Sulaiman H., Gadzama D.A., Jibril M.B.

Background: Community participation is a process where community members come together to identify and plan how to solve their needs. It is thought that community participation in primary health care will result in more accessible, relevant, and acceptable services which will in turn result in better health outcomes and patient satisfaction. This study sought to determine the level of community participation in Ward Development Committee from the perspectives of the committee members, Healthcare workers and community members. Objective: to evaluate the extent of Ward Development Committees' (WDCs) involvement in community-based initiatives and projects. Methods: The study was a descriptive cross-sectional study, conducted in Kudan Local Government Area of Kaduna State, Nigeria. All HCWs who had been in service for at least 6 months and WDC members who had served on the committee for at least 6 months were involved in the study. A multistage sampling technique was used to select the respondents from the community. Data was collected using a semi- structured interviewer-administered questionnaire developed by the researchers. The level of community participation was assessed by adapting Rifkin’s model for assessing community participation which has 5 indicators; needs assessment, organization, resource mobilization, leadership, and management. Results: From the perspective of the healthcare workers, ward development committee and community members, the level of community participation was 5 in organization and 4 in Leadership, Resource mobilization and Management, respectively. This indicates wide participation. The level of community participation is 3 in Needs Assessment from the perspective of healthcare workers and Ward Development Committee members and 1 for community members indicating moderate and narrow community participation. Conclusion: While community participation in Kudan’s WDC activities is commendable, there is potential for enhancement. We recommend that the government develops a policy on community engagement to ensure comprehensive community participation in all health-related projects.

Umar UH, Adamu A, Yunusa DM, Farate A, Lawan MM, Ahmadu MS, Ahidjo A, Mustapha Z

Background: Paranasal sinuses (PNS) are air-filled spaces which surround the nasal cavity. Sinonasal diseases (SNDs) are various pathologies ranging from inflammatory to benign and malignant neoplasms of the PNS and nasal cavity. Rhinosinusitis (RS) is the most frequent SND and its prevalence in the general population is relatively high, worldwide. Objective: To evaluate the computed tomographic findings of patients with SNDs in Maiduguri, North-eastern Nigeria. Methods: This was a retrospective study on CT scans of patients with SNDs who were referred to the Department of Radiology, Federal Neuro-psychiatric Hospital Maiduguri and State Specialist Hospital Maiduguri for computed tomography (CT) scans of PNS from January 2019 to December 2022. Data were retrieved and recorded from archives of the Departments which include age, sex, clinical presentations and CT findings. Data were analysed using IBM SPSS version 23. Results: The CT scans of one hundred and forty-six patients were reviewed; the majority of them being adolescents and young adults, with a mean age of 34.6 ± 16.1 years and a male-to-female ratio of 1.8:1. The commonest clinical presentation was nasal obstruction and inflammatory SNDs were the most frequent subgroup of aetiology. Mucosal thickening was the most frequent CT finding, and the most common CT diagnosis was RS. The maxillary sinus was the site that was mostly involved. Also, the lesions of SNDs were mostly multiple and bilateral. Conclusion: SNDs are common health conditions and the findings in this study showed that CT was a useful diagnostic tool. CT also helped to establish the extent of disease making it easier for preoperative preparation in case of surgical intervention. Rhinosinusitis was the most common inflammatory SND in this study.

Keywords: Computed tomography, Paranasal sinus, Sinonasal disease, Inflammatory, Rhinosinusitis, Polyposis

Umweni A.A, Otaren N.J.

Background: Diabetic nephropathy (DN) is the leading cause of end-stage renal disease (ESRD) worldwide and it is estimated that more than 20% of type 2 diabetic patients may develop ESRD during their lifetime. methods: The study is a prospective ultrasonographic evaluation of kidney volumes in 228 adults with type 2 diabetes and 228 normal non-diabetic adult controls carried out at Aminu Kano Teaching Hospital, Nigeria from June 2015 to May 2016. The data were analysed using computer-based SPSS version 23 software for Windows. Results: The 228 patients with type 2 diabetes studied were composed of 120 (53%) females and 108 (47%) males with a mean age of 47.7years, (range 29– 67 years), while the 228 normal control group were composed of 108 (47%) females and 120 (53%) males with a mean age of 46.9 years, (range 28- 69years). The age difference between the study and control groups was not statistically significant (p=0.43). The mean renal volumes were significantly higher in the study group (114.10+3.97ml) compared to the control group (95.34+2.59ml); this was statistically significant (p=0.001). The mean renal volumes were higher in males compared to the females in both the study group and the control (p=0.001). The left mean renal volumes were higher than that of the right in both the study and the control groups (p=0.001). There was, however, no significant correlation between renal volume and BMI (p=0.086). Conclusion: The mean renal volume is significantly higher among diabetics compared with normal controls. Patients with Type 2 diabetes mellitus have no significant correlation between renal volume and BMI.

Keywords: Type 2 diabetes Mellitus, BMI, renal volume.

Kwari SD, Chama CM, Mairiga AG

Background: Teenage pregnancy is becoming one of the most important social and public health problems worldwide, with a varying prevalence rate. It is associated with adverse maternal and fetal outcomes. Objective: To determine the maternal and fetal outcomes of teenage pregnancy at a tertiary care hospital. Method: A retrospective case-control review of all teenage pregnancies seen at the University of Maiduguri Teaching Hospital over ten years was carried out. The outcome was analysed and compared with that of older mothers who served as controls. Result: Teenage pregnancies accounted for 7.3% (n =1558) of the 21,310 deliveries within the study period. The mean age was 18.1 years. The majority of the teenagers were nulliparous (80.3%) and had no formal education (54.8%). Pregnancy-induced hypertension (22.9 % vs. 7.5% P<0.0001), preeclampsia (5.0% vs. 1.8% P0.001), eclampsia (9.7% vs. 3.6%, P<0.0001), malaria (19.0% vs. 6.4% P<0.0001), anaemia (16.5% vs. 11.5% P<0.0001), blood transfusion (7.5% vs. 1.8% P0.001), urinary tract infection (11.8% vs. 1.1%, P<0.0001), and duration of hospital stay (3.52 vs. 2.42 P0.003) were significantly higher in teenage mothers. Similarly, preterm delivery (21.1% vs 6.4% P <0.0001), low birth weight (22.2% vs. 6.1% P<0.0001), birth asphyxia (6.1% vs. 3.6% P 0.0001), and stillbirth (6.8% vs. 3.6% P 0.001) rates were higher in the teenage group. Teenagers were also more likely to be delivered by caesarean section (18.3% vs. 10.7% P <0.0001) and to have instrumental deliveries (5.0% vs 1.4% P< 0.0001). Conclusion: pregnancy among teenagers is associated with poorer maternal and fetal outcomes compared with older mothers.

Keywords: teenage pregnancy, maternal outcome, fetal outcome, tertiary care setting

Asheikh MM, Yusuf HM, Garba MA, Farouk AG, Abatcha MB, Mustapha MG

Background: Fever is a common symptom in children and urinary tract infection (UTI) is one of the most common causes of fever in children. This study evaluated the co-morbidities associated with UTI in febrile children at the University of Maiduguri Teaching Hospital. Methods: Proforma detailing the history, physical examination and clinical diagnosis of the subjects were filled for all the 200 children aged 2 months to 15 years who were consecutively recruited. Urine samples were collected from each of the subjects for dip-stick urinalysis as well as microscopy, culture, and sensitivity. Data was analysed using IBM SPSS version 25. Results: Thirty- nine subjects had UTI giving a prevalence of 19.5%. The common symptoms in the subjects with UTI were poor appetite and vomiting. Genito-urinary symptoms were not common among the children studied. Co-morbidities associated with UTI were malaria, (OR = 2.808; 95%CI = 1.243 – 6.346; p = 0.013), acute respiratory tract infection (OR = 0.324; 95%CI = 0.073 – 1.439; p = 0.139) and enteric fever (OR = 1.382; 95%CI = 0.544 – 3.515; p = 0.497), with malaria being the most common co-morbidity. Conclusion: Co-morbidities in children presenting with fever are common, especially in developing countries and the occurrence of UTI in the absence of genito-urinary symptoms in febrile children is not uncommon. Recommendations: Clinicians managing febrile children should have a high index of suspicion for UTI even in the absence of genito-urinary symptoms and evaluate the children for co-morbidities, for appropriate management.

Keywords: urinary tract infection, co-morbidity, fever, children, Maiduguri.

Musa A, Abba U, Ahmad A, Muhammad KG, Nehemiah BV, Jibril MB Ibrahim AM

Background: Premarital screening remains the only realistic approach to reduce the burden of genetic diseases such as sickle cell disease and other sexually transmitted diseases like HIV and Hepatitis B which remain a serious public health concern. The study was conducted among GOPD attendees of Bauchi State Specialist Hospital to assess their knowledge, attitude and practice of premarital screening and to find a way of increasing the awareness to the general public. Methods: A descriptive cross-sectional study was employed using a semi- structured interviewer-administered questionnaire to 331 respondents among GOPD attendees of Bauchi State Specialist Hospital. The data was analyzed using SPSS version 22.0 and level of significance was set at 0.05. Results: The mean ±SD age of the respondents was 32.2 ±11.9 and 70.7% of the respondents have good knowledge, 73.1% positive attitude and 74.3% good practice of premarital screening. Formal levels of education, age, religion, tribe, gender, occupation and marital status were the factors associated with the knowledge, attitude and practice of the premarital screening among the GOPD attendees: levels of education, gender, age and occupation for knowledge, levels of education for attitude and age for practice; remained independent predictors of knowledge, attitude and practice of the premarital screening among the GOPD attendees. Conclusion: This study shows that there is good knowledge and attitude of Premarital Screening among the study participants. However, the practice is relatively poor when compared to the other two variables. Government should sustain the awareness campaign by engaging the stakeholders, media, non-governmental organizations, religious bodies, hospitals and schools.

Keywords: Knowledge, attitude, practice, premarital screening, Bauchi

Daibu U, Usman B, Mohammed B

Background: Neurosurgical conditions are fairly common in our facility. They present to the emergency unit and trauma centre in an emergency state, and otherwise to the outpatient clinic of our facility. Our facility has three (3) neurosurgeons, addressing the growing burden of neurosurgical conditions. There is little information on the pattern of presentations of these non-emergency neurosurgical conditions to the outpatient clinic in our centre. Objective: To determine the pattern of presentations of non-emergency neurosurgical conditions at our facility's outpatient clinic. Patients and Methods: A prospective observational study that recruited all patients with non-emergency neurosurgical conditions who presented to the outpatient neurosurgical clinic of the University of Maiduguri Teaching Hospital from February 2023 to January 2024. Data was analyzed using a statistical package for social sciences (SPSS) version 26. Results: A total of 139 patients were recruited during the study period. The majority (67.6%) were males with a male-to-female ratio of 2.1:1. The most common age range at presentation was 17-45 years (37.4%) with a mean age of 37years ± 20.104 SD. Back pain (25.9%) from lumbar spondylosis was the most common clinical symptom, followed by weakness of the limbs (13.6%). Forty-six-point seven percent (65 patients) presented with cranial pathologies, while 49.7% (69 patients) presented with spinal pathologies. Spondylosis (27.3%) and hydrocephalus (9.4%) were the most common diagnoses at presentation in adults and children, respectively. Majority (62.6%) of the patients required surgical intervention at the time of presentation. Conclusion: Lumbar spondylosis and hydrocephalus are our facility's most common indications for outpatient neurosurgical consultations.

Keywords: Neurosurgical conditions, Outpatient clinic, Spectrum, Presentations, Maiduguri

Azees A. S, Adebisi O. I, Olubodun T.1, Adeniyi M. A

Mshelia DS, Gali RM, Dogo HM, Ummate I, Ibrahim AG, Musa AH, Medugu JT, Dungus MM, Bukar B, Genesis RY.

Background: A lot of attention has been drawn to primary hyperparathyroidism (PHPT) and vitamin D as risk factors of urolithiasis due to their association with calcium metabolism and stone formation. This study intends to assess the Vitamin D status of stone formers and prevalence of primary hyperparathyroidism amongst them in Maiduguri, Nigeria. A cross-sectional descriptive study was conducted in the University of Maiduguri Teaching Hospital from February 2018 to January, 2019. Eighty five stone formers who consented were recruited. ELISA technique and autoanalyzer (Cobas C311, ISN) was used for sample analysis. IBM SPSS version 26.0 was used for statistical analysis. The prevalence of PHPT in the stone formers was 8.2%. The most common site where stones were found is the kidney (68.2%). A total of 45 (52.9%) have vitamin D3 deficiency or insufficiency, 29 (34.1%) had optimal vitamin D3 levels and 1 (1.2%) had hypervitaminosis D3. Twelve patients had hypoalbuminemia, 24 patients had elevated inorganic phosphate, 8 patients had hypercalcaemia, 17 had hypocalcaemia, while 21 had hyperuricaemia. Given the high incidence of vitamin D deficiency/insufficiency in PHPT in this study and previous findings, evaluating vitamin D and calcium levels could be beneficial for a
thorough assessment of urinary tract stone formers.

Keywords: Urolithiasis, Primary hyperparathyroidism, Vitamin D3 status.

Bobo TI, Bakare TY, Afolabi OA, Adeniji DO, Ladoye OO

Background: Introduction: Emergency peripartum hysterectomy is a life-saving surgical procedure, the procedure is usually performed when all conservative measures have failed to achieve haemostasis during life threatening obstetric haemorrhage. Objective: This was to review emergency peripartum hysterectomy performed in Bowen University Teaching Hospital (BUTH), Ogbomoso, South- West, Nigeria between 1st January, 2014 and 31st December, 2023. Methods: A retrospective review of cases of emergency peripartum hysterectomy between January, 2014 and December, 2023. Result: During the 10- year study period, 6,734 deliveries occurred in the hospital and 42 cases of emergency peripartum hysterectomy were performed giving a prevalence of cases as 0.6% or 6 per 1000 deliveries. The mean age of the studied patients was 35 ± 3.856 years with (28.9%) of the patients being within 26-30 years of age. Majority (71.1%) were multiparous with the modal parity of 3. Majority (63.2%) of the patients were unbooked and fourteen (36.8%) were booked. The leading indication for hysterectomy was uterine rupture 21 (55.3%), 9.4% had maternal death, 54.8% of the patients had stillbirth and 5.3% had early neonatal death. Conclusion: The risk factors associated with EPH should be identified during the antenatal period and pregnant women in high-risk group should be delivered by skilled birth attendants. There is need to enlighten women in our communities on the benefits of antenatal care services and hospital delivery as well as the dangers of delivering under unskilled supervision.

Keywords: Uterine rupture, caesarean section, emergency peripartum hysterectomy, maternal mortality

Lawan M, Loskurima U, Ndahi AA, Habib AG, Ladu AI, Shettima J, Amali AO, Chiroma I, Dungus MM, EmeanwuCH, Tijjani ZM, Ummate I

Background: Sickle cell anaemia (SCA)is a common life-threatening haematological disorder that affects millions of people worldwide. Albuminuria has been identified as an early marker of sickle cell nephropathy. The study aimed to determine the prevalence, pattern and risk factors associated with proteinuria among patients with SCA in Maiduguri. Methods: This was a cross-sectional descriptive study that involved 240 patients with SCA attending the heamatology clinic, UMTH and 240 controls with Hb AA that fulfilled the inclusion criteria. The participants were screened for proteinuria (albuminuria or overt proteinuria) using spot urine to assess for albumin creatinine ratio (ACR). The glomerular filtration rate was estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Albuminuria was defined as a UACR of 3.4 – 33.9 mg/mmol while overt proteinuria as a UACR of > 33.9mg/mmol. Results: The mean age of the SCA group was 23.95±5.93 years while that of the control group was 24.69±6.58 years (p =0.313). The prevalence of albuminuria and proteinuria were significantly higher among the SCA group compared with the control group, 23.3% vs 10.4% and 12.1% vs 4.2% respectively. (p-value <0.001). Serum creatinine levels correlated positively with albuminuria (r = 0.178; p = 0.006), while PCV correlated negatively with albuminuria (r = -0.178; p=0.006). Albuminuria and high diastolic blood pressure were predictors of kidney disease (odds ratio 0.937, 95% CI 0.019 - 0.981, p = 0.002 and 0.971,95% CI 0.937 - 0.971, p = 0.001 respectively. Conclusion: Albuminuria is a marker of early-stage kidney disease in patients with SCA in Maiduguri. Albuminuria correlates with low PCV and elevated serum creatinine levels in SCA patients.

Keywords: Sickle cell anaemia, Albuminuria, kidney disease, northeastern Nigeria.

Arfo FS, Adamu A, Buba B, Shettima HB, Zarami AB

Background: Schwannomas are rare tumours which arise from the sheaths of Schwann cells either from the peripheral, autonomic or central nervous system. It is rare and very few have been reported locally. We report a case of schwannoma, in a 40-year-old woman who presented with a ten-month history of right lateral neck mass which was slow-growing and painless. There were no associated obstructive or toxic symptoms. Examination revealed a well-demarcated right-sided lateral neck mass in zone II of the neck measuring 13 X 6cm, firm, non- tender, not attached to the overlying skin and mobile in the horizontal plane. She had an examination under anaesthesia and total excision of lateral neck mass. Histopathological examination of the mass revealed features in keeping with schwannoma. The patient did well postoperatively.

Keywords: schwannoma, lateral neck mass, histopathology

Oduola owoo LT, Oduola owoo BB, Said AA, Rasheed MW, Omidiji O, Odetayo OF, Idowu NA

Background: Germ cell tumour (GCT) of malignant origin is a rare and heterogeneous group of tumours in the paediatric population. It could be seminomatous and non-seminomatous. The non-seminomatous group is less commonly seen. The most commonly seen type under the non-seminomatous group under the age of three years is the yolk sac tumour. The majority of yolk sac tumours is seen in the gonad while very few develop in extra gonadal sites such as the sacrococcygeal region, retroperitoneum, mediastinum, pelvis and stomach among others. Extra gonadal germ cell tumour is extremely rare in the cervix and when it occurs there may be challenges in the management. We report this case due to its rarity and the possibility of cure by chemotherapy, thus preserving fertility. Case Presentation: A 2-year-old female toddler presented with a 9-month history of persistent bleeding and discharge per vagina. At first, the bleeding was once a month and progressively worsened to once a day. There was no change in bowel and urinary habits. There was a pooling of blood in the vaginal vault on pelvic examination, otherwise unremarkable. Abdominopelvic ultrasound scan and magnetic resonance imaging were suggestive of a tumour of the uterine cervix. The mass was excised and sent for histopathological analysis. The histology of the mass showed a yolk sac tumour. Other laboratory investigations including tumour markers were essentially normal. She had treatment with bleomycin, etoposide, and cisplatin regimen (BEP) of chemotherapy as against radical surgery for potential preservation of fertility. She is five years on follow–up at the time of this report. There was no clinical, laboratory, or radiological evidence of recurrence. Conclusion: The 2-year-old female toddler responded well to chemotherapy. This obviated the need for radical surgery. There was preservation of potential for future fertility.

Keywords: Yolk sac, tumour, chemotherapy, uterine cervix.