Background: It has been stated that poor utilization of quality reproductive health service continues to contribute to maternal morbidity and mortality in Nigeria. Objective: The objective was to investigate the pattern of orthodox and/or traditional healthcare utilization among pregnant women and mothers of under.five children in Njaba and associated factors. Materials and Methods: A. cross.sectional survey of 422 women using multi.stage sampling, data collection instrument was a semi.structured interviewer.administered questionnaire. Data were analyzed with SPSS. (16.0) and Mathcad 7 professional. Frequency distributions and percentages were tabulated; Z.test was applied as a test of significance, and confidence intervals. (CIs) calculated. P < 0.05 was considered significant. Results: Ante.natal choice of care for 83.65% of them was orthodox healthcare, while 11.37% used traditional healthcare. Experienced/trained staff. (Z-score = 13.64, =0.000 and CI = 0.41–0.65) and neat environment. (Z-score = 13.98, =0.000 and CI = 0.45–0.69) were statistically significant reasons why the women preferred orthodox healthcare, whereas, good staff attitude. (Z-score = 12.57, =0.000 and CI = 0.62–0.80) was a statistically significant reason why some preferred traditional healthcare. Among the respondents who had delivered previously, 85.83% of the 374 deliveries were in orthodox healthcare facilities, while 14.17% were in traditional healthcare facilities. Conclusions: Majority used orthodox healthcare facilities because of experienced staff and neat environment, while some used traditional healthcare facilities due to better staff attitude. Attitudinal change in the orthodox facilities and training for traditional healthcare personnel are recommended.

Background: In Maiduguri, the utilization of available postnatal care services is still very low. This may be influenced by demographic, socioeconomic, cultural, and obstetric factors among others. Objective: The aim of this study is to understand the current status of utilization of maternal postnatal health care services and identify factors responsible for under.utilization of available postnatal care services in Maiduguri. Materials and Methods: A. cross.sectional, questionnaire.based study was conducted involving 350 women in their reproductive age group. (15.49. years), who had delivered previously, residing in Maiduguri and who came to access any of the available maternal health care services at the State Specialist Hospital, Maiduguri over a 3.month period. The Chi.squared statistics and multivariate logistic regression analysis were used. Results: Out of the grand total of 350 questionnaires that were distributed during the study period, 18 questionnaires were excluded from analysis due to incomplete responses, 332 with complete responses were therefore analyzed, giving a response rate of 94.9%. The results showed that only 16.9% of the respondents attended postnatal care services within 42. days after delivery. Most of the mothers. (60.9%) were not knowledgeable about postnatal care services. A. very high proportion of participants. (69.4%) did not attend antenatal clinics, and over. 70% of the study population had delivered at home. The study has identified some factors that have an important influence on utilization of postnatal care services in Maiduguri. These included awareness of postnatal care services. (odds ratio. [OR] 12.04, 95% confidence interval. [CI]: 10.26, P =. 0.000), higher educational status of the woman. (OR 7.15, 95% CI: 5.19, P =0.000), lower parity. (OR 5.22, 95% CI: 3.21, P = 0.001) and marital status. (married woman.OR 3.44, 95% CI: 2.17, P =0.002). Educational attainment of the husband also significantly affected the respondents' seeking behavior of postnatal care. (OR 2.01, 95% CI: 1.13, P =0.042). Conclusion: Utilization of postnatal care services is quite low in Maiduguri. Socioeconomic and sociodemographic factors influenced the use of postnatal care services. Government should provide culturally acceptable health educational programs and expands maternal health care services into the communities for the better, effective and efficient health care delivery.

Background: Erectile dysfunction (ED) is a common complaint in general medical practice. This study describes the clinicodemographic features of ED. Materials and Methods: Two hundred and twelve subjects in the outpatient clinic of a tertiary care hospital were interviewed for demographic data, tobacco smoking, alcohol consumption, history of medications, previous abdominal surgery, history of diabetes mellitus, hypertension and ED, duration of ED if present, self-assessment of the level of sexual satisfaction, partner's assessment of the level of sexual satisfaction, type of remedies sought and used for ED in the past, whether or not subject has discussed the problem and patients' perception of the cause of the ED, all were interviewed with the international index of erectile function questionnaire for ED. Data was analyzed as appropriate. Results: Forty-two (19.8%) had ED and ED score was associated with age (P = 0.013), educational level (P < 0.001), monthly income (P < 0.001), alcohol consumption (P = 0.026), type of abdominal surgery done in the past (P = 0.002), self-rating of ED (P < 0.0001), partner rating (P < 0.0001), partner complaint (P < 0.0001), and frequency of complaint (P < 0.0001), it was however not significantly associated with marital status (P = 0.133), tobacco smoking (P = 0.259), quantity of tobacco smoked in pack years (P = 0.370), duration of ED (P = 0.141), drugs taken (P = 0.680). 77 (36.3%) never discussed ED before, 40 (19%) claimed that someone else was responsible, and only 15 (7.1%) had taken a phosphodiesterase inhibitor. ED score correlated negatively with fasting blood sugar with a trend toward significance (r = −0.134, P = 0.064). Conclusion: ED may be more frequent in the population studied considering the level of knowledge and attitude.

Background: Japanese Stroke Scale for Depression (JSS-D) is not a validated instrument for post stroke depression (PSD) in sub-Saharan Africans. Methods: Ninety-two subjects on follow-up in a stroke clinic were consecutively assessed for demographic and clinical variables, and all were subsequently assessed for depression with the JSS-D. Functional ability was assessed with Rankin score and good functional recovery was defined as Rankin score of ≤2. Stroke type was determined using cranial computed tomography or magnetic resonance imaging as cerebral infarct or intracerebral hemorrhage. Data was compared between subjects with and without PSD. Symmetric agreement between JSS-D and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV) criteria for depression was compared on Cohen's kappa statistics and the sensitivity, specificity of JSS-D was tested on a receiver operated characteristics (ROC) curve. Results: PSD occurred in 17 (18.5%) of study subjects. Mean age was not significantly different between PSD and no PSD, P = 0.226, but there was a difference in the sex distribution (P = 0.034) with a male sex preponderance for both groups. Rankin score was higher in PSD and significantly different both at discharge and the time of evaluation (P = 0.019 and 0.003). JSS-D agreed with DSM IV criteria for mild depression significantly on Cohen's kappa statistics, kappa = 0.69, P < 0.0001. The sensitivity and specificity of JSS-D on ROC curve were 94.1% and 97.2% respectively at a JSS-D cut-off value of 2.37, area under the curve = 0.99, P = < 0.0001. Conclusion: JSS-D could be used for PSD with acceptable sensitivity and specificity in sub-Saharan Africans.

Background: Left circumflex artery (LCx) related acute ST-segment elevation inferior wall myocardial infarction (IWMI) is less well-reported in literature than the right coronary artery (RCA)-related IWMI. Little is known about the outcome of patients with LCx infarct-related acute IWMI. Recently, studies have shown that LCx-related infarcts carried less favorable outcome. Materials and Methods: Between January 2007 and December 2012, data of all patients with acute IWMI, who presented to a university hospital in Saudi Arabia were reviewed, and the various in-hospital outcomes were compared. Results: A total of 90 patients comprising 63 (70%) patients in the RCA-related IWMI group and 27 (30%) in the LCx-related IWMI group were reviewed. Diabetes mellitus, dyslipidemia and renal impairment were more prevalent in the RCA-related infarct group. The prevalence of atrio-ventricular block (14.3% vs. 0%, P = 0.053) and the frequency of cardiogenic shock needing inotropic support (14.3% vs. 0%, P = 0.053) were higher in the RCA related infarcts. Conclusions: Our study showed that in a sample from Saudi Arabia, the in-hospital prognostic outcomes were less favorable in patients with RCA-related acute IWMI when compared to LCx-related infarcts.

Introduction: Hygienic umbilical cord care is necessary for the well-.being of the newborn. Health education is a strong tool for lifestyle modification aimed at healthy living. This ought to extend to mothers who care for their infants' umbilical cord stump in various ways especially after discharge from hospital. The content of health education on cord care given to mothers (if any) at various health institutions which they accessed for antenatal care is thus worth evaluating. Objective: To evaluate the content of health education on cord care given to mothers at various health facilities which served as their places of antenatal care in Benin City, Nigeria. Methods: The study subjects included mothers who brought their babies to Well Baby/Immunization Clinic of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. A structured questionnaire was used to assess their biodata, places of antenatal care, whether health education on cord care constituted part of the services received in health facilities and the content of the cord care education. Results: Of the 497 subjects studied, 487 (98.0%) received antenatal care (ANC) in both orthodox and unorthodox facilities. Amongst these, 352 (72.3%) received health education on cord care while 135 (27.7%) did not. Teaching and private hospitals contributed 116 (48.9%) and 103 (43.5%) respectively to the total documentation of the advice concerning use of methylated spirit alone. The relationship between content of health education on cord care and method of cord care practiced by mothers was statistically significant. Conclusion: Health education on cord care is lacking in some of our health facilities and where available, content may not be evidence-.based. We must equip health workers with facts required to enlighten patients. A standard and universal method of cord care should be adopted to reduce or abolish the confusion which mothers presently encounter in caring for their babies' umbilical cords.

Context: Sacral hiatus is used for administration of caudal epidural block. A frequent problem in this is needle placement as it is difficult to determine the location of sacral hiatus. The knowledge of anatomy of sacral hiatus plays a major role in the success of needle placement. Aim: To study the anatomy of sacral hiatus from point of view of caudal epidural anesthesia. Materials and Methods: The sacral hiatus of 300 sacra was studied. Parameters of sacral hiatus such as shape, level of apex and base, length, anteroposterior (AP) diameter at apex, and intercornual distance along with distance between superolateral sacral crests and their distance from apex of sacral hiatus were studied. Results: Inverted "U" shape (46.33%) was most commonly encountered. Apex and base of the hiatus were most commonly seen at the level of S4 and S5 respectively. Length of sacral hiatus ranged between 8.8 mm and 45.7 mm. AP diameter at apex of sacra and intercornual distance were seen most commonly in the range 4–6 mm and 11–15 mm respectively. Conclusion: The study of these sacra indicated the type of variations in shape and size of sacral hiatus in population of state of Maharashtra in India. While absent sacral hiatus leads to poor outcome of the caudal epidural anesthesia, dorsal agenesis of the sacrum would lead to only partial anesthesia. The formation of equilateral triangle by joining superolateral sacral crests and apex of sacral hiatus forms a practical guide in locating sacral hiatus for caudal epidural anesthesia.

Autoimmune polyglandular syndrome (APS) type III A refers to the coexistence of autoimmune thyroiditis and immune-mediated diabetes mellitus. Although diabetic lipemias in APS type III have been described in medical literature, the degree of metabolic derangements in our patient, especially in the lipid profile is an extremely rare scenario. In this case report, we share this valuable experience.

Ewing's sarcoma or Ewing tumor is a rare primary bone tumor that affects mainly children and adolescents. It belongs to a group of cancers known collectively as Ewing sarcoma family tumors or Ewing family tumors. By the time, the patients present and diagnosis is made, the disease is usually advanced. We reviewed the case files of two patients managed in our hospital within one (2013). Fine-needle aspirations for cytology (FNAC) and tissue biopsy were used for diagnosis in the two patients we had. The two patients, both males aged 20 years and 38 years presented late and FNAC and tissue biopsy revealed Ewing's sarcoma. They were referred for radio- and chemotherapy. However, due to poor socioeconomic status, they died of their primary disease. Unless diagnosed early, and in the absence of a multidisciplinary approach, Ewing's sarcoma is a fatal disease.