Background: Malaria remains a major cause of high morbidity and mortality in sub­ Saharan African children especially those aged between 1 and 5 years. Amongst the survivors of those with cerebral malaria, 10% to 35% may exhibit residual neurological sequelae. Objective: To determine the pattern of neurological sequelae complicating cerebral malaria in children aged 6 months to 12 years that were admitted consecutively into Emergency Paediatric Unit (EPU), Usmanu Danfodiyo University Teaching Hospital Sokoto a one-year period. Methods: This was a prospective study that was conducted between 1"1 June 1999 and 181 May 2000. All the children with confirmed diagnosis of cerebral malaria formed the stud y cohort. Intravenous (I .V .) quinine dlhydrochlorlde was the antimalarial drug of choice. Neurological sequelae were documented among the survivors of cerebral malaria. Results: A total of 78 children with cerebral malaria were admitted Into EPU over the study period. Twenty (26%) patients died while 11 (14%) developed residual neurological . Four (36%) had generalized spasticity of the limbs, 3 (27%) generalized hypotonia with inability to walk, 2 (18%) hemiparesis, and 2 (18%) partial seizure disorder with secondary generalization. Others include 2 (18%) cortical blindness, 2 (18%) aphasia , 1 ( 9%) and 1(9%) cerebellar ataxia. Hemiplegia and cranial nerve palsy were , however, not seen. Six (67%) of the 9 patients who came for follow-up had completely recovered b y the sixth week of outpatient follow-up. Conclusion: The neurological disability following cerebral malaria in children ma y therefore, constitute a larger public health problem than gener·ally recognized ; hence there Is a need for longer follow0-up of such children.

Background/Aims: The incidence of sella turcica bridging has been reported In anatomical and radiographic studies. In both anatomical and radiological practice in Nigeria, normal data in relation to the bridging of the sella turcica are based on Caucasian studies. We report the prevalence of sella turcica bridging In African subjects from Sokoto, Northwestern Nigeria. Design: A retrospective study of the prevalence of bridging of the sella turcica was undertaken using normal lateral radiographs of Nigerians examined in the department of Rad iology , Usmanu Danfodlyo University Teaching Hospital (UDUTH), Sokoto , from 2002 to 2004. Methodology: All available lateral radiographs of subjects over a 3-year period from 2002 to 2004 were retrieved from the Radiology Department of the Usmanu Danfodiyo U niversity Teaching Hospital, Sokotofor the study. Radiographs were mounted on the viewing boxes and sellae turcicae with bridge were studied and classified. Results: A total of 228 subjects were involved In this study. Only 26(11.4%) subjects had bridged sella turcica. The predominant type of sella turcica bridge In the African subjects studied Is type B, but the d ifference In frequency of type B sella turcica bridge and that of type A Is not statistically significant . (p>0.05) . On the frequency of sella turcica bridging in relation to sex of the subjects studied , the difference in frequency of males and females Is not statistically significant. (p>0.05). There Is statistically significant difference when each of the t wo types of sella turcica bridge Is compared with those with no bridge. (p<0.05). Conclusion: It Is concluded that the prevalence and the relative frequencies of the types of sella turcica bridging reported in this study on Nigerian subjects Is similar to t hose In Caucasians. Further studies on a larger scale are needed to corroborate our findings.

Background: Whenever HIV and AIDS Is diagnosed, the CD4+ T-l ymphocyte (CD4) counts In addition to clinical staging Is used to determine the severity of the disease and immune depression, make treatment decisions, monitor progress or change treatment options especially in resource- poor setting lacking facilities for viral load estimation. Low CD4 cell counts are a marker and "hallmark" of the progression of HIV infection and AIDS. A CD4 cell count ≤ 200 cells!ml In HIV-positive person is Indicative of AIDS (WHO stage1). Aims/Objective: To determine the Immunological status of HIV-positive pregnant women using maternal CD4 count levels and what the implications are for the Nigerian PMTC Program. Methodology: Only 120 (48.9%) HIV- positive pregnant booked women seen during the period afforded the cost of CD4 count and other tests. Another cohort of 10 HIV -negative pregnant women who consented was used as control. Each woman had 5 ml of blood each drawn from the antecubital vein and the sera separated by centrifugation. The CD4 count levels were estimated using the Manual Magnetic Bead Technique. The data were analyzed using the Graphad Instat tm software version 2.05a statistical package; the Fischer's exact test was used to co0 m pare the means and median values of the CD4 count levels of the two groups and association between CD4 count level and HIV-posltive test using Woolf approximation. Results: The CD4 count ranged between 50 and 934 compared with 511 and 920 cells/ , and a mean of 267 ΁ 50.93 vs 731 ΁ 289.20 (p< 0.0001) and a median value of 212 /mL vs 576 cells0/ mL cells/ml (p< 0.0001) respectively for the HIV1- positive and negative women. 32 (48.5%) HIV-posltive women had CD4 count level ≤200 cells/mL. Only 39.4% had CD4 co0unt levels ≥250cell/mL and 9.1% had CD4 count ≥5OOcells!mL Conclusion: Significant proportion of HIV-infected pregnant women Is lmmuno-depressed and qualifies for HAART In pregnancy. The modest goal of a 20 percent reduction in vertical transmission by 2005 set by The United Nations AIDS Summit can only be realised through aggressive approach to HIV management In these women. CD4 count estimation and use of HAART for PMTCT program tertiary and In well endowed secondary hospitals in Nigeria is advocated.

Background/Aims: Breastfeeding still remains the ideal food for the growth and development of the infant and in Nigeria, breastfeeding is universal. Many mothers who work outside the homes continue to breastfeed. As the number of working mothers increases, employers are becoming more supportive of breastfeeding and have come to realize how breastfeeding can help their businesses. This study therefore, was aimed at determining the prevalence of breastfeeding among working class mothers in Sokoto, North W tern Nigeria. Methodology: Through a cross-sectional descriptive study within the Sokoto metropolis. Results: A total of 118(43.5%) of the respondents Initiated breastfeedlng Immediately after delivery. Majority of the mothers 252(93%) breastfed beyond six months with an exclusive breastfeeding rate of 54.6%. Only 61(22.5%) of the mothers had breastfeeding break s to allow for breastfeeding of infants at home and majority of the respondents 70(62.7% ) complained of employers being against bringing infants to workplace and breastfeed them as this was thought to reduce concentration and thus efficiency at workplace. The relationship between maternal employment status and exclusive breastfeeding was statistically significant (p<0.0001) as the women in private employment tended to breastfeed exclusivel y compared to those in public sector. Conclusion: There is the need to increase employers' awareness to become supportive of breastfeeding and realize how breastfeedlng can reduce work absenteeism and thus increase productivity.

Background: Muslim presbyopes In Nigeria who require reading glasses and who are only and minimally literate In Arabic; experience difficulty In getting properly assessed for this in the eye clinics because of their Illiteracy in western education. Aim: The aim is to design an appropriate Arable near reading test chart (ANRTC) for such presbyopes In llorln, Nigeria. Methods: Short continuous reading passages In Arable were designed with their separate corresponding transliteration , and then formatted Into varying print sizes (N5-N48). After validation with the standard English reading chart among dual-literate (Arabic and English ) lecturers, the ANRTC was then used to determine the reading glass needs of presbyopes. Results: ANRTC was found meaningful and readable, validated well with the standard English one among 12 dual-literate lecturers, and also found easy to use In accurately determining the reading glass need of 50 Individuals. Conclusions and Recommendations: ANRTC was found very useful In determining the reading glass needs of some Nigeria Muslims who has no western education. This chart or its adaptation would also be found useful in other non-Arable speaking Muslim populations of Africa, Asia and Eastern Europe.

Background: Intellectual impairment is a devastating complication of alcohol abuse. The consequences of intellectual impairment are far-reaching, particularly for young people in their most reprod uctive years. Objectives: To determine whether there are differences in cognition between Nigerian chronic alcoholics and non-alcoholic controls. Method: Sevent y non-intoxicated chronic alcoholics and 70 non-alcoholic controls were compared using the modified Community Screening Instrument for Dementia. were matched for age, gender and educational level. The alcoholics were classified in two sub­ groups based on their consumption of ethanol per occasion on jive or more days in the past 30 days: light drinkers (<5 alcoholic drinks) (n=45) and heavy drinkers (≥alcoholic drinks) (n=25). Results: Overall, non-alcoholics performed better than alcoholics In most of the entire neuropsychological measures. However, light drinker performed better than heavy drinkers in one function domain ( orientation to place p<0.0001). Conclusion: Cognitive decline occur In un-intoxicated Nigerian chronic alcoholics and appear to be ind e pendent of quality of ethanol consumed.

Objective: With paucity of reports In this area of Nigeria, the study was aimed at prospectively quantifying the baseline and longitudinal vitamin A status in Protein Energy Malnutrition and Controls. The influence of vitamin A supplementation would also be deciphered. Methodology: A prospective cohort study which included 50 each of Kwashiorkor and Marasmus hospitalized children aged 7 months to 5 years. 60 well nourished children that were age and gender matched served as a control cohort . We evaluated serum retinol levels using HPLC. Clinical and epidemiological variables were assessed. Results: Mean (SD) serum retinol levels were significantly lower in PEMs than controls (Kwashiorkor , 0.75 (0.16p.MOL/L; Marasmus, 1 .12(0.17), Controls, 2.77(0.25 ); p<0.001). The frequency of inadequate serum retinol levels ( <1 .05 umol/1) was 100% In the Kwashiorkor Group on Day 1, and reduced to 13.9% by Day 16 of vitamin A Supplementation. There were atistically significant associations between serum retinol deficiency and the clinical and epidemiological variables studied. More severe PEM was observed In 14!50 (28%) of the Kwashiorkor Group. There was no statistically signiflcant association between plasma retinol Inadequacy after recovery and degree of malnutrition. Conclusion: Serum retinol levels were significantly low In PEMs than controls. There was statistically significant association between the deficiency of serum retinol and the clinical and epidemiological variables studied. Adjuvant use of high-dose vitamin A is recommended.

Background: CD4 +T cell counts are useful in the staging and monitoring of response to therapy in the management of HIV!AIDS. In our set-up, determination of CD4 +T cell counts cannot constantly be guaranteed on the same day of blood sample collection due to many factors. study was therefore carried out to compare possible variations In CD4+T cell counts at different times. Methods: Manual Dynabeads methods of CD4+T cell counts were used to determine CD4+T cell counts at 6 and 24 hours after blood sample collection. Results were analysed by the use of SPSS version 1 software. Results: 142 patients' blood samples were anlyzed. Age of patients ranged from 26-53 (mean 37 yrs). Sixty-two (43.7%) were males while 80(56.3%) werefemales. CD4+T cell counts ranged from 80-060 cells/ul at 6hours with a mean of 212 cell/ul and standard d eviation of 135 , while CD4 +T cell counts after 24 hours ranged from 67-987 cells/ul with a mean of 213 cells/ul and a standard deviation of 146. Conclusions: No signature variations were noted in CD4 +T cells counted using the Dynabeads method at 6 hours or within 24 hours of sample collection. CD4 +T cell counts on samples collected between 66 or 24 hours can therefore serve in the evaluation and monitoring of HIV/AIDS patients in our setting.

A 38-year old multiparous woman presented at the 37'h week with a day history of bleeding per vaginum . Ultrasound scan made a diagnosis of Placenta Praevia. She had a laparatomy and was delivered of a live female neonate, 2.7kg with Apgar scores of 7 and 9 at the first and fifth minute. The baby was lying within the peritoneal cavity with the placenta attached to the ileum and Jejunum. Haemostasis was secured and the wound was closed with the placenta and membranes left In-situ. She was transfused with four units of blood and both mother and baby did well. This case highlights the Importance of ultrasound scan In pregnancy by a competent sonologlst and the possibility of a viable abdominal pregnancy at term.