Sexual abuse in children and adolescents is a silent epidemic because despite the fact that close to 20% of children and adolescents (1 out 5) are affected , less than 10% of the cases get reported to law enforcement age11ts or medical practitioners. abuse- is associated with physical injuries such as bruises and lacerations to the neck, back, buttocks, extremities, vulva and the vagina. Other complications relate to sexually transmitted diseases, unwanted pregnancy and psychological pathologies such as intense anxiety, anger, depression, mood swings, nightmares , phobias and somatisation. This review discusses the apparent low incidence and of sexual abuse in children and adolescents, complications as well as management. The aim is to increase the level of awareness of sexual abuse among medical practitioners and improve the care of victims .

This is a fifteen-month prospective study to assess the diagnostic accuracy of appendicitis. One hundred and fifty nine patients were diagnosed on clinical basis as having acute appendicitis and subseqently had appendicectomy. 52.8% were confirmed on histology . The diagnostic error (negative appendicectomy) was 47.2%. the error was lower in males (35%) compared with females. The reason for the high negative appendicectomy in women is pelvic inflammatory diseases, which mimics acute appendicitis. Post-operative complications were noted in 3% of the negative appendicectomy group but in the positive appendicectomy group complications were much more common particularly when the appendix was ruptured.

This is a retrospective stud y of sixty eight cases of chronic suppurative otitis media seen in the Ear, Nose and Throat ( ENT ) Department of Usmanu Danfodiyo University Teaching Hospital Sokoto from June 1998 to M ay.1999. It was commonest in the paediatric age group ( 68 .8 2%) . commonest symptom at presentation was ear discharge (100%), ear ache ( 26.47% ), hearing loss (22.46% ) and itchiness (10.29%). The commonest signs were ear discharge (100% ) and tympanic membrane perforation (100% ) . All patients had the tubotympanic ty pe of chronic suppurative otitis media . onas aeruginosa and staphylococcus aureus were the most commonly cultured organisms ( 28 .5% each) . Cultures were sensitive t o gentamicin and peflacine in most cases. chronic suppurative otitis media is a pu blic health problem affecting mainly the paediatrics age group with attend ant learning impairment , caused by some degree of hearing loss and frequent hospital visitation for treatment. Therefore, prevention is stressed to reduce the morbid it y of the disease.

The practice of traditional bone setters can no longer be denied in this environment as some of the complications resulting from their treatment are still seen commonl y in orthopaedic surgical practice. This study was undertaken at the Federal Medical Centre , Owo, Ondo State, Nigeria t o find out about knowledge , attitude and practice about the traditional bone setters ( TBS) among health workers. A pre -tested questionnaire was distributed among the health work ers through t heir heads of de partments for ease of collection. The response rate was 88 .2% with a male to female ratio of 1:1.7. .1% were aware of the TBS practice in our environment and 32.7% got t o know about them through the mass media; constituting the greatest percentage proportion. Onl y 19.6'7o - of the respond ents claimed the knowledge of how traditional bone setters acquired their skills, 73.6% of these responded that it was innately acquired . While most of the res pondents assessed their care as inadequate and that they should not be allowed to treat patients with fractures ; 12.9% believed that the T BS possessed special powers to treat fractures that is lacking in ortho paedic surgeons. H ealth assistants were the most likely to be believe in the possession of such powers. It was recommended that the TBS should be banned from unvented access t o t he use of the mass media. the hospital environment , there is need to organize regular updat e or instructional lectures for health workers , especially the health assistants who are most likel y to give wrong interpretations to events surrounding the patient treatment by the orthodox practitioners.

Serum glycated protein concentrations as fru ctosamine were estimated in 30 non- diabetic patients with hyperbilirubinaemia and 20 controls using the colorimetric nitroblue tetrazolium reduction technique. This was aimed at assessing the effect of hyperbilirubinaemia on serum total glycated protein concentrations (fructosamine levels) in Nigerians. The mean serum fructosamine concentration was significantly higher (p < 0.05) in the hyperbilirubinaemic patients than in the control subjects. Mean glucose and albumin concentrations in the controls were similar to those of the hyperlailirubinaemic patients (p > 0.05). Conjugated bilirubin correlated significantly with serum fructosamme levels (r = 0.37; p < 0.05) in the hyperbilirubinaemic patients. There was no significant correlation betweenfructosamine and total bilirubin or unconjugated bilirubin (p > 0.05). These observations show that hyperbilirubinaemia, especially conjugated bilirubin fraction positively affects the concentrations of fructosamine at level probably greater than 100 umoi/L. A correction factor is thus suggested.

Fungal sinusitis is a known cause of persistent or chronic sinusitis. Various authors have reported various fungal organisms such as aspergillus species, candida species and phycomycetes but not histoplasma duboisii as the cause of fungal sinusitis. A rare case of facial deformity secondary to invasive fungal infection by histoplasma duboisii of the left paranasal sinuses and left orbit associated with proptosis and loss of vision is presented in a 44 year old female trader from Usmanu Danfodiyo University Teaching Hospital ( UDUTH) Sokoto. T his had defied all antifungal agents. Following computerized tomographic (CT ) scan of the brain and paranasal sinuses to ascertain the extent of invasion , radical t:urgical clearance, through anterior craniofacial resection with removal of all orbital contents except the eyelid and optic nerve stump was carried out with no recurrence 1 112 years after surgery. There is no place for conservative medical or surgical treatment in invasive sinus mycosis of the paranasal sinuses and orbit .

A 24-year old Nigerian woman presented at our clinic with extensive h ypopigment ation following the use of very potent steroidal cream in widerspread lichen planus. She was t reated with intramuscular injection of triamcinolone acetonide and the associated secondary bacterial infection was treated with an antibiotic. The cosmetic result at 18 months follow-up was impressive.