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Colorectal cancer (CRC) in Nigeria used to be a rare disease. However, over the last 40 years it has gradually become a significant health concern. Several publications on this disease from Nigeria have documented an increase in the incidence. To suggest possible and credible pathogenesis for the observed increase in CRC incidence in Nigeria, a search through AJOL, PubMed, and Google Scholar using search items like "colon cancer in Nigeria," "rectal cancer in Nigeria," and "CRC in Nigeria" was carried out. Also, a search for known risk factors in the development of CRC such as diet, carcinogens in red meat, alcohol, and polyposis coli syndromes were also initiated. Factors responsible for the increase in CRC incidence in Nigeria include poor refrigeration facilities resulting from poor electricity services; leading to deep-fried, smoked and charcoal-grilled meat. Other risk factors include an affinity for consumption of offal, an increase in obesity, proliferation of fast food joints, and an increase in alcohol intake. It is unclear how long and large the factors that cause CRC in a patient will have to be present before developing the disease. A dietary intake of fresh, wholesome, non-processed, preservative and hydrocarbon free foods should be encouraged; while habits such as consumption of alcohol and cigarette smoking are discouraged.

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Background: The principle and practice of birth preparedness and complication readiness (BP/CR) in resource-poor settings have the potential of reducing maternal, and neonatal morbidity and mortality rates. Aim: The aim was to assess BP/CR among pregnant women attending Antenatal care in Primary Health Care Centres in Oredo Local Government Area (LGA) in Benin City, Edo State. Materials and Methods: A descriptive cross-sectional study carried out among pregnant women attending antenatal clinic in Primary Health Centres in Oredo LGA. Data were collected using structured questionnaires, and analyzed using the Statistical Package for Social sciences (SPSS) Version 16.0. Descriptive data were presented in frequency tables. Statistical testing using Chi-square was carried out with level of significance set as P < 0.05. Results: One hundred and fourteen pregnant women (49.6%) were aware of at least one danger sign associated with pregnancy, labor, and postpartum, while 201 women (87.4%) had identified a skilled birth attendant. Twenty-six (11.3%) had saved money for obstetric care, and 143 (62.2%) had purchased or made plans to purchase birth supplies. Two hundred and one (87.4%) respondents were found to be well-prepared for the birth. Having a tertiary education and being married were factors found to be significantly associated with BP. Conclusion: Majority of the women had BP/CR in place. However, emphasis should be placed on identifying target groups and practice gaps, for intensified health education.

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Symmetrical peripheral gangrene (SPG) is a rare syndrome. It is characterized by bilateral distal ischemia leading to gangrene, in the absence of major vascular occlusive disease. It is considered a cutaneous marker of disseminated intravascular coagulation, and more than half of the patients who survive require amputation of the affected limb(s). The etio-pathogenesis of SPG is not well understood, but the hallmark is the occurrence of microcirculatory failure. We present two patients with SPG. The aim of this report is to sensitize and to help make the diagnosis easier for the clinician. Patients who are identified to be at risk require frequent observation and examination of the appearance of their distal extremities, nose, and ears. No treatment is universally effective. It should be individualized according to the underlying disease and patient's general condition. The guiding principle is prompt identification and reduction or removal of aggravating factors.

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Background: Renal disease in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) contributes significantly to morbidity and mortality associated with HIV infection worldwide. Aim: To determine the prevalence, risk factors, and histological pattern of kidney disease in HIV-positive patients in Kano, Nigeria. Materials and Methods: Four hundred consecutive treatment naοve HIV-positive patients with no other condition known to cause kidney disease were screened for proteinuria and reduced glomerular filtration rate (GFR). Kidney disease was defined as the presence of persistent microalbuminuria/proteinuria or decreased GFR (<60 ml/min/1.73 m ² ). Kidney biopsy was performed on 20 patients. Data were analyzed using SPSS version 17. Results: The mean ± standard deviation age of the study population was 34.03 ± 10.23 years with 240 (60%) being females. Kidney disease was found in 227 patients (56.8%), with a higher prevalence seen in males (odds ratio = 1.9305, 95% confidence interval = 1.2760-2.9207, P = 0.0018). Proteinuria including persistent microalbuminuria was found in 211 (52.8%) and reduced GFR was found in 64 (16.0%). The risk factors for developing kidney disease were age >40 years, male gender, low CD4 cell count, cigarette smoking, low body mass index, and low serum cholesterol. Logistic regression identified low CD4 cell count as an independent risk factor for kidney disease. Collapsing focal segmental glomerulosclerosis (FSGS) was the predominant histological pattern seen. Conclusion: The prevalence of renal disease in HIV-positive patients was high in Kano, Nigeria; and microalbuminuria was a manifestation of collapsing FSGS.

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Background: Acanthosis nigricans (AN) is a skin condition associated with insulin resistance, and highly correlated with hyperinsulinemia, type 2 diabetes, and obesity; with scarcity of information regarding its status in young adult subjects. Aim: To determine the association between the presence of AN with biochemical parameters and anthropometric variables. Subjects and Methods: This analytical cross-sectional study included young male subjects from outpatient department of Medicine of a tertiary care center in North India. They were divided into three group of 40 subjects each. Group I consisted of subjects having AN, Group II consisted of obese/overweight subjects without AN, and Group III consisted of control subjects without AN or obesity. Covariates included family history of diabetes. Results: There was a significant positive association (P < 0.001) between AN and high body mass index (BMI), fasting glucose, waist-hip ratio (WHR), and systolic blood pressure (BP) even when controlled for obesity. For lipoproteins, insulin, and diastolic BP, the association even though significant, was inconsistent when obesity was taken into consideration. Conclusion: Individuals with AN have lower high-density lipoproteins, and higher BMI, fasting blood glucose (FBG), serum insulin, total cholesterol, triglycerides, low-density lipoproteins, and systolic as well as diastolic pressure. Irrespective of being obese, AN is associated with a high BMI, WHR, FBG and systolic BP in young adults.

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Primary pulmonary fibrosarcomas are rare malignant tumors of mesenchymal origin. We report a case of primary pulmonary fibrosarcoma in a 35-year-old man who presented with chronic cough and progressive breathlessness. Further clinical evaluation revealed a right lung mass extending from the base of the lung to the mid zone. Histology of biopsied sections of the mass confirmed a lung fibrosarcoma thought to be primary in view of the absence of any other source. Outcome was however unfavorable due to death of the patient. Late presentation and the extensive nature of the disease were identified as the cause of mortality. This case is reported because of its rarity.

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Introduction: India has a high suicide rate, and a large proportion of these suicides occur through poisoning. Poisoning by hair dye has been increasing, and in some regions, constitutes a large proportion of the poisoning cases. Aims: To determine the clinical and biochemical features of hair dye poisoning, and to identify factors affecting mortality among these cases of hair dye poisoning. Subjects and Methods: A cross-sectional study conducted from April to December 2010 in Thoothukudi, Tamil Nadu, among 125 cases of hair dye poisoning. Cases with the prior history of cardiac/respiratory illness, seizure disorder, and those consuming a mixture of poisons were excluded from the study. A standardized questionnaire was administered. Biochemical and other investigations were carried out; and patient outcomes were documented. Statistical Analysis Used: The results were compiled and analyzed using Statistical Package for the Social Sciences (version 20) software. Chi-square test, Mann-Whitney U-test, and Kruskal-Wallis test at 5% level of significance was used to analyze the data. Results: Among the 125 cases, 68.8% were females, and the overall median age was 24 (20-30.5) years. The median time of presentation was 155 min (40-275), and the average amount of hair dye consumed was about 50.0 mls (25-55 mls). Almost 68.8% of the cases developed oropharyngeal edema, and among them, 57 (66.28%) had an emergency tracheostomy performed. About 27.2% of the patients died. Conclusions: The time of presentation to the hospital is an important risk factor for developing oropharyngeal edema, which in turn determines the risk of mortality. Females, especially those in the younger age groups should be targeted for supportive and preventive strategies, so as to reduce the incidence of hair dye poisoning.

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Background: Endotracheal intubation is one of the most important anaesthetic skills. Endotracheal intubation in patients with limited mouth opening always remains a challenge, especially in the absence of a flexible fiber-optic bronchoscope. The retrograde catheter technique is an acceptable option for airway management in cases where oral intubation is not possible because of limited mouth opening, or is not recommended because of fear of dislodgement of fracture segments of facial bones. We performed retrograde intubation in a complicated bilateral mandibular fracture from a gunshot injury.

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Context: Radiofrequency ablation (RFA) is a recognised mode of therapy for cardiac arrhythmias. The procedure is carried our regularly at the Cardiac Catheterization Laboratory of Madras Medical Mission, India. Aim: To evaluate the intermediate term follow-up results of radiofrequency catheter ablations. Subjects and Methods: This was a retrospective study carried out in the Cardiac Electrophysiology Department of the Institute of Cardiovascular Diseases, Madras Medical Mission (MMM), India. Records of consecutive cardiac electrophysiologic studies carried out between January and October 2009, together with records of follow-up to March 2014 for those that underwent RFAs were reviewed. In total, the records of 139 cases that had RFAs were analysed. Results: The 139 patients comprised of 65 males and 74 females. The indication for RFA was drug refractory arrhythmias in the vast majority (137 patients). There was a very high success rate (97.1%), following cardiac ablations. Early complications were observed in only 3 (2.2%) patients. Recurrence rate of the indication for RFA was very low (1.43%), and there was no mortality associated with the procedure. Conclusions: The treatment of patients with cardiac arrhythmias using RFA, was associated with a high rate of success, and low rate of complications.

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