Background: Hypoxemia often occurs in Coronavirus disease 2019 (COVID-19) patients. This condition requires adequate oxygen therapy to achieve oxygen saturation target. Objective: This review aims to explain the rational oxygen therapy in COVID-19. Materials and Methods: A literature search for studies on COVID-19 was performed using PubMed and Science Direct database. About 46 articles were identified. Twenty-five articles were considered suitable for review. The bibliographies of included studies were also searched for additional references. Results: Oxygen therapy involves conventional devices such as nasal cannulas, simple masks, reservoir masks, and venturi to advanced devices such as high-flow nasal cannulas. Initial therapy is given based on holistic assessment of the patient, followed by close monitoring. In emergency situations, airway management is required, and resuscitation is carried out with a saturation target of ≥94% while in stable patients, the SpO₂ target is >90% in nonpregnant and ≥92%–95% in pregnant patients. Oxygen escalation might be needed during therapy without delaying intubation. Besides its intricate management algorithm, the rational management of oxygen therapy in COVID-19 also requires caution on the issue of each aerosol-generating device and transmission risk, especially for health-care workers. Conclusions: Rational management of oxygen therapy includes the provision of initial therapy, followed by proper monitoring and escalation without delaying intubation and also the considerations of the health-care workers' protection and the risk of transmission.

Background: Diabetes mellitus (DM)-related morbidity and mortality is gradually assuming an endemic proportion in Africa. In Nigeria, DM-related complications are responsible for 3%–15% medical admissions in most facilities. Despite this growing trend, there is a paucity of studies highlighting the morbidity and mortality due to DM in Nigeria. Objective: This retrospective study documented the pattern of DM-related complications and mortality rates in Warri Central Hospital, Warri, Delta State, Nigeria. Materials and Methods: This was a retrospective, descriptive, hospital-based study covering a 7-year period (2012–2018). Data on age, sex, fasting blood sugar (FBS), random blood sugar (RBS), comorbid conditions, and the number of deaths were extracted from the case files of DM patients in the records department of the hospital. The extracted data were analyzed using the IBM IBM SPSS software version 20.0 (IBM Corp., Chicago, USA). Results: A total of 78 patients were studied. The age range of cases was between 20 and 79 years, with a mean age of 54.9 ± 13.9 years. The overall prevalence of DM was 18.3%; overall mean FBS and RBS were 186.0 ± 49.1 mg/dl and 272.9 ± 59.2 mg/dl, respectively. The overall mortality rate was 28.2%. Major complications observed were hyperglycemic emergencies (20%), hypertension (18%), stroke (17%), and nephropathy (14%). Conclusion: The study highlighted that DM is associated with morbidity and mortality among the patients. Therefore, efforts must be intensified on promoting DM management practices by individuals, families, communities, health-care system, government, and its international partners to reverse this ugly trend.

Background: Breast cancer is the number one killer of women in the world, and its incidence is rising in developing countries including Nigeria. Breast cancer has expressed variation in terms of histological types, hormonal receptor status, and Her-2-Neu receptor status in different races and environments. These biological characteristics are relevant in disease presentation, treatment, and outcome. Objective: This study examined the histology, hormone receptor status, and Her-2-Neu receptor status of breast cancer patients. Materials and Methods: This is a retrospective review of histology reports of breast cancers diagnosed over a 5-year period from January 1, 2010, to December 31, 2015, in Aminu Kano Teaching Hospital, Kano, Northwestern Nigeria. Data regarding age of the patient, histological type, hormone receptor, and Her-2-Neu overexpression were obtained. Results: The records of 215 patients with breast cancer during the period of the study were requested. Out of this number, only the record of 153 patients could be obtained. Furthermore, of the 153 patients, only 103 had complete records and were included in the study. The age of the patients ranged between 25 and 80 years. The modal age of the groups was 31–40 and 41–50 years, each having 27 participants (26.2%). More than two-thirds of the study participants, 74 (71.8%), had intraductal carcinoma. Other variants of breast cancer in the participants were papillary and medullary carcinoma, each accounting for 4 (3.9%). After receptor typing, it was found that 39 (37.9%) of the participants were positive for Her-2 and progesterone receptors, respectively, while 32 (31.1%) were positive for estrogen receptors. The mean age of women triple-negative status was lower (46.8 years) than that of women without triple-negative status (48.9 years). However, this was not statistically significant (t = 0.74, P = 0.462). More than half of the premenopausal women, 32 (61.5%), had triple-negative status while more than two-thirds of women who had attained menopause, 35 (68.6%), had triple-negative status. However, the relationship between age and negative status was not significant (χ² = 0.569, P = 0.451). Conclusion: The predominant histological type of breast cancer in the study area remains intraductal carcinoma, and many patients had triple-negative tumors.

Introduction: Epilepsy impacts negatively on the health-related quality of life (HRQoL) of affected individuals. Aim: This study compared the HRQoL of patients with epilepsy with age- and-sex matched healthy controls. Materials and Methods: A comparative cross-sectional case–control study was carried out on 206 participants who were ≥18 years. The World Health Organization Quality Of Life instrument was interviewer administered to all the participants. Statistical significance was set at P < 0.05. Results: The mean ages of the patients and controls were 33.4 ± 15.8 and 34.5 ± 11.8 years, respectively. Both the groups consisted of 54 males (52.4%) and 49 females (47.6%) each. The mean HRQoL score of the patients, 65.2 ± 16.4, was significantly lower than that of the controls, 69.6 ± 14.6 (t = −2.043, P = 0.042). Furthermore, people with epilepsy (PWE) had significantly impaired HRQoL in general health (t = −3.826, P = 0.0005), physical health (t = −2.768, P = 0.006), and psychological health (t = −2.266, P = 0.025) domains. However, no significant difference was observed in the social relationship and environmental health domains (t = 0.682, P = 0.496, t = −0.516, P = 0.606), respectively between PWE and controls. Conclusion: Epilepsy significantly impaired the HRQoL of its sufferers compared to healthy controls, especially in the general health, physical health, and psychological health domains. There is therefore the need to ensure comprehensive and evidence-based individualized care to improve their HRQoL and overall outcome.

Background: Patients coming to the hospital hope on getting well or cured of their ailment, but this hope goes unrealized, sometimes leading to their death. Objectives: We looked at the pattern and causes of death at adult surgical wards and autopsy rates in our facility. Materials and Methods: Retrospective descriptive study of the mortalities in adult surgical wards at Ekiti State University Teaching Hospital, Ado-Ekiti, in South-Western Nigeria, over a period of 5 years, July 2011–June 2016. Results: Two thousand one hundred and thirty-eight patients were managed in the adult surgical wards, and there were 89 (4.16%) cases of death during the study with 51 case notes available for the analysis. Twenty-eight males and 23 females with a male: female of 1.2:1. Age ranges from 18 to 93 years, with a mean of 57.14 ± 20.42 years. The highest mortalities were recorded in general surgical unit (25, [49.0%]) with a mortality rate of 3% and highest in patients with neoplastic diseases (24, [47.1%]), followed by trauma (17, [33.3%]). Overwhelming sepsis (14, [27.5%]) and hypovolemic shock (10, [19.6%]) were the leading immediate causes of death. Only 4 had autopsy done with autopsy rate of 7.8%. Conclusion: Neoplasm and trauma are the leading underlying causes of death. Strategies geared toward early detection and treatment of neoplasms, as well as prevention and prompt care of trauma patients, are advocated. Autopsy rate is low in our center.

Introduction: Public health programs (PHPs) provide unique opportunities for addressing health issues in resource-limited settings. A major challenge to the implementation of existing PHPs in Nigeria is the absence of effective monitoring of the safety of medicines and vaccines. The introduction of the World Health Organization (WHO) pharmacovigilance (PV) indicators provides a useful tool to address this challenge. Objective: The objective is to assess the structures, processes, and outcomes of PV activities in three selected PHPs (the National Malaria, tuberculosis [TB], and HIV/AIDS) in Nigeria using the WHO PV indicators and identify possible challenges to achieving the outcomes. Materials and Methods: A cross-sectional mixed method study of the PV system in selected PHPs. Data sources were from the Federal Ministry of Health, the National PV Center (NPC), the National Malaria/TB, and HIV/AIDS Control Programs and official documents were reviewed. Data were collected quantitatively using the WHO PV and PHP indicator questionnaires and qualitatively using key informant interviews. Results: The basic structures and tools for carrying out PV activities in the PHPs were in existence but optimal implementation was lacking. Of the 790 adverse drug reaction (ADR) reports from the PHPs to the NPC ADR database, 77% were from the HIV/AIDS Control Programs, 14% from the malaria control program, and 9% from TB program. The interview with representatives of the different programs revealed a consensus of opinion around lack of adequate human resource for PV, poor funding, poor stakeholders' coordination to improve PV reporting across all three programs as well as in the NPC. Conclusion: This study highlighted the magnitude of suboptimal implementation of PV activities evident by the number of reports as against the expected.

Background: Antimicrobial stewardship (AMS) is a coordinated program that promotes the appropriate use of antimicrobials. According to the World Health Organization, education of medical students on AMS is an integral part of antimicrobial resistance containment activities. The perception of undergraduate clinical medical students on AMS has not been studied in Nigeria recently. This study aims to identify the perception of AMS among medical students in Ahmadu Bello University (ABU) Zaria. Methodology: We conducted a cross-sectional survey on medical students in the 4^th, 5^th, and 6^th years of study. A stratified sampling technique was employed. Open Data Kit for android was used to administer the questionnaire. Information on sociodemographics, perception of AMS, perception of the usefulness of AMS education as well as familiarity with the term AMS were collected from study respondents. Data were presented in frequency and percentages for categorical variables, while descriptive summary statistics were used for numeric variables. Results: Most of the respondents (96.2%) belonged to the age group of 20–29 years. The mean age (±standard deviation) of our respondents was 25.75 (±2.47) years. Only 34.6% were “very familiar“/”familiar” with the term “AMS.” Majority (89.2%) of the respondents did not have any knowledge about antimicrobials before entering medical school. The perception of AMS among medical students was generally good. Conclusion: Our respondents recognized the importance of judicious antibiotic use and would like more instructions on how to make rational use of antimicrobials. There is a need by authorities of the ABU medical school to revamp our clinical medical curriculum to include more AMS teaching so as to better equip our “future prescribers” on the appropriate use of antimicrobials.

Encephaloceles are neural tube defects that are characterized by protrusion of brain and meninges through a defect in the cranium. Encephaloceles are very rare with an incidence of about 1 in 5000 live births and a female preponderance with an unknown etiology. This is a case of a 3-month-old female infant with a huge occipital swelling, delayed developmental milestones, and microcephaly without neck control and social smile and poor suckling. The patient was referred by the neurosurgical unit of the hospital to the department of radiology for a contrast-enhanced computed tomography (CECT) of the brain on account of a huge occipital mass and microcephaly. The CECT showed a huge cystic mass with brain density substance and cerebrospinal fluid density fluid. Conservative management which includes the parent's reassurance, supportive care, symptom management, and close monitoring plays a role in their nonsurgical management.

Spontaneous scrotal fistula is an extremely rare complication of incarcerated hernia, especially in children. To date, only 12 cases in children have been reported in the literature worldwide. We present the case of a 31-day-old male infant who had scrotal fecal discharge from an irreducible right inguinoscrotal swelling. Inguinal exploration revealed an incarcerated right inguinal hernia containing a segment of the ileum with a 3 cm perforation on its antimesenteric border. Segmental resection and end-to-end anastomosis along with debridement and closure of the scrotal wound were successful in the management of this index patient. This complication appeared to be the result of a neglected inguinoscrotal hernia. This report aims to highlight the morbidity associated with this complication and to review the available literature. We conclude that early repair of inguinal hernias in infants and children of all ages would reduce this complication and its attendant morbidity and mortality.