative cultures were found in 64 (67.4%) of the patients. In 28 (90.3%) of the patients the bacteria cultured were gram positive while in 3 (9.7%) the bacteria were gram negative rods. The commonest bacterial isolate was Staphylococcus epidermidis, isolated in 14 (45.2%) patients followed by Staphylococcus aureus in 13 (41.9 %). Ciprofloxacin was the most sensitive (93.3%) antibiotics tested followed by chloramphenicol (87.5%),

Conclusion: The commonest bacterial isolate was Staphylococcus epidermidis, followed by Staphylococcus aureus. Ciprofloxacin was the most sensitive antibiotic tested followed by chloramphenicol

Background: Publication of a scientific research in a peer-reviewed journal is one of the most common written means of disseminating of findings which is of importance to all researchers. However, it is also an area that often present challenges, and can result in disagreements among researchers, especially regarding the choice of journal for publication Objective: To determine the factors influencing journal publication choice among University of Benin lecturers.

Methods: This prospective cross-sectional study was conducted among lecturers across the thirteen (13) faculties in University of Benin, Benin City. Data collection tool was a nineteen (19) item, selfadministered questionnaire which elicited information on demographic characteristics, human determinant of journal publication choice and factors influencing journal publication choice. Six (6) of the questions were demographic characteristics which assessed age, sex, status, experience, faculty and department of participants. One question which assessed the human determinants of journal choice was a semi-structured question containing both closed and open-ended response options. The remaining twelve (12) questions assessed factors influencing the journal choice. The responses were scored as irrelevant = 1, less important = 2, important = 3 and extremely important = 4. The mean and standard error of mean were computed for each variable to determine the most ranked factor.

Results: A total of 53 lecturers who have worked between 1 and 38 years compromising 39 (73.6%) males and 14 (26.4%) females from 33 departments of all the 13 faculties were studied. The journal choice is mainly a sole decision (66.0%) of the principal investigator. Prestige, promotion and journal impact factor were the three most ranked factors in journal publication choice. The ranking of the factors was not influenced by sex, faculty, academic status, and years of experience of the participants.

Conclusion: Data from this study revealed that journal choice is mainly a sole decision of the principal investigator and the factors that influenced the choice were prestige, promotion and journal impact factor. Nation-wide study is highly recommended

Background: Hypertension has been identified as the leading risk factor for mortality, and is ranked the third leading cause of disability-adjusted life-years. Men are generally at greater risk for cardiovascular and renal disease than age-matched premenopausal women. Our study aimed to determine the variation in blood pressure control between male and female hypertensive patients receiving care in a Nigerian tertiary hospital.

Method: The study was a cross-sectional study of consecutive hypertensive patients receiving care at the Federal Medical Centre Nguru Yobe State Nigeria from June 2016 to December 2016. A prevalidated questionnaire was used, and controlled hypertension defined as blood pressure of less than 140mm Hg systolic and less than 90mm Hg diastolic was determined based on a blood pressure reading at the time of consultation.

Results: Two hundred and ninety-one (291) participants comprising 134 (46%) males and 157 (54%) females were consecutively recruited. Two hundred and thirty-eight (81.7%) were hypertensive, while 53 (18.2%) had hypertension and diabetes. The mean age of the participants was 56.15 ± 12.72. Males were older than the females (60.11±11.63 and 52.78±12.68, p value<0.001). Mean systolic blood pressure was comparable in males (135.97±23.40) and females (139.81±24.79) participants (P = 0.17). However, the females had a higher diastolic blood pressure than males (84.52±12.58 vs 81.42±12.51, p=0.03), uncontrolled hypertension was documented in 172 (59.1%) participants. The rate of hypertension control did not differ between males and females (44.8%vs 37.6%, p=0.213).

Conclusion: The rate of uncontrolled hypertension was high among the participants. Women were found to have a significantly higher diastolic blood pressure compared to the male counterpart however, there was no significant difference in systolic blood pressure between the male and female subjects. Age, body mass index and eGFR independently predicted uncontrolled hypertension.

Background: The shortage of radiotherapy services in Nigeria has led to tremendous suffering for breast cancer patients across the country. The aim of this study is to explore the effect of distance on the care of breast cancer patients in Nigeria.

Materials and Methods: This was a retrospective study of breast cancer patients from 1st January 2003 to 31st December 2012 in University College Hospital (UCH), Ibadan. Data obtained included biodata, disease features and follow-up information using a structured questionnaire. Univariate, bivariate and multivariate statistics was used to analyse the data.

Results: We studied 504 breast cancer patients. The mean age of the patients was 47.7 (±10.6) years, late presentation with symptoms beyond 3 months was seen in 88.1% while advanced stage disease was seen in 58.7% of patients. Patients that lived at distances within 50 km and beyond 50 km from UCH, Ibadan were 74 (14.7%) and 430 (85.3%) respectively. Majority of the patients 87.3% completed treatment, however, 94.8% of patients treated during the period discontinued follow-up care at the end of the study. The reasons for discontinuation were “death”, “financial constraints” and “referred back to distant primary surgeon after treatment” accounting for 90 (18.8%), 230 (48.1%) and 158 (33.1%) respectively. The factors affected by distance were socioeconomic status [OR=2.9; 95% CI=1.42-6.01], bilateral breast cancer disease [OR=14.22; 95% CI = 7.32 – 27.620], left breast disease (OR=11.45; 95% CI = 5.89 – 22.62) and reasons for discontinuing follow-up care: financial constraints [OR=2.0; 95% CI =0.9 – 3.2], and referred back to primary breast surgeon [OR=3.0; 95% CI =1.3 – 6.0].

Conclusion: Long distance and shortage of functioning radiotherapy centres in Nigeria are critical challenges for breast cancer treatment, leading patients to late presentation with advanced disease and poor compliance with follow-up care. Therefore, more centres should be built in each state to minimise these challenges.

Background: This study was undertaken to compare the effect of two surgical techniques of cataract extraction on corneal endothelial cell density in eyes of Nigerian adults with uncomplicated age-related cataract with the view to improving surgical visual function and quality of life.

Materials and Methods: It was a prospective randomized non blinded hospital based interventional study. Two hundred and seventy-seven (277) eyes of 269 eligible patients with cataract were randomized to either manual small incision cataract surgery (MSICS) or conventional extracapsular cataract extraction (ECCE). The endothelial cell density (ECD), Coefficient of variation (CV), and Hexagonality (%) were measured pre-operatively, at one, four and twelve weeks post-operatively with a non-contact specular microscope (CSO SP 02). Statistical analysis – Data obtained were entered into microsoft Excel and analyzed using SPSS version 16 software.

Result: Of the 277 eyes studied, 263 (94.9%) were analysed. The mean age of patients for MSICS and ECCE was 64.03 (SD + 11.2, range 40 – 95 years) and 62.69 (SD +10.48, range 42 – 94 years) respectively. The Male to female ratio was 1.9:1, in the two study groups. Pre-operatively, corneal parameters (mean ECD, CV and hexagonal cells) were similar between the two surgery groups. Postoperatively cataract surgery induced a mean endothelial cell density loss of 5.31% at one week, 7.28% at 4 weeks and 7.06% at 12 weeks in the study population. There was no statistically significant difference in the mean endothelial cell density loss between MSICS and ECCE groups.

Conclusion: Both MSICS and ECCE induced fairly equal moderate and reversible degree of endothelial cell density loss in adults with uncomplicated age related cataract.

Background: Malaria still remains the leading cause of morbidity and mortality among children in Nigeria. The initial decrease in the global burden of uncomplicated malaria reported by World Health Organization in 2014 was lost; presently 80% of cases of Malaria reported in the world are in the sub-Saharan African region in which Nigeria is the most populous country. In the insurgency-infested north eastern Nigeria, effort at reduction of malaria cases has not only stagnated but the gains have been reversed. Objective: To determine the burden of severe malaria during the period of high transmission in a region infested by insurgency.

Materials and Methods: We retrospectively reviewed all the records of children admitted with malaria into the paediatric wards of the specialist hospital in 2017, at the peak of malaria infestation. Rapid assessment kit was used to make the diagnosis of malaria. Children with packed cell volume of less 15% transfused with blood were recorded.

Results: Of the 2,316 children admitted, severe malaria constituted 1832 (79.1%), of which 104 (5.7%) died. About a quarter (23.4%) of these children had blood transfusion.

Conclusion: Malaria infestation was high especially in the latter half of the raining season; there is need to have a multi-pronged and coordinated strategy to halt this ugly trend and ensure qualitative blood transfusion services in the community during this peak period.

Background: The significance of recovery time and adequate postoperative analgesia for day case surgery has led to various trials of drug combinations in other to get the benefit of both early recovery with prolonged postoperative analgesia. Various intravenous analgesic agents in combination with propofol has been tried in an attempt at finding the ideal drug combination for short surgical procedures.

Objectives: This study compared the recovery time and time of first request for postoperative analgesia of two drug combinations: propofol-ketamine and propofol-fentanyl used as the sole anaesthetic agents for short surgical procedures in adult’s day case surgery.

Methods: One hundred and eight adults aged 18 to 50 years of either gender with ASA physical status I or II scheduled for elective short surgical procedures were randomly allocated into group K and F, comprising of 54 patients each. Group K received propofol-ketamine while group F received propofol-fentanyl for induction and maintenance of anaesthesia. Vital signs were recorded at the time of induction, maintenance and recovery. Recovery time was assessed using Steward Recovery Score. Postoperative analgesic requirement was assessed based on pain score using the Verbal Rating Scale.

Results: Demographic and clinical characteristics such as age, sex, weight, duration of surgery and types of surgical procedures used were comparable between the two groups. Recovery time was prolonged in group K compared to group F (p=0.01). Time for first request of postoperative analgesia was found to be significantly shorter in group F (p=0.01).

Conclusion: Both propofol-ketamine and propofol-fentanyl combinations produced effective postoperative analgesia and appreciable recovery time for daycase surgery. While Propofol-fentanyl has a shorter recovery time, Propofolketamine has a longer period of postoperative analgesia.

Background: The existence of calculi in the urinary tract are well known urological conditions. A giant bladder calculus is one weighing more than 100g and is a rare finding in present-day urological practice.

Case summary: The patient is a 58-year-old man who presented with a 20year history of progressive irritative Lower Urinary Tract Symptoms (LUTS) associated with poor stream which improves with change in posture. He had episodes of intermittent painful terminal haematuria and pyuria with occasional fever. About three months to his presentation, he developed progressively worsened constipation. He also had weight loss and anorexia. On examination, His vital signs were normal. There was a suprapubic mass about 6cm above pubic symphysis, smooth surface, hard, mobile and bi-manually palpable. The prostate was not enlarged on digital rectal examination. His Abdominopelvic ultrasound scan and KUB revealed a giant bladder calculus with bilateral hydronephrosis. Urine Microscopy, Culture and Sensitivity (M,C,S) showed numerous red blood cells, pus cells, and cultured Klebsiella spp sensitive to Ciprofloxacin. Serum Electrolytes, Urea and Creatinine were normal. He was treated for Urinary tract infection then had cystolithotomy. Intraoperative findings were a giant bladder calculus, thickened bladder wall and hyperaemic bladder mucosa. The bladder mucosal biopsy revealed chronic inflammation on histology. The calculus weighed 1000g. Post-operative recovery was uneventful, the catheter was removed and the patient was discharged home 2 weeks after surgery with resolution of all lower urinary tract symptoms. He had remained symptom-free in his last follow up visit which was 1year post operation.

Conclusion: A giant bladder calculus is a rare finding in contemporary urological practice.

Jidda MS, Amodu M, Victor CO, Abdu W, Wakil MA

Background: Suicide is the second leading cause of death among youths aged 10-24 years worldwide. Suicidal ideation, therefore, represents a growing global public health issue among youths and adolescents. Exposure to psycho-trauma due to Boko Haram conflict puts the adolescent in especially difficult circumstances that predisposes them to a range of mental health challenges including suicide.

Aim and Objective: The aim of the study is to assess the rate of suicidal ideation and attempt and the significant variables associated with these phenomena.

Methodology: A cross sectional study with stratified sampling techniques was used to recruit a sample of 300 secondary school adolescents. Data was extracted using the BDI and BSI.

Results/ Discussion: A total of 300 students were recruited into the study with a mean age of 16.5 years and SD (2.3). 52.3% were females. 40.7% have been directly exposed to violent acts of terrorism. 28% report suicidal ideation and 1.3 have attempted suicide. Spearman’s rank correlation was run to determine the relationship between the level of depression and suicidal ideation. There was a moderate positive correlation between the degree of depression and suicidal ideation which was statistically significant (rs=0.413; p=0.0001).

Conclusion: There is a high rate of exposure to psycho-trauma and suicidal ideation among adolescent students in Maiduguri. Targeted intervention to assist this demographic is relevant to the postconflict reconstruction effort to be designed by the national health system. Key

Sulaiman MM1, Shettima J2, Lawan M1, Loskurima U1, Ummate I1, Pindiga UH3

Ahmadu MS, Farouk AG, Ahidjo A, Tahir A

Isezuo KO1, Adamu A, Jiya FB, Ibitoye PK, Onankpa BO, Sani UM1, Bolajoko TA, Sanni MA, Bello LA

Anthony O. Atimati, Olusola P. Okunola

Adekwu A, Ibiam F A, Ogbeyi G A, Abah R, Agaba E I, Ezeanolue B C,

Enabulele Joan E, Aghamiogie Ehis

Ballah Akawu Denue, Wadzani Gashau

Kida IM, Umar B, Goni BW, Garbati MA, Adamu I, Ogah D, Bakki B, Dayar AD, Ummate I, Yusuph H.

Oludare Folajimi Adeyemi,1 Godwin Enosakhare Okungbowa,2 Osesogie Usuale Ogbeide

Usman B, Mohammed B

Babagana Mohammed, Nasiru Ismail Jinjiri, Mohammad R. Mahmud, Ali Lassieni

Rufa’i AA, Oyeyemi AL, Salamatu UA, Saidu IA, Aishatu US, Oyeyemi AY

Background: Engaging in sufficient physical activity (PA) improves health and quality of life (QOL) across all ages.
Objective: The objective of this study was to determine the relationship between demographic variables, PA and QOL among adults in Maiduguri, Nigeria.
Methods: A total of 390 apparently healthy male and female adults (age range =18–65 years) in Maiduguri participated in the study. PA level was assessed with the International Physical Activity Questionnaire- Short Form. Health-related QOL was assessed using the physical and mental components summary scales (PCS & MCS) of the MOS Short Form-12 health survey questionnaire. Pearson’s correlation was used to explore the relationships between age, PA and QoL of the participants.
Results: The mean age of the participants was 29.51±10.12 years. About half of the participants were males (52.8%) and employed (54.4%). Age was inversely correlated with total PA (r= -0.13, P<0.001) and PCS (r= -0.32, P<0.001). Total PA was negatively correlated with PCS (r= -0.13, P= 0.010) but positively with MCS (r= 0.17, P= 0.001). There was significant difference in total PA (P<0.001), PCS (P<0.001) and MCS (P<0.05) between female and male, and also between the employed and unemployed. Also, there was significant difference in PCS (P<0.001) and MCS (P= 0.003) between participants with higher education and those with non-formal education.
Conclusion: Significant relationships were found between demographic variables, PA and QOL components among the participants. These results affirm that PA is important to improving the QOL of adults in Maiduguri.

Olatunji Lawal K, Oche Mansur O, Adamu Habibullah1, Mohammed Dantani A, Abdulsalam Latifatu B, Arisegi Sarafadeen A

Hadiza A. Usman, Bala M. Audu, Ibrahim M. Sanusi, Mohammed Bukar, Pindiga U. Hamidu2

Yusuf Ibrahim, Aminu Dahiru MC

Ighodaro O. Emmanuel, Ehigiamusoe O. Festus

SUMMARY
Congenital cystic eye is an extremely rare congenital anomaly that results from failure of the invagination of the primary optic vesicle between the 2mm and 7mm stage of fetal development in which the globe is replaced by a cyst. Management is multidisciplinary involving but not limited to the Ophthalmologist, Paediatrician, Radiologist, Histopathologist, an ocularist and a counsellor. Surgical intervention is usually carried out for cosmetic reasons and to confirm the diagnosis. We present the case of a seven-month female infant who presented with right orbital mass since birth and a normal left eye. She had excisional biopsy done and histology confirmed the diagnosis

SUMMARY
Proximal femoral focal deficiency is a rare and complex skeletal anomaly characterized by failure of normal development of the proximal femur, shortening of the lower limb, and pelvic abnormality especially the acetabulum. It was first described by Aitken in the late 1950s. It commonly occurs as a unilateral form but the bilateral variant is rare occurring in 10-15 % of cases. To the best of our knowledge, bilateral proximal femoral focal deficiency has not been reported in Nigeria. We, therefore, present this case in a 25-day-old neonate who presented to our hospital with features consistent with this complex skeletal anomaly.

SUMMARY
The occurrence of spontaneous pregnancy (viable or not) in one or more sites other than the endometrial cavity at the same time is an unusual phenomenon. We aimed to draw attention to
the varied clinical manifestations and outcomes of heterotopic pregnancy (HP) amongst four consecutive patients who were managed in our facility over a two-year period. It is imperative
for all clinicians to have a high index of suspicion for HP when seeing a woman of reproductive age with suspected ectopic.

SUMMARY
Background: Distal migration of nails is one of the reasons for nails removal, though they are hardly reported in relation to cannulated interlocking nails.
Objectives: To present a rare case of distally migrated cannulated interlocking nail of the tibia and a proposed technique for the removal of the nail using Schanz screw.
Case: A 55year old woman had cannulated interlocking nailing for diaphyseal left tibial fracture 5 years prior to presentation. She later had septic loosening of the distal locking screw with subsequent symptomatic distal migration of the nail despite united osteosynthesis. Attempt at free hand removal using conventional instruments failed due to increased distance of the nail from the entry point, malrotation and lack of visibility of the nail following obliteration by fibrous and granulation tissues within the nail cavity. Thus, an improvisation with Schanz screw, due to its threading surface was used to capture and remove the nail successfully without any cortical damage of the bone.
Conclusion: The use of Schanz screw is a safe, cheap and effective means of free hand removal of distally migrated cannulated interlocking nails.

DAUDA YAHI, NICHOLAS ADETAYO OJO, GIDEON DAUDA MSHELIA

Background: Goat meat is very popular and has a great demand all over Nigeria. However, the slaughter of pregnant goats in abattoirs and slaughter slabs for meat is becoming a serious
concern not only for future livestock population, but also for public health. Dyslipidaemia of pregnancy in meat animals may constitute threat to consumers in terms of cardiovascular risks.
Objectives: The purpose of this study was to investigate the concentrations of serum lipids at different stages of gestation in Sahel goats and to evaluate the atherogenic capacity of the lipid profile. Materials and Methods: Serum lipids profiles and atherogenic indices in pregnant and nonpregnant Sahel goats were studied. Fourteen apparently healthy adult Sahel goats comprising 12 does with mean gestation length of 148.33 ± 1.52 days and 2 bucks were used for the study. They were managed in the University of Maiduguri livestock research farm on low fat diet. Sera samples were collected biweekly for 5 months and were used for the analysis of total Cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL-c), low density lipoprotein (LDL-c) and very low density lipoprotein (VLDL-c). Atherogenic indices were calculated as base 10 log (TG/HDL-c). Results: Serum TG and VLDL-c concentrations increased significantly (p < 0.05) in pregnant does compared to non-pregnant. HDL-c and LDL-c concentrations did not vary significantly (p > 0.05) between the two groups. Atherogenic indices increased progressively with advancing pregnancy compared to non-pregnant. Conclusion: It was concluded that atherogenic capacity of the lipid profile in pregnant Sahel goats is high and therefore consumption of meat from pregnant animals has high potential for atherogenic risk. Routine antemortem inspection should be conducted at abattoirs to identify pregnant animals for restriction against slaughter. Legislation prohibiting the slaughter of pregnant animals should be enforced

Background: As women increasingly delay child bearing, the proportion of women having their first delivery at ''advanced maternal age'' is expected to rise. These elderly primigravidae have traditionally been considered to be at increased risk of adverse maternal and perinatal outcomes compared to their younger counterparts, because of associated pregnancy and labour complications. Objectives: To determine the prevalence of elderly primigravidae and compare their pregnancy outcome with that of younger primigravidae in Aminu Kano Teaching Hospital, Kano. Materials And Methods: This was a retrospective case control study comparing the pregnancy outcome of primigravid mothers aged 35 years and above (elderly primigravidae) with those of younger primigravidae aged 20-25 years, who delivered at Aminu Kano Teaching Hospital between January 2009 and December 2013. Results: There were 18,452 deliveries during the period under review, out of which 295 were primigravidae aged 35 years or above giving a prevalence of 1.6%. There was statistically significant higher preterm delivery rate ( X2= 10.30, P= 0.001) and caesarean delivery rate (X2= 12.15, P= 0.0001) among the elderly primigravidae compared to younger primigravidae. The elderly primigravidae were more prone to hypertensive disorders in pregnancy (X2=23.96, P=0.0001) and diabetes (X2=4.689, P=0.030) compared to the younger primigravidae. The prevalence of antepartum haemorrhage (X2=6.434, P=0.011) and uterine fibroids (X2=5.549, P=0.019) were also statistically significant among the elderly primigravidae compared to the younger primigravidae. There was no significant difference in the other maternal and foetal outcome measures. Conclusion: The prevalence of elderly primigravidae in this study was 1.6%. The prevalence of obstetric complications such as preterm delivery, antepartum haemorrhage, uterine fibroids coexisting with pregnancy and medical conditions like hypertensive disorders in pregnancy and diabetes mellitus are higher among elderly primigravidae compared to younger primigravidae. The elderly primigravidae were also more liable to have caesarean deliveries than the younger primigravidae. However there was no difference in the fetal outcome in the two groups.

Background: Traditional uvulectomy is widely practiced in some African countries with children more vulnerable to such practices, which may be associated with life threatening complications. Objectives: To determine the age at the time of the procedure, reasons and complication(s) following traditional uvulectomy. Materials And Methods: Retrospective study of hospitalized neonates presenting as emergencies following traditional uvulectomy to the accident and emergency department of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, from June, 2004 to May, 2015. Results: A total of 21 cases were reviewed. Twelve(57.1%) males and 9(42.9%) were females: ratio of 1.3:1. The age ranged from 1 to 21 days with the mean age of 8.8 days. Majority 11(52.4%) of the thtraditional uvulectomies were performed before the 7 day of life. The mean duration before hospitalization was 8.4 hours. Post-uvulectomy haemorrhage 18(85.7%) was the most common complication and this was followed by septicaemia 3 (14.3%) with 2(9.5%) mortalities from the septicaemia. All the patients were anaemic. Prevention of sore throat 12(57.1%) was the main reason for traditional uvulectomy. Sixteen (76.2%) patients were lost to follow-up. Conclusion: Neonatal traditional uvulectomy was mostly done in the first week of life, prevention of sore throat was the common intent and complicated with post-uvulectomy bleeding and septicaemia. Health institutions have a role to play in public health education on the harmful effects of traditional uvulectomy.

ABDULLAHI MOHAMMED, MOHAMMED MANU.

Background: Adiponectin is an adipocytokine that is exclusively produced by adipocytes with potent insulin-sensitizing property. It has been proposed to be involved in the pathogenesis of gestational diabetes mellitus, but its role is not clear; Findings from studies done across different ethnic groups are often inconsistent. Objectives: The aim of the study was to compare maternal serum adiponectin levels between Nigerian pregnant women with and without gestational diabetes mellitus. Materials And Methods: A cross sectional analytical study including one hundred and sixty nine pregnant women, 85 with gestational diabetes mellitus and 84 with normal gestation, who were evaluated between 24-28 weeks gestation. Diagnosis of gestational diabetes mellitus was made according to the WHO diagnostic criteria. Maternal serum level of adiponectin was measured and compared between pregnant women with gestational diabetes mellitus and the controls. Results: Mean maternal serum adiponectin level was significantly lower in pregnant women with gestational diabetes mellitus than in the controls (8.1 ± 1.6 vs. 10.1 ± 2.4 µg/ml, p< 0.05). When 2 2 subjects in the study groups were further categorized in to BMI < 25kg/m and BMI 25 kg/m , maternal serum adiponectin level remained significantly lower in the normal weight pregnant women with gestational diabetes compared to their BMI-matched controls (8.4 ± 1.7 vs. 11.4 ± 2.1 2µg/ml, p< 0.05). Among the overweight pregnant women (BMI 25 kg/m) on the other hand, there was no difference in maternal serum adiponectin level between pregnant women with gestational diabetes mellitus and the normal controls (7.8 ± 1.5 vs. 8.0 ± 1.1µg/ml, p> 0.05). Conclusion: It is concluded that normal weight Nigerian pregnant women with gestational diabetes mellitus in this study have lower serum adiponectin level compared to the normal weight pregnant women with normal gestation

ABDULAZEEZ AHMED

Background: As a result of workplace noise, dental personnel are potentially predisposed to auditory and non-auditory effects of noise which may expose hidden or imminent hearing impairment. There is the need to capture these self-reported hearing and hearing-related complaints using well designed questionnaires as a prelude to formal audiometric tests. Materials And Methods: This was a cross-sectional self-administered questionnaire study conducted between the periods April to August 2015. Participants were given questionnaires to fill and return which captured socio-demographic data and exposure to noise at workplace and symptoms experienced. Upon return of the questionnaire, each questionnaire was examined to ensure they were properly filled with signed consent. All data and findings were evaluated anonymously. Results: One hundred and thirty eight questionnaires were returned giving 86% response rate, 35(25.4%) reported hearing impairment. Eighteen (13.0%) respondents have experienced tinnitus, while 20 (14.5%) of the respondents experienced Hyperacusis, another 53(38.4%) of the respondents also have difficulty hearing in places with competing noise. Stress and sleep disturbance were also common complains. Conclusion: The presence of especially tinnitus, hyperacusis, impaired hearing in areas with competing sounds are all symptoms indicative of imminent hearing impairment that could be used to predict undetected hearing losses among dental personnel.

ABBA K,TAHIR MB, DOGO HM , NGGADA HA

Objectives: The present study is undertaken to describe the spectrum of histopathological features and age distribution of non-neoplastic testicular and paratesticular lesions in the University of Maiduguri Teaching Hospital (UMTH). Materials and methods: A retrospective descriptive study of 70 testicular and paratesticular nonneoplastic lesions was conducted over a period of 10 years; between January-2005 and December2014 in the Department of Histopathology, UMTH. Histopathological examination was done after routine processing and staining with Haematoxylin and Eosin. Special stain (Ziehl-Neelsen stain) was done to confirm the presence of acid fast bacilli in cases of tuberculous epididymoorchitis. Results: There were of which
(24.3%) followed by testicular torsion and infarction (14.3%). The youngest patient was 2 years old and the oldest was 80 years of age. The highest incidence occurred in the age range of 30 – 59 years with a total of 25 cases representing 35.7%. The lowest incidence was observed in the elderly (= 60 years) with a total of 21 cases (30%). Conclusion: This study shows that inflammatory disorders are the predominant causes of the testicular and paratesticular non-neoplastic lesions capable of interfering with fertility and mimicking malignancy. There is also the need to emphasise the necessity of proper evaluation and treatment of acute orchitis and microabscess to avoid unnecessary orchidectomy.
70 cases of non-neoplastic testicular and paratesticular lesions the majority were inflammatory disorders accounting for 53 cases (75.7%). They included acute orchitis (4.3%), tuberculosis (12.9%), schistosomiasis (8.6%), hydrocoele (24.3%), chronic orchitis (10.0%), epididymal cyst (11.4%) and tumoral calcinosis (4.3%). Other categories of the lesions included congenital abnormalities (10.0%) and traumatic disorder (14.3%). Long-standing hydrocoele was the commonest lesion

Background: Obstetrics haemorrhage is one of the leading cause of maternal mortality in our settings, this was compounded by the non availability to safe blood in situation of need. Hence the prompt access and availability of blood can avert this preventable cause of maternal death. Objectives: to highlight the benefits of effective collaboration with NBTS in ensuring prompt availability of blood for emergency obstetric services requiring blood for transfusion. Material And Method: All obstetrics cases requiring blood transfusion in FMC Nguru from 1st stJanuary 2006 – 31 December 2011 were retrospectively reviewed. Trends and pattern of the st strequest and source of blood were looked at within the two periods (from 1 January 2006 – 31 st stDecember 2008 and 1 January 2009 – 31 December 2011). Records of 1634 obstetric patients requiring blood transfusion or received blood transfusion in the maternity units were retrieved from the medical records, maternity ward record and blood bank. Information pertaining to their age, parity, indication for the transfusion or requests and source of blood was obtained for analysis. Data was analysed using simple percentage. st st Results: Between 1 January 2006 and 31 December 2008 only 513 (56%) of the units requested st st907 units of blood were supplied, while between 1 January 2009 and 1 December 2011 1367 ( 87%) of the 1567 units of blood requested were supplied. Within the earlier study period the only available source were from willing relatives and commercial blood donors, however between 2009 and 2011 more than 2/3 (64.2%) were supplied from the north east zonal NBTS office in Maiduguri. In 2006 through 2008, donation from relatives and commercial donors accounted for 53.22% and 46.78% respectively, but in 2009 and 2011 donation from relatives and commercial donors were recorded as 23.9% and 11.6% respectively. The commonest indication for the requests were anaemia, obstetrics haemorrhage (PPH, APH) and emergency C/S. Conclusion: Ready available source of blood will significantly improve timely availability of blood in our setting. There is the need to encourage this collaboration in other regions to ensure prompt availability of blood to attend to emergencies requiring blood transfusion.

AWWALU S, HASSAN A, DOGARA LG, MUSA AU, WAZIRI AD, BABADOKO AA

Background: BMA is a clinical procedure that exploits microscopy and lends itself to specialized biochemical and molecular assays for diagnosis, staging, prognostication and determining choice of therapy. Eligibility for BMA is determined following review of a patient's history, physical examination findings, Complete Blood Count and other relevant investigations. Bone marrow aspirates may be obtained from different sites of the body such as iliac crest, sternum etc. This study was to determine some patient characteristics, sites, indications and outcomes of all BMAs done between January 2002 and December 2004. It is hoped that this study will help haematologists and other physicians to understand the utility of BMA and some of its limitations. Material And Methods: It was a three-year retrospective, analytic review of all BMAs done in the stDepartment of Haematology, Ahmadu Bello University Teaching Hospital Zaria. Records from 1 stJanuary 2002 to 31 of December 2004 were retrieved, collated and analyzed using SPSS version 16. Results: A total of One hundred and thirty five (135) BMAs were done in the period under review. There was a male preponderance 77 (57.00%) with females constituting 58 (43.00%). The mean age was 31.78±20.76 years with a mode of 45 years. The minimum and maximum ages were 1 and 78 years respectively. The commonest site for BMA was the RPSIS 97(71.9%). Anaemia was the commonest indication for BMA 56(41.5%) followed by Splenomegaly 15(11.1%) and Lymphadenopathy 14(10.4%).The commonest diagnosis was combined deficiency anaemia 21(15.6%) followed by Megaloblastic anaemia 19(14.1%). Whereas 9(6.7%) were inconclusive, 14(10.4%) were normal. The complication rate was 0% and lymphadenopathy was the commonest indication that turned up with a normal BMA 5/14 (35.7%) . Conclusion: BMA is important in the evaluation of several conditions. However, there is a need to ensure proper consultation to ensure only patients that require BMA do so due to its invasive nature.

Background: Posterior urethral diverticulum calculus (PUD-C) is a rare urethral lesion that can pose as a diagnostic dilemma and in instances laborious to treat. Objectives: To report a rare case of posterior urethral diverticulum calculus (PUD-C) treated by the use of Mauermayer stone punch in a patient with double ureter , mal-development of the prostate and chronic viral hepatitis. Case: A 37year old male, who presented with a year history of bothersome Lower urinary tract symptoms (LUTS) with episodes of purulent urethral discharge. His posterior urethral diverticulum calculus (PUD-C) was confirmed at urethrocystoscopy alongside maldeveloped prostate, hanging verumontanum, urinary bladder trabeculations, and sacculations. He had urethrolitholapaxy using Mauermayer stone punch with a concurrent alleviation of the LUTS. Conclusion: The pertinent publications on the clinical features, treatment, and the outcome of PUDC were reviewed. Utilization of Mauermayer stone punch for PUDC urethrolitholapaxy is a novel treatment technique. It, however, alleviated the bothersome lower urinary tract symptoms and granted a satisfactory outcome in the index patient.

Background: Spigelian hernia is an uncommon ventral hernia characterized by a defect in the semilunaris linea and is known as “hernias through the conjoint tendon”. The symptoms of Spigelian hernia are usually non-specific. CT scanning is considered the most reliable technique for diagnosis .These hernias require surgical treatment. Case: A case of Spigelian hernia was diagnosed in the patient of 56-year-old man presenting with abdominal pain associated with a reducible mass in the right iliac fossa. CT scan confirmed the diagnosis. We had performed successfully surgical treatment to repair the hernia defect. The recovery was uneventful.

Gynecomastia is defined as enlargement of the male breast and derives its origin from 2 Greek words- 'gyne' and 'mastos' which mean "woman's" "breast". Gynecomastia is a clinical condition and often has three radiological patterns which are nodular, dendritic and diffuse glandular patterns. We report a case of a 42 year old man of Hausa-Fulani descent with massive bilateral breast enlargement of multifactorial origin. Investigations done included thyroid function test, liver function test and additional basic blood workup. A mammogram was done, which was followed by breasts ultrasound. Additional radiological imaging included abdominal and testicular sonograms and diagnosis of massive bilateral gynecomastia was made. Anti-psychotics are a documented cause of gynecomastia while thyroid dysfunction is an often overlooked etiology of male breast enlargement. Medical treatment may address the underlying pathology in some cases; however, surgical reconstruction must be considered in severe, chronic cases as it addresses the physical deformity which is a significant cause of depression in these patients. The role of radiology in excluding the causes of gynecomastia cannot be overemphasized and is pertinent in the management of this condition.

A case of giant cell tumour of the first metacarpal has been presented, its radiological features discussed and literature reviewed

Ellis-van Creveld (EVC) syndrome or chondroectodermal dysplasia is a rare, autosomal recessive thdisorder that was first described by Ellis and van Creveld in the mid-20 century.The syndrome is characterized by a tetrad of chondrodystrophy, post axial polydactyly, and hidrotic ectodermal dysplasia, mostly involving teeth and nails and a high frequency of congenital cardiac anomalies, most frequently a common atrium.There has been no documented case report of EVC syndrome from Nigeria in the literature. We, therefore, present a 30 year-old Nigerian woman who presented to our hospital with features consistent with this rare syndrome.

Chronic Myelogenous Leukemia (CML) is a clonal disorder of the pluripotential stem cell characterized by anaemia, extreme blood granulocytosis and granulocytic immaturity, basophilia, often thrombocytosis, and splenomegaly.Only a few cases of extramedullary manifestation have so far been reported in CML. Wepresent a case of CML in accelerated phase with massive ascites who responded well to combination chemotherapy and oral hydroxyurea.