Introduction: Delays in care seeking for obstetric emergencies are major determinants of maternal death in Nigeria. Birth preparedness has been found to be effective in reducing these delays. Male involvement is necessary for improving birth preparedness because of patriarchy which allows men to control women's access to and utilization of maternal health care. Aim: To assess the effect of a health promotion intervention on male involvement in birth preparedness in a rural community in northern Nigeria. Materials and Method: A quasi-experimental study in which 205 and 206 married men were enrolled into study and control groups respectively. Pre-intervention, data were collected from both groups. Thereafter, a three-component health promotion intervention was carried out among the study group. Six months after, a post-intervention survey was carried out among both groups. Quantitative data was analyzed using SPSS Statistics 17.0, and statistical significance of difference between pre- and post-intervention levels of birth preparedness was determined using Chi-square test at P < 0.05. Qualitative data was analyzed manually according to themes. Results: Post-intervention, both study and control groups did not show statistically significant increase in the practice of birth preparedness. Analysis of qualitative data revealed that their religious beliefs were not in favour of the practice of birth preparedness. Conclusion: The intervention did not increase male involvement in birth preparedness likely due to religious misconceptions. Therefore, future studies should consider assessing the effect of interventions that employ religious approaches on birth preparedness.

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This case presents an uncommon fungal infection in the setting of HIV infection. This patient with meningitis from Rhodotorula spp. presented with headache, neck pain, and seizures; in the setting of low CD4 cell count of 50 cells/μl. The diagnosis was confirmed by the isolation of the fungus from the CSF and blood. She improved remarkably on high dose fluconazole.

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Background: Benign breast diseases (BBDs) constitute a source of morbidity and mortality among women globally. Most of these lesions are common in women of reproductive age and are associated with hormonal influences. However, studies have reported an increasing incidence of these lesions in children and adolescents. Aims: The aim was to highlight the spectrum and histological patterns of BBDs among women in Delta State and other Southern states of Nigeria as seen at central hospital, Warri. Materials and Methods: This study was a 7-year retrospective analysis of all histologically diagnosed breast diseases in women. Request forms were scrutinized for clinical bio-data, diagnosis. Hematoxylin and eosin stained-slides of breast biopsies carried out at the central hospital, Warri were archived and studied. Results: A total of 905 breast lesions were received during this 7 years period in the Pathology Department. Of these, 644 cases accounting for (71.2%) were benign lesions, while 261 cases (28.8%) were malignant giving a ratio of 2.5:1. A total of 638 cases occurred in female while only 6 cases occurred in males. The mean age was 31.2 ± 8.4 years, and the peak age incidence was 20-29 years constituting 49.8% cases of BBDs. Fibroadenoma was the most common BBD accounting for 302 cases (46.9%). Fibrocystic disease was the second majority and constituted 126 cases (19.6%). Conclusion: Fibroadenoma constituted the most common histopathological patterns of BBDs in children and adolescents in our environment.

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Background: Intimate partner abuse (IPA) has many negative consequences on the health of women and their children, and on the economic and social development of communities. Aim: This study was conducted to determine the prevalence of IPA among men in an urban community of North-Western, Nigeria, their reasons for engaging in it, and the complications experienced by their partners. Materials and Methods: The study was conducted in Samaru, Sabon Gari Local Government Area of Kaduna State. This was a cross-sectional study in which 397 married men were interviewed using a structured interviewer-administered questionnaire containing both open- and close-ended questions. A man was considered to have engaged in IPA if he had engaged in at least one form of physical, sexual, emotional and/or economic abuse in the last 12 months. Results: Mean age of the respondents was 30.3 ± 27.5 years, and they were mostly Hausa-Fulani 183 (46.1%), and having tertiary education 238 (59.2%). Among all respondents, 186 (46.9%) had engaged in IPA in the last 12 months, the most common type being physical abuse 184 (46.3%). Of all IPAs, 78 (41.9%) occurred, while the partner was pregnant. Some common reasons for engaging in IPA include wife's nagging and impatience, husband's heavy drinking, and negligence of domestic duty by wife. Major complications of IPA experienced by their wives were physical injury and miscarriage. Conclusion: Prevalence of IPA amongst the respondents is very high, with almost half occurring during pregnancy. It is recommended that excessive alcohol consumption and gender roles should be discouraged in the community. In addition, screening of antenatal clinic attendees for IPA should be instituted in such communities.

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Background: Adipose tumors are the most common soft tissue tumors in humans. The reported incidence of lipoma is probably less than the actual incidence because of its insidious growth pattern and minimal associated symptoms. Objective: The objective of this study is to document the pattern of these tumors in a tertiary hospital in Northern Nigeria. Materials and Method: This is a retrospective study of all diagnosed adipose tissue tumor over a 10-year period (January 2002 to December 2011), in the Department of Pathology, Ahmadu Bello University Teaching Hospital. Tissue biopsies fixed in 10% formalin and stained routinely with hematoxylin and eosin were studied. Biodata and sites of involvement were retrieved from patients' requisition cards. Results: Four hundred and three adipose tissue tumors were diagnosed during this period. Three hundred and ninety-five (98.0%) of the tumors were benign, while 8 (2.0%) were malignant. The male to female distribution was 197 and 206, respectively. Patients ages ranged from 3 months to 75 years with a peak age distribution in the fifth decade (23.6%). The most common site of involvement was the trunk (38.0%), followed by the head and neck region (21.3%) and lower limbs (17.4%). Conventional lipoma was the most common benign tumor, accounting for 328 cases (81.4%), while myxoid liposarcoma was the most common malignant tumor with 4 cases (1.0%). Conclusion: Adipose tissue tumors are not uncommon in our setting and accounted for 6.0% of all tumors seen within the study period. There is a slight female preponderance and the trunk is the most common site of involvement. Benign tumors formed the bulk of lesions recorded.

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Introduction: Pattern of hospital admissions and mortality can be a valuable tool in auditing hospital performance. Medical childhood morbidity and mortality in developing countries are high; there has been no reported hospital audit of paediatric admissions in Gusau, Zamfara State. Aim: We undertook the first hospital audit of paediatric medical admissions at Yariman Bakura Specialist Hospital, Gusau to evaluate the morbidity and mortality pattern. Materials and Methods: This is a descriptive, cross-sectional study involving postneonatal children aged 1 month to 12 years 11 months, admitted and managed in the paediatric medical wards between April 1, 2013 and March 31, 2014. Results: Of the 801 children admitted over the study period, 449 (56.1%) were males; with a male: female ratio of 1.3:1. Children under the age of 5 years accounted for 64.9% of the admissions. The common diagnosis was infectious; with malaria, Diarrhoea, sepsis and pneumonia as the most common. Mortality rate was 11.2%, and 1.9% were discharged against medical advice. Malaria, sepsis, diarrhea and pneumonia were the major cause of death in under fives. Malaria, sepsis and seizure disorder were the commonest cause of death in children >5 years. There was no association between mortality and gender (p = 0.320). Children under 5 years were more likely to die than those over 5 years (odds ratio-1.5; 95% confidence interval (1.1-2.5); p = 0.035). Conclusion: The morbidity and mortality pattern of children in Gusau is similar to what has been reported in other studies. There is a need for more effort by the stakeholders in the health sector to ensure adequate vaccination of children and provision of essential drugs in health care centers in Zamfara state.

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Foramen magnum tumors are rare in neurofibromatosis type 1. They may present with bizarre symptoms and may mimic many neurological conditions. We report a case of foramen magnum syndrome secondary to tumor misdiagnosed as cervical spine tuberculosis.

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Spontaneous bilateral tubal ectopic pregnancy is a rare occurrence. A case of a recently managed spontaneous bilateral tubal ectopic pregnancy is discussed. A 37-year-old grand multiparous farmer, who had been amenorrhoeic for 12 weeks, presented with lower abdominal pain, bleeding per vaginam, and dizziness. Other clinical and ultrasonographic findings were suggestive of ruptured ectopic gestation. Intra-operative findings included ruptured right tubal and unruptured left tubal ectopic pregnancies. Bilateral partial salpingectomy was performed with uneventful recovery. Intra-operative diagnosis of bilateral tubal ectopic pregnancy was confirmed by histology of the specimens.

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Introduction: Sickle cell anemia (SCA) is frequently associated with liver disease. The constant state of hemolysis due to reduced red cell survival; and multiple blood transfusions, places these patients at risk hepatic sinusoidal congestion, viral hepatitis, cholestasis, and hemosiderosis, all of which may contribute to the development of liver disease. Objective: The aim was to assess the pattern of biochemical liver function tests and their relationship with liver size in steady state adult SCA patients in Zaria, North-West, Nigeria. Materials and Methods: Seventy-one adult SCA patients in steady state and 20 hemoglobin AA controls were enrolled into the study. Liver function tests were carried out and liver spans assessed using B-mode ultrasound scan in all subjects. Results: The serum bilirubin, aspartate transaminase (AST) and AST/alanine transaminase (ALT) ratio were significantly higher in SCA patients than in controls, with P values of 0.04, <0.001, and <0.001 respectively. Thirty-four (48%) SCA patients had AST/ALT ratio of >2. Hepatomegaly was present in 67/71 (94%) of the patients, and absent in the controls. The liver span was significantly greater in SCA patients (P < 0.001). There were no significant difference in the mean values of ALT, alkaline phosphatase (ALP), total protein and albumin. There was no correlation between the liver span and the biochemical parameters. Conclusion: Steady state SCA patients in Ahmadu Bello University Teaching Hospital, Zaria, have hepatomegaly associated with minimal elevation of ALT and ALP. There was no correlation between the liver span and the biochemical parameters. It is advisable that liver function tests and liver ultrasound scan be interpreted with caution in these patients.

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Background: Sickle cell disease (SCD) is an important public health problem in Nigeria, with a prevalence of about 20/1000 births, and with up to 24% of the general population carrying the trait. Globally, drugs account for about 60% of nonpersonnel cost of healthcare and about 50% of medications are presumed to be inappropriately prescribed, dispensed, or sold. This leads in part to increased cost of healthcare and emergence of drug resistance. Aim: The aim of the study was to assess the drug prescribing pattern in the management of SCD patients in a hematology unit of Usmanu Danfodiyo University Teaching Hospital in Sokoto, North-West Nigeria; and assess conformity to World Health Organization (WHO) specification. Materials and Methods: This was a cross-sectional retrospective study involving the review of 272 prescriptions from the case notes of SCD patients seen in the hematology clinic of Usmanu Danfodiyo University Teaching Hospital, Sokoto, a Tertiary Health Care Center in North-West Nigeria from June 2009 to July 2011. Data were collected from case notes of patients and were analyzed using descriptive statistics. Result: The mean age of SCD patients was 19.6 ± 4.5 years and 54.4% of the patients were male. A total of 1230 drugs was prescribed with an average of 4.5 drugs per prescription. Analgesics, antimalarials, vitamins, and antibiotics, accounted for 30.1%, 28.7%, 23.1%, and 8.7%, of the total prescriptions, respectively. Of the analgesics prescribed, acetaminophen accounted for 24.8%, nonsteroidal anti-inflammatory drugs (32.2%), and narcotics 43%. Artemisilin-based combination therapy was used in the management of malaria, and 73% of SCD patients had prophylactic antimalarial (proguanil). Penicillins accounted for over 60% of antibiotics used. Conclusion: Drug prescription in SCD patients is high, and thus it is recommended that WHO/International Network on Rational Drug Use standard and core prescribing indicators be adhered to.

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Background: Cardiovascular autonomic diabetic neuropathy (CADN) is an important diabetes-associated complication. Reduced heart rate variation is the earliest indicator of CADN. Aims: The aim was to study the prospect of using short term heart rate variability (HRV) analysis for early diagnosis of CADN. Settings and Design: The type of this study was hospital-based comparative cross-sectional study. Materials and Methods: A total of 30 asymptomatic, type 2 diabetic male patients with duration of diabetes of 1-5 years with random blood sugar ≥200 mg/dl (11.1 mmol/L) or fasting blood sugar ≥126 mg/dl (7 mmol/L) in the age group of 30-65 years were selected as subjects. Thirty age and sex matched healthy nondiabetics were selected as controls. HRV analysis was performed using electrocardiogram recorded in lead II, at rest, in the supine position for 5 min. Results: Total power, low frequency power, high frequency power, standard deviation of all R-R intervals, root mean square of successive RR-interval differences, number of intervals differing by >50 ms from adjacent interval (NN50), and percentage of NN50 (pNN50) were significantly less in diabetics when compared to nondiabetics (P < 0.05). Conclusion: Data from the study demonstrated that asymptomatic diabetics with <5 years history had already developed autonomic neuropathy. Short term analysis of HRV can be used as a valuable tool for early diagnosis of autonomic neuropathy.

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