Fever is the commonest presenting feature of infections in the neonate. A detailed evaluation of the febrile neonate worrisome as the spectrun1 of perinatal bacterial infections continues to widen. There are also changes in the sero-types and antibiotic susceptibilities of microbes, both in the delivery room and the Special Care Baby Unit or Neonatal Intensive Care Unit. Fortunate y, with the creation of new antibiotics in the face of a thorough ͳ1$wessrnent of the infe-cted pregnant woman and the febrile neonate, effective antimicrobial coverage remains possible. With information and knowledge of national and local trends of infecting organism and disease pattern available it is possible to select an appropriate empiric antimicrobial regimen following a proper assessment of the febrile neonate. It is relevant that in developing countries, unsophisticated research and using basic facilities, can be of value 111 identifying fever cause d by neonatal infection and in recognising its possible solutions.

Analysis of the electrical axis of the heart (p-wave axis, T-axis, and QRS axis) using the triaxial reference system and the hexaxial reference system was carried out in 880 normal Nigerians. Results show that the values of the electrical axis of the heart obtained by the triaxial reference ,system was significantly greater than those from hexaxial reference method (P < O.05). wave axis exhibited no sex variation, but there was progressive rightward shift with age. T-wave axis showed no sex variation. There was progressive leftward displacement ofT-axis with increasing age. Q-wave axis showed no sex differences but there was leftward shift with increasing age. to the Caucasian, Nigerian subject have a more leftward orientation of the mean frontal QRS. I 0.27% our subject met the criteria for left axis deviation while 0.76% met the criteria for right axis deviation.

A comparative st udv of obstetrics performance of unhooked and booked patients in the University of Ilorin Teaching Hospital, Ilorin, Nigeria over a period of twelve months (January1994 to December 1994) was conducted. The objectives of this study are: .. (i) To identify the magnit ude of the problem posed to unhooked mothers in this centre (ii) To determine the obstetrics performance in those mothers. (iii) To make suggestions on areas of improvement. The unhooked patients who had singleton deliveries during the study period constituted the study group. The proportion of deliveries, which occurred in hooked women, were matched for age and parity during the study period was used as control.Multiple pregnancies wen! excluded. Maternity records of women in two group 1ere careji1lly examined and information relat ed to mode of delivery, perinatal outcome and mortaliy were extracted. · Duril1g the study period 6.4% deliveries were·recorded in unhooked women with a perinatal morality rate of per thousand as against 37.5 per thousand in the booked ·women. Maternal mortality rate was six times higher in unhooked than the book ed women. is evide1it that the unhooked stats is associated with poor obstetrics pe1jorrnance when compared with the booked women.

A retrospective study of the determinant factors of perinatal mortality among Breech Delivery in University of florin Teaching Hospital, florin, Nigeria over a period of thirty six months (January 1996 to December, 1998) was conducted. The incidence of singleton breech delivery was 3. 3% with a Perinatal Mortality Rate ,(1'NlvfR) of224. 1 per thousand as against the overall perinatal mortality rate of 31.5 per thousand. Perinatal ri10rtality rate was highest in breech extraction (857. 1 per thousand). Caesarean section appears to offer best prognosis for breach delivery as perinatal mortality rate of 11.32 per thousand occurred in the study which was the lowest. was advocated that adequate antenatal care and proper assessment as to decide the route of delivery in breech presentation, will assis(in reducing perinatal death.

A cross-sectional study was designed to gather information from 360 mothers of children under 5 years of age , order to find out the factors that affected utilisation of primary health care (PHC) services available in Barkin Ladi. a rural local government area (LGA) in .Plateau State, Nigeria. Of th360 mothers interviewed using a structured questionnaire, 357 (99.2%) wen? analysed. The major factors that caused non-attendance of the available services in the local government area included the high costs of drugs (29%) and service charges (19%), easy access to traditional healers (39%) and difficulty in getting transport !o a health facility (JOOA). The unfriendly attitude of the health workers (3.6%) and the wasting of patients time at the facility (7.8%) did not constitute serious constraints .at ,attendance of facilities for use of services. R.ecommendations suggested for corrective measures inlude raising the standard of health workers through trai1fing, provision of integrated services .at all Primary Health Care (PHC) facilities, the introduction and sustenance of facility level Revolving Drug Fund Scheme.

This was a prospective study o{39 cases of dog bites and 4 cases (![rabies seen in the Emergency Paediatric Unit of University of Ilorin Teaching Hospital over a 3 year period. The peak age range of the children who had dog-bite was -1 to 8 years with a mean (SD) age(!{ 55 (I 2. 4) months. All those with rabies were aged over 5 years. Over seventy percent o{ the dog bit e occurred during the d1·y season (October through]I![ arch). ]I![ ales accounted for .8%, whilst all the cases of rabies were males. the patients with rabies did not inform their parents of the bite and never received anti rabies vaccination. Stray dogs accounted for 58.9% of the bit es, domestic dogs in 33.3% and dogs used for hunting in 7. 7% of the cases. None of the children bitten by a vaccinated dog (with certificate of vaccination) developed rabies. Also none of the patients given anti rabies vaccine post exposure developed the disease. All the cases of rabies die d. conclusion, children with dog-bite in whom the certificate o f vaccination in the dog could not b e produced should be given anti rabies vaccine. There should be public enlightenment campaigns aimed at informing the public of the need to vaccinate all dogs, and the need to report all cases of dog-bite at health facilities.

Peak expiratory flow rate was measured in 1500 rural Nigerian children using the mini-1-Wright's Peak Flow Meta Their ages ranged from 5-16years (mean SD: 10.0(5.-1) years for boys and 11.2(3.2) years/or girls). The mean (SD) values for PEFR were 350.4(52. 2) Ll111in for boys and 300. 0(60. 3) Limin for girls. The predicted data derived from the prediction formula for Caucasians was significantly higher (PLO. 001) than the observed values of the same age group. PEFR showed significant correlation with many constitutional variables. A positive correlation observed age and PEFR suggests that in Nigerians, a fal1 in PEFR will occur only after the age at which maximum PEFR is attained A combination o/age and height gave the regression equation with the least standard error of estimate for predicting PEFR in both sexes.

One hundred and eighty-eight adult Nigerian (112females and 76 males) were screened for lumbo-sacral osteoarthritis (LSOA) both clinically and radiographically. Eighty (42.6%) patients had osteoarthritis5. Females(52) were significantly more affected than males (ͳ8), p < O. 001. Factors that have contributed to the development of LSOA include female gender, advancing age,_ occupation, physical activities as well as increased body mass index (BMI) of the patients. Load carriage on the head and neck by the patients also contributed to the genesis of LSOA. There has also a good correlation between the radiographic severity of osteoarthritis (OA) and appearance of symptoms.

This paper examines the practical approach to National Health Insurance Scheme (N HIS) as a viable option to health care financing. It re views the current method1· of funding health care in Nigeria, the classification of Health Insurance Scheme with the pros and cons as applied to Nigeria situation, the criteria needed for successful take off of N HJS and modalities of operation. A survey was conducted to determine whether we have a sufficient money currently in the health sector to ensure a successful Health Insurance in Nigeria today

A survey of infant mortaliV in Orba, Udenu Local Governnient Area of Enugu State hetween 1996-1997 was carried out. The study revealed that the infant mortality rate (IMR) for the period 1996- 1997 was 63.5 per 1000 live births. The neonatal and postnatal mortality races stood at 20.3 per 1000 and -13.1 per 1000, respectively, A decline of26% in the IA1R was observed between 1996 and 1997. Similarly; the neonatal and postnatal mortality rates declined by 20% and 29% in the same period. major factors related to infant deaths were found to be fever, convulsion., diarrhoea, respiratorv infection and prematurity. High births orders, low socio-economic class, very early introduction of bottle feeding, late hooking for antinatal care and caesarian section were all associated with high infant mortality rates.