Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disorder with no effective treatment. It occurs when specific nerve cells in the brain and spinal cord that control voluntary movement gradually deteriorate. The loss of these so-called motor neurons causes the muscles under their control to weaken and waste away, leading to paralysis. ALS varies from patient to patient, depending on which muscles weaken first. ALS strikes in mid-life and it is observed that men are about one-and-a-half times more likely to have the disease as women. The present review is an attempt to give an insight into the signs, symptoms, diagnosis and symptomatic treatment of ALS.

Background : Tuberculous meningitis (TBM) is often under and over diagnosed, thereby making the ancillary diagnostic tests important for establishing the diagnosis of TBM. The objective of this study was to evaluate cerebrospinal fluid adenosine deaminase (CSF-ADA) as an ancillary test for the diagnosis of TBM, and further, its correlation with adverse neurological outcome in these patients. Materials and Methods : This was a prospective study of 83 patients. The diagnosis of TBM was established by Thwaites criteria. CSF-ADA levels were measured in all these patients and were taken to be positive at levels >10 IU/l. These patients were followed up at 1 and 3 months after discharge, and the resultant neurological deficit was measured as per the modified Rankin score and correlated with the initial CSF-ADA levels. Mann-Whitney U test, χ² test, Kruskall-Wallis tests were used for statistical analyses. Results : CSF-ADA values were higher than 10 IU/l in all the 83 patients diagnosed to be suffering from TBM. It was seen that the mean ADA level for patients with stage I/II was 18.23 ± 8.64 IU/l, while it was 31.97 ± 226 004, India.

Aim : To determine the prevalence and distribution of refractive errors and presbyopia in the university community. Materials and Methods : A prospective study of all consecutive patients who visited A.B.U. Sick Bay between March 2009 and May 2010 was conducted. The ophthalmic nurse booked all patients whose visual acuity improved with the use of pinhole for further examination and refraction by one of two ophthalmologists who visited the facility twice a week. Those who did not turn up for refraction were excluded. Results : A total of 1448 patients with mean age of 24.6 SD± 4.9 years, distributed along gender and occupational lines, were seen within the study period. The prevalence of refractive errors and presbyopia was 15.8%. The prevalence of refractive error alone in the sample population was 9.5%, that of presbyopia only was 4.2% and that of those who had both refractive error and presbyopia was 2.1% (i.e. total prevalence of refractive errors = 11.6%). However, the total prevalence of presbyopia among those above 40 years was 49.7%. The predominant errors were astigmatism and simple myopia. Conclusion : Presbyopia and refractive errors, especially astigmatism and simple myopia, are common eye conditions in the university environment. Many patients would not turn up for their refraction appointments. It is recommended that mass enlightenment and screening for refractive errors be commenced, while routine assessment of new students and staff will also help to curb the negative impact on academic performance.

Objectives : The objective is to determine transrectal ultrasound (TRUS) findings and their relevance in the diagnosis of prostatic cancer among patients with abnormal digital rectal examination (DRE) and elevated PSA. Materials and Methods : This was a prospective study of 131 patients suspected to have advanced prostate cancer based on clinical presentation, abnormal DRE and elevated PSA (>10 ng/ml), who were evaluated with TRUS prior to prostatic biopsy and the findings correlated with the histologic outcome. Results : The mean prostate size by TRUS was 66.8 g with a range of 15-219 g. The majority of patients with hypoechoic nodules 56.3% (45 of 80) had a malignant histology and the yield was higher among those with both hypoechoic nodules and prostatic capsule invasion 25 (31.3%). Cancer detection in those with mixed echogenicity was next in frequency 33.8% (27 of 80). All the prostates with hyperechoic pattern and most of those with isoechoic appearance had benign histology. Conclusion : Though TRUS findings generally have a low specificity for prostate cancer, the specificity of TRUS findings is probably higher in advanced prostate cancer.

Background : With improvement in preventive medicine and advancement in the management of otherwise morbid eye conditions, the reasons for destructive eye surgeries have changed overtime. Objectives : This study aims at determining the current indications for destructive eye surgeries and compares these to the findings of a similar study done in the same unit two decades earlier. Materials and Methods : It is a retrospective study of 278 cases of destructive eye operations performed at the Guinness Ophthalmic Unit of Ahmadu Bello University Teaching Hospital Kaduna from January 1991 to December 2000. Results : They were 152 eviscerations, 67 enucleations, and 59 exenterations. Tumors were responsible for the majority of destructive eye operations in the unit (31%). This was followed closely by endophthalmitis/panophthalmitis (30%). Others were trauma (23%), corneal disease (8%) and painful blind eyes (7%). Conclusion : They were noticeable changes in the indications for destructive eye operations especially for some infective and nutritional causes which are largely preventable.

Penoscrotal transposition may be partial or complete, resulting in variable degrees of positional exchanges between the penis and the scrotum. Repairs of penoscrotal transposition rely on the creation of rotational flaps to mobilize the scrotum downward or transpose the penis to a neo hole created in the skin of the mons-pubis.