Ambe JP,¹ Asheikh MM,¹ Ayman SS,² Mohammed BA,³ Mohammed GA,³ Adamu H,⁴ Oyefabi A,⁴ Nglass IN⁴

Background : Malaria remains one of the leading causes of mortality among under-five children due to the transmission of the Plasmodium parasite through the bites of infected Anopheles mosquitoes in tropical regions. In Nigeria, where the distribution of Insecticide Treated Nets (ITNs) for prevention is high, suboptimal utilisation and misperceptions are major obstacles to effective malaria control. We conducted this study to assess the ownership and utilisation of ITNs, as well as the factors associated with their proper use, in Yobe State, Nigeria. Methods: A community-based cross-sectional survey was conducted among children aged 3-59 months in Yobe State, Northeastern Nigeria, during the implementation of the Seasonal Malaria Chemoprevention (SMC) program. A sample of 2,880 households with children aged 3-59 months was selected using a modified cluster sampling technique across six Local Government Areas. Data were collected through interviewer- administered, pretested, structured questionnaires to primary caregivers and household heads. Descriptive and regression analyses, using IBM SPSS version 25, were conducted to examine ownership and utilisation, as well as factors that affect ITN use. Results: Ownership of ITNs was reported by 84.9% of households, with most owners having multiple nets. Utilization was high, with 97% of the children having slept under nets the night before the survey. The prevalence of fever in children in the preceding month was 19.7%, of whom 87.4% tested positive for malaria parasitaemia. The main predictors of appropriate ITN use were female caregiver (OR = 0.579, 95% CI = 0.346 – 0.970, P = 0.038); occupation (OR = 3.783, 95% CI = 1.585 – 9.028, P = 0.003); number of nets owned; (OR = 4.611, 95% CI = 2.022 – 10.514, P < 0.001); source of the net; (OR = 2.677, 95% CI = 1.345– 5.392, P = 0.005) and mosquitoes not biting through the nets (OR = 0.508, 95% CI = 0.291 – 0.887, p = 0.017). Malaria was found to be more prevalent among net users. Conclusion: While the study showed a high level of ownership and utilization of ITNs in Yobe State, there are still some problems regarding proper malaria prevention. Some of the factors that need to be addressed include the education of the caregiver, maintenance of the nets, and behavioural practices through health education and community involvement to further improve the effectiveness of ITNs in the control of malaria. Interventions in the future should target net care and proper usage practices to sustain protection against malaria.

Key words: Malaria, Insecticide-treated mosquito nets (ITNs), utilisation, Children, prevention.

Shu'aibu L¹, Adamu A¹, Aliyu N¹, Abubakar MY²

Background: Nasopharyngeal cancer (NPC) is a malignancy arising from the epithelial cells of the nasopharynx, with high prevalence in Southeast Asia and North Africa. It has various histologic types with bimodal presentation, with clinical features classified as nasal, cervical, neuropthalmic and otologic mimicking symptoms of other head and neck pathologies leading to delay in presentation, diagnosis and commencement of treatment. Objectives: This study analysed the clinical presentations, histological subtypes, and treatment outcomes of nasopharyngeal malignancy among patients in FTH Katsina, Nigeria. Methods: A retrospective study and data obtained analysed using IBM-SPSS 25.0. Results: A record of 11 patients with confirmed histological diagnosis of NPC were analysed. Male (72.7%), 54.5% were within the 5th to 8th decades of life and 45.5% of patients between the 2nd-4th decades of life. Nasal symptoms included epistaxis (72.7%), nasal blockage (63.6%), cervical lymphadenopathy (100%), and otologic symptoms (54.5%). Histologically, undifferentiated squamous cell carcinoma (SCC) accounted for 72.7% of cases and lymphoma was the least (9.1%). About 54.5% did not receive treatment, primarily due to financial constraints. The mortality rate was 27.3%, with 54.5% of patients lost to follow-up. Conclusion: Nasopharyngeal caner is a rare nasopharynx tumour with varied clinical and histologic features. It is curable if diagnosed and treated early, and radiotherapy is the most important treatment modality. 

Keywords: Nasopharynx, Cance, Epistaxis, Cervical lymphadenopathy, Radiotherapy

Boysungni Z,¹ Shehu CE,² Panti AA,³ AbdulRahman MB,⁴ Habib AA⁵

Background: Maternal serum alpha-fetoprotein (AFP) screening in the second trimester was initially discussed as a method of detecting neural tube defect and trisomy 21. But it has also been noticed that high AFP level is linked to other poor pregnancy outcomes, such as intrauterine growth restriction (IUGR), congenital anomalies, and preeclampsia. Objectives: To establish the correlation between the level of AFP in the maternal serum in the second trimester and poor pregnancy outcomes among pregnant women that presented at Usmanu Danfodiyo University Teaching Hospital during antenatal clinic, Sokoto. Methods: This was a prospective study in the form of a cohort study, in which selected pregnant patients who booked antenatal care at the teaching hospital were enrolled in the study. The enrolment of participants took place at 16-18 weeks of gestation and they were followed until the parturition. Socio-demographic and clinical data were gathered with the help of a self- structured questionnaire. The measurement of maternal serum AFP was carried out by a completely automated chemiluminescence (Roche) test at 16 and 18 weeks of gestation. When levels of AFP were above 110 ng/ml (>2MOM), an elevated level was determined. The analysis of data was performed with the help of SPSS version 20, and the Chi-square test was employed to test the correlation between AFP levels and pregnancy outcomes, setting the significance level equal to p < 0.05. these women were followed till delivery and any adverse maternal and foetal outcomes were documented and correlated with the alpha-fetoprotein levels. Results: AFP level was on average 89.01 ng/ml; median of 55 ng/ml. The option of increased AFP was found among 28.6 percent (115/402) of participants. A significant association between elevated AFP and most fetal and maternal outcomes was not identified (p > 0.05), whereas the prevalence of IUGR (50%) and congenital anomalies (50%) outcomes among women with elevated AFP levels was higher, so a possible clinical association was considered, and was identified. Conclusion: In the present cohort, although elevated maternal serum AFP in second trimester was not significantly related to adverse fetal or maternal outcome, trends were towards elevated risk of IUGR and congenital abnormalities in women with elevated AFP levels, indicating that AFP may still have a role as risk stratification agent. Routine monitoring and closer antenatal surveillance are recommended in cases of unexplained elevated AFP to improve perinatal outcomes. 

Keywords: Second Trimester, Maternal, Alpha Fetoprotein, Adverse Outcome, Pregnancy

Gali RM¹, Dogo HM², Nggada HA³, Medugu JT¹, Bukar M⁴

Keywords: Awareness, attitude, belief, screening and prostate cancer. 

Adamu A,¹ Usman BB,¹ Adamu A,² Kirfi AM,² Arfo FS,¹ Shattima HB,¹ Khalil J³, Garandawa HI ¹

Background: Pharyngo-oesophageal foreign body (FB) can occur across all age groups but is most common in children. They can lead to significant morbidity and mortality. Method: A retrospective review of the clinical record of all patients with pharyngo-oesophageal FBs who presented at the University of Maiduguri Teaching Hospital (UMTH) between 1st January 2013 to 31st December 2022 was carried out. Data on demographics, clinical histories, examination findings, investigations and interventions were extracted. Results: The age range spanned from 6 months to 74 years with a male-to-female ratio of 2.1:1. Pharyngo-oesophageal FB were commonly seen in children 9 years and below (52.2%), with 33 (63.5%) of these patients aged 3 years and younger. The most common symptoms were dysphagia, odynophagia, foreign body sensation, and drooling of saliva. The commonest site of FB entrapment is the cricopharyngeal area (49%), followed by the oesophagus 34.4%, and the least common site was the hypopharynx (3.1%). In 4 (4.2%) no FB was detected. Meat/fish bones (26%) were the most common FBs, followed by denture 17 (17.1%), metallic objects 13 (13.5%), beads 8 (8.3%), and disc batteries 7 (7.3%). Of the 92 retrieved FBs, 63 (68.5%) were inorganic materials and 29 (31.5%) were organic materials. The FBs were removed endoscopically. No mortality was recorded but 4.2% of the patients sustained mucosal laceration due to impacted dentures which was managed conservatively. Conclusion: Pharyngo-oesophageal FBs are common medical emergencies that are more frequently seen in children and has significant risk of morbidity and mortality, Early diagnosis and retrieval is essential for the prevention complications associated with delayed presentation.

Keywords: Pharyngo-oesophageal, foreign body, endoscopy, ingestion

Lawal OL^1*, Adeyemo AA^1,2

Background: Traffic noise is an increasing problem in our modern society and the dominant source of noise in urban environments. There is limited data on the impact of noise on health in the local environment despite the increase in vehicular traffic on Nigeria's roads. Objective: This study seeks to assess the effect of road traffic noise annoyance on health-related quality of life of the citizens. Method: This is a cross-sectional study that employed a multi-stage sampling technique. Three hundred and eighty respondents were selected in Ibadan, Nigeria. Using a GPS-linked mobile app, residential homes situated between 50m and 2km from major roads were identified. Estimates of noise levels were derived from manual traffic counts using an online noise calculator. The abbreviated World Health Organization Quality of Life questionnaire was used to assess the quality of life. Results: Respondents who lived in high-noise areas were exposed to an average road traffic noise level of 71 – 77dB, values which exceeded the WHO recommendations of 50–55 dB. Moreover, annoyance caused by traffic noise was more prominent in high-noise areas compared to low-noise areas. A significant association was found between health-related quality of life across the four domains and annoyance due to traffic noise and traffic fumes in both high-noise and low-noise residential areas. Conclusion: This study highlights the need for enforcement of regulatory measures to control high road traffic noise in residential areas.   

Keywords: Noise, quality of life, low-noise area, high-noise area, WHO Quality of Life

Mohammed ZB¹, Mustapha Z¹, Goni MA¹, Farate A¹, Zarami AB², Ahidjo A¹, Tahir A¹, Umar HU¹

Keywords: Mammography, Breast, Density pattern, Cancer 

Mba PC,¹ Katagum DA,² Mandara MU,³ Bako B³

Background: Misoprostol is administered either orally or rectally as an adjunct to oxytocin in the active management of the third stage of labour in high-risk patients to prevent primary postpartum haemorrhage (PPH). Objectives: The objective of this study was to evaluate the effectiveness, safety and participants' satisfaction of oral versus rectal misoprostol administration during the third stage of labour for the prevention of primary PPH at the University of Maiduguri Teaching Hospital. Methods: A randomised controlled trial was conducted amongst 206 consenting participants in the active phase of labour at UMTH. After delivery of the baby, active management of the third stage of labour (AMTSL) was initiated with intramuscular oxytocin and misoprostol. Participants in group I received 600 micrograms of misoprostol orally while participants in group II received 600 micrograms of misoprostol rectally. Blood loss was measured and analysed using IBM SPSS version 25. Variables were presented as median ± IQR, proportions and percentages. Chi-square and Mann- Whitney U- test were used as appropriate. A p-value <0.05 was considered statistically significant. Results: Median blood losses were similar in both groups. The median blood loss in group I was 247(172-368) ml and that in group II was 253(192-354) ml. There was no statistically significant difference in both groups with respect to median blood losses (P=0.431). The incidence of primary PPH was 5.3% in group I and 9.4% in group II (P=0.285). Shivering occurred in 54.3% of the participants in group I and in 28.1%of participants in group II. Also, fever was detected in 28.7% of participants in group I and in 15.6% of participants in group II. There were statistically significant differences between the participants in both groups in terms of the occurrence of shivering and fever. Only 1% of the participants experienced allergic reactions. The majority of the participants (79.8% in group I and 88.5% in group II) expressed satisfaction with the route of administration of misoprostol received during the study, with p-value =0.098. Similarly, most of the participants in both groups expressed willingness to choose the same route of administration for future deliveries (91.5% for the oral route and 92.7% for the rectal route; p- value=0.755). Conclusion: Adjunct misoprostol use in the third stage of labour to prevent PPH is effective and safe, with tolerable side effects and significant patient satisfaction. Both routes of administration were acceptable to the patients; there was no preference for one route over the other. We recommend that women be given the options and asked to choose their preferred route of administration of misoprostol as an adjunct for AMTSL

Abiso MA,¹ Bukar FL,² Abulfathi AA,² Ambe JP,² Usman G,² Chamba MI,² Hafsat HS,² Bedu HA,² Yunusa Y²

Background: Family planning (FP) plays a key role in population growth, poverty reduction, and improving maternal health. Family planning advocates call for engaging men in contraceptive decision-making. Nigeria's contraceptive prevalence stood at 22% in 2022, which is below the global average of 58.7% and sub-Saharan Africa's 22% average, contributing to increased maternal mortality in the region. Objectives: This study assessed the determinants of FP methods among men in Jere Local Government Area, Borno State. Methods: A quantitative, descriptive, cross-sectional study was conducted in Jere Local Government Area, Borno State, from May to November 2024. Four hundred and twenty-one participants were recruited and interviewed regarding their knowledge, attitudes, and practices of family planning methods using a predesigned interviewer- administered questionnaire. Probability (multi-stage) and non-probability (convenience) sampling techniques were used to collect data. Results: The mean age was 34.3+11 commonest age group among the respondents (22.5%) was 30-34 years and 40-65 years. The study found that 100% of the men were aware of FP methods. More than half (76%) of the participants demonstrated a good knowledge of FP methods, among which the most common method known was a male condom (14%). The majority (96%) of the men had a good attitude towards FP. Regarding FP methods practice, 32.5% reported ever using at least one FP method, while 20.5% were current users. The majority (80.8%) of respondents utilised male condoms as a FP method. Ethnicity, religion, and the number of children significantly affected FP knowledge (P<0.001). At the same time, respondents' religion is statistically associated with their attitude toward FP (p=0.025), respondents' age and marital status were also statistically associated with practice, P = 0.005 and 0.015, respectively, using chi-square and Fisher’s exact tests. Conclusion: The study concludes that most of the men had good knowledge and attitudes regarding the use of contraceptive methods; however, the practice of FP methods was very low. Men should be the target audience for the behavioural change communication campaign because the participants were knowledgeable about FP methods.   

Keywords: Knowledge; Attitude; Practice; Family planning method

Adamu AI¹, Kabir A², Zarami AB², Abdullahi YM³, Nggada HA², Pindiga UH²

Background: Breast cancer is the most common malignant neoplasm and the leading cause of cancer related deaths among women worldwide. Traditional breast cancer classification based on histopathologic features has limited prognostic and predictive value compared to the molecular classification which although was developed based on hierarchical clustering analysis of gene expression profiling, has been shown to be similar to immunohistochemically defined schemes which can predict clinical outcomes. These immunohistochemically defined schemes are being used as surrogate markers for molecular classification of breast cancer especially in low resource settings like ours. Objectives: Paucity of publications on the molecular classification of breast cancer from Northeastern Nigeria prompted this study. Methods: The study was a hospital based, descriptive and cross sectional one. One hundred and thirteen (n=113) archived tissue blocks from confirmed cases of breast cancer that fulfilled the inclusion criteria for the study were retrieved along with their request cards. Immunohistochemistry was performed on the tissue blocks using monoclonal mouse antibodies to human ER, PR and HER-2 (Novocastra post primary, Leica Biosystems REF7111, 7102 and 7101 respectively). The slides were evaluated using the semi-quantitative quick score and ASCO/CAP 2013 guidelines. Equivocal HER-2 cases had FISH done on them at Unistel medical laboratories, South Africa using the IQFISH protocol. The slides were evaluated using the ASCO/CAP 2013 guidelines. Results: Out of the 1415 cancers diagnosed at the Department of Histopathology, UMTH over the study period, breast cancer accounted for 276 (19.5%) cases. Of the 113 breast cancer cases analysed by immunohistochemistry for the study, 24 (21.2%), 11 (9.7%) and 13 (11.5%) cases were positive for ER, PR and HER-2 respectively. Three (2.8%) cases were equivocal for HER-2 by immunohistochemistry and had FISH done. Using immunohistochemistry as surrogate markers for molecular classification, Luminal A subtype constituted 23 (20.4%) cases, Luminal B had 2 (1.8%) cases, HER-2/neu over expressing had 10 (8.8%) cases and triple negative/Basal-like subclass had 78 (69%) cases. Conclusion: The present study buttresses the fact that breast cancer in Nigeria is predominantly triple negative (69%) and have a high unfavourable molecular subclass (Basal-like). It also shows that FISH if available, can influence management decisions in cases that are HER-2 equivocal by immunohistochemistry.

Keywords: Breast cancer, immunohistochemistry, in Situ Hybridization, Surrogate Markers, Maiduguri 

Ramat AM,¹ Isa BF,² Shodipo OM,³ Bunu B,⁴ Timta AS,⁴ Gana YL,⁴ Kajiama HG,⁴ Kumshe BB⁴

Background: Osteoarthritis (OA) of the knee is a significant contributor to chronic pain and disability. Platelet- rich plasma (PRP) has recently been introduced as a biologic therapy for OA with the aim to reduce pain and potentially retard disease progression. Objectives: To analyze the impact of intra-articular PRP injections on decreasing pain and the period required for improving symptoms in patients suffering from knee OA. Methods: Three consecutive weekly shots of intraarticular platelet rich plasma injections (IPRPI) were administered to 52 patients. This included 18 bilateral and 34 unilateral knees with radiographic confirmation OA. Pain intensity was assessed using a visual analogue scale (VAS) score at baseline, at 24 hours and after 1 week post injection, and then again at 3 months and 6 months. Results: Forty eight (92%) patients had baseline VAS =8, worse during the first few hours after injection and improved to =3 within a week in all but four patients. Improvement lasted 3 months in 11 patients (Kellgren–Lawrence grade 2-3) and = 6 months in the other 39 patients (KL grade 1-2). In four patients (KL grade 4), pain reduced partially before it returned to baseline pain level at approximately three weeks after the last injection (VAS 9 to 7 then 9 again). Conclusion: Injection of PRP has beneficial effects for pain relief based on short to medium term in patients with mild to moderate OA, but its effect appears to be less effective in advanced stages of the disease. 

Keywords: Intra-Articular, Injection, Platelet-Rich Plasma, Treatment, knee osteoarthritis 

Bukar LM,¹ Monguno HFK,² Garba AM,¹ Imam RA,¹ Musa HY, ¹ Mele AM¹ 

Keywords: Severe Acute Malnutrition, Treatment outcomes, mortality, default, Risk factors 

Ogah SA¹, Ashraff A², Muazu OM², Nwafor IP³, Tamasanni SO³, Obaro SY³, Adaja GO⁴

Background: Cut-throat injuries, though relatively rare, are emerging more frequently due to the rising incidence of violent crimes such as terrorism and banditry. Cut-throat injuries pose significant management challenges, often requiring a multidisciplinary approach involving the anesthesiologist, otolaryngologist, and psychiatrist, especially in cases with suicidal intent. Case Summary: We present management of a case of an 18- year-old male with a homicidal cut-throat injury. Early presentation, prompt resuscitation, airway management via tracheostomy, and layered wound repair led to a successful outcome. 

Keywords: Cut-throat, injury, emergency.

Daibu U¹, Usman B¹, Mohammed B ¹

Background: Meningocele is a neural tube defect that is usually seen in infants. Adult presentation is extremely rare, with few cases reported in the literature Case Summary: We report a case of a 27year old black African lady who presented to our facility with a lumbosacral swelling since birth that gradually increased in size. No associated weakness of the lower limbs, faecal or urinary incontinence. No swelling in other parts of the body. Patient and relatives attributed the late presentation to lack of initial awareness of the condition, and subsequently to lack of accessible neurosurgical care within their reach. Examination of the spine revealed a huge sessile lumbosacral swelling measuring 20 x18 x 8cm, cystic, fluctuant and brilliantly transilluminating. Neurological examination revealed normal lower limbs muscle bulk and tone. Power was 5/5 in all muscle groups with normal reflexes and intact sensations. Other systems were essentially normal. Lumbosacral MRI revealed a huge swelling in the lumbosacral region, containing cerebrospinal fluid that communicates with the spinal canal. Patient had excision of the swelling and repair of the dura. Postoperative period was uneventful. Conclusion: The adult presentation of meningocele is often a consequence of limited public awareness and inadequate access to neurosurgical care. Increasing public education and expanding the availability of specialized neurosurgical services could significantly reduce the incidence of such late presentations, along with their associated psychological and social burdens. 

Keywords: Neglected, Meningocele, Adult.

Buba BU,¹ Hassan I,² Dansani UI², Ali S²

Background: Mycotic laryngitis is a rare disease commonly seen in immunocompromised individuals with nonspecific clinical manifestations. The condition is often misdiagnosed as other laryngeal pathologies and it is not usually suspected in immunocompetent individuals. Case Summary: A 51-year-old male military personnel who presented to our facility with a desire to have his tracheostomy tube removed. About 5 years prior to presentation, he was seen at a tertiary health centre with complaints of progressive unremitting hoarseness associated with features of upper airway obstruction which necessitated an emergency tracheostomy. He had laryngeal biopsy with a histology report of squamous cell carcinoma, and he was sent for chemo-radiation in another facility where he had only chemotherapy session. Examination revealed a functioning tracheostomy tube in situ and a flexible laryngoscopy finding of an exophytic mass with a smooth overlying mucosa on the epiglottis extending to the posterior pharyngeal wall, preventing further view of the laryngeal inlet. Contrast- enhanced CT scan of the neck revealed a multi-loculated non-enhancing hypodense lesion involving the epiglottis and wall of the supraglottic larynx with narrowing of the adjacent airway. HIV screening was non- reactive. Random blood glucose and chest X-ray were normal. He had two series of direct laryngoscopy and excision of a laryngeal mass with histologic diagnosis of mycotic laryngitis. He had systemic itraconazole for six weeks and was successfully decannulated thereafter, and is doing well on follow-up. Conclusion: Mycotic laryngitis is a rare condition; therefore, there is a need for a high index of suspicion for early detection and efficient management. 

Keywords: Mycotic laryngitis, fungal staining, histology.

Nganjiwa US,¹ Sulaiman AT,¹ Tizhe L,¹ Gali BM,¹ Tarfa H,² Nganjiwa HU¹

Background: Amyand’s hernia (AH) is the presence of a vermiform appendix (inflamed or not inflamed) in the inguinal hernia sac. It is a rare condition, commonly seen in males, and very difficult to clinically diagnose preoperatively. Clinically, it may be asymptomatic or present with complications of either the hernia, the appendix or both. Imaging may be a valuable tool, and management depends on the patient’s presentation. Case Summary: We report a case of type II AH in a 28-year-old male who presented with a right irreducible indirect inguinal hernia, with an operative finding of an inflamed appendix in the sac. The patient had both an appendectomy and an open right herniorrhaphy. We discussed the rarity of AH, the difficulty in pre-operative diagnosis, a literature review on sensitization, and various treatment options available. 

Keywords: Amyand’s Hernia, Vermiform Appendix, Appendectomy, Herniorrhaphy, Rare.

Dansani UI¹, Sani K¹, Aliyu Z², Abubakar SS¹

Background: Self-inflicted cut-throat injuries represent rare but potentially fatal emergencies requiring urgent multidisciplinary intervention. These cases pose significant challenges in terms of the multi-level management, including emergency care, definitive treatment, prevention of sequalae, psychiatric management and overall rehabilitation. Objective: To highlight the occurrence of this rare condition, to outline the treatment and the need for improvising of laryngeal stenting in resource constraint setting. Case Summary: We report the case of a 40-year-old male police sergeant who presented with a severe self-inflicted anterior neck injury, following a suicide attempt. On examination, he was restless, in painful distress, pale with blood-soaked cloths and generally looked unkempt, Examination of the neck revealed a 12-cm transverse wound extending across the anterior neck, with deeper penetration on the right side, involving complete transection of the thyroid cartilage, near-amputation of the epiglottis, and laceration of the hypopharynx. The wound had irregular, ragged edges. Other examination was unremarkable. Emergency tracheostomy was carried out, followed by staged laryngeal and hypopharyngeal reconstruction with an improvised laryngeal stenting by Naso-tracheal intubation kept in place for two weeks. Psychiatric evaluation and treatment were also instituted. Complete functional recovery was achieved within six weeks, with successful decannulation and return to normal swallowing and phonation. Two years post treatment, he was in a physical and psychologically satisfactory condition. Conclusion: Early airway management, meticulous surgical repair, and comprehensive psychiatric care are essential for optimal outcomes in suicide attempts with self-inflicted cut-throat injuries. Innovative use of available materials in resource-constrained environments can achieve satisfactory outcome. 

Keywords: Cut-throat injury, self-inflicted cut-throat, suicide attempt.