Polymerase Chain Reaction (PCR) is a rapid procedure for in vitro enzymatic amplification of specific DNA sequences using two oligonucleotide primers that hybridize to opposite strands and flank the region of interest in the target DNA. Repetitive cycles involving template denaturation, primer annealing and the extension of the annealed primers by DNA polymerase, result in the exponential accumulation of a specific fragment whose termini are defined by 5' end of the primers. The primer extension products synthesized in one cycle can serve as a template in the next. Hence the number of target DNA copies approximately doubles at every cycle. Since its inception, PCR has had an enormous impact in both basic and diagnostic aspects of molecular biology. Like the PCR itself, the number of applications has been accumulating exponentially. It is therefore recommended that relevant scientists and laboratories in developing countries like Nigeria should acquire this simple and relatively inexpensive, but rather robust technology.

Background: Autopsy is a veritable tool for auditing the accuracy of clinincal diagnosis. This study determined the accuracy of clinical diagnosis of diseases using autopsy result. The present report was informed by the unusual presentation of this case and the intent of increasing the index of diagnostic suspicion. A brief appraisal is provided of the clinical parameters, management strategies and challenges. Method: A twelve year consecutive clinico-autopsy study. (1 ^st Jan 1995 - 31 ^st Dec, 2006) at University of Port Harcourt Teaching Hospital (UPTH), was carried out. A total of 150 patients who were previously diagnosed of various diseases and treated for variable period of time, and later died were thoroughly autopsied on request to ascertain the cause of death. Of the 2848 autopsies performed during the study period, 150 were hospital autopsies representing 5.3% of the total autopsies. The 2698 (94.7%) medicolegal autopsies were excluded from the study. Result: The autopsies were performed on patient of both sexes of different ages. Ninety (60%) autopsies were males and 60 (40%) female, giving a male to female ratio of 1.5:1. Out of 150 clinincally diagnosed cases, autopsy accurately confirmed 127 (84.6%) (84.6% concordance rate) and varied in 23 (15.4% discordant rate). Conclusion: Autopsy pathology is beneficial to the clinician, the surviving relatives and constitutes a vital tool for medical education. It should be incorporated in the patient care and management delivery system in the country

Background: Though the epidemiologic profile of patients with acute stroke has been described in the sub Sahara African region, little is known about predictors of mortality in patients with acute stroke. This study aimed to determine the predictors of 30-day mortality of acute stroke so that early therapeutic measures could be instituted to improve functional outcome. Methods: Case records of patients admitted from January 2007 to December 2009 with clinical diagnosis of stroke were retrieved. Relevant clinical data were extracted using structured questionnaire. Results: A total of 370 case files with clinical diagnosis of stroke were traced but only 260 had complete information. The mean age of patients was 55.7±14.3 years; Hypertension was the most common modifiable risk factor for stroke followed by diabetes mellitus. The 24-hour and 30-day case fatalities were 11.9% and 38.4%, respectively. Predictors of 30-day mortality were admission blood glucose, level of consciousness and age at stroke. Conclusion: The 30-day case fatality of acute stroke was high and predictors of outcome included old age reduced level of consciousness and elevated blood glucose at presentation.

Background: Stroke has been reported as a complication of HIV/AIDS. However, sparse data exists to quantify the risk of AIDS-associated stroke. The purpose of this study was to determine the HIV status of stroke patients; as well as the frequency of well-established stroke risk factors disease. Method: This was a hospital-based, case-control study. Sixty five (65) consecutive stroke patients (36 males and 29 females) aged 20-68 years and sixty five (65) age-and-sex matched controls were enrolled. A structured questionnaire was administered. Neurological examination was performed and computed tomography scan of the brain done. Blood samples were taken for HIV 1&2 screening using ELISA method positive test using two different kits constituted a positive result. Result: The frequency of HIV infection among stroke cases was significantly higher than in controls 13 (20%) versus 3 (4.6%): p-value <0.016. Odds ratio 5.17. Conclusion: Human Immunodeficiency virus infection might be a risk factor for ischemic stroke in the adult population of North-eastern Nigeria. Therefore, a longitudinal community based study is suggested to further elucidate the relationship between HIV infection and risk of stroke.

Background: The relationship between depression and stroke has been described in different studies. However most of these studies were done in stroke condition arising from different risk factors. Since the risk factor for stroke determine the lesion volume which in turn influences the frequency of depression, it is important to determine the frequency of depression in specific risk factor for stroke. The purpose of this study is therefore to determine the frequency of major depression among patients who developed stroke from hypertension. Methods: This is a retrospective study. Thirty four patients who developed stroke from severe hypertension were included. Using Diagnostic Statistical Manual (DSM) IV criteria, the stroke patients who were diagnosed with depression were identified. Data obtained were analyzed using SPSS Version 11. Results: The age of the patients ranged from 30 to 80 years (mean= 60.2 ±10.5 years). Compared to the males (57.4 ±11.7years), female patients appeared to be older (mean = 62.2 ±9.4 years). However the difference was not statiscally significant (P=0.46). Half of the stroke patients were married while 30% were gainfully employed. Left hemispheric stroke constituted about 70% of stroke site, five patients (14.7%) had depression. Conclusions: This study suggested that depression is not infrequent among hypertensives with stroke. Further studies with larger sample size are recommended to confirm our findings.

Background: Bladder tumour is a leading type of urinary tract malignancy after the prostate. This study was carried out to analyse the pathological and ultrasonographic features of urinary bladder tumours. Method: Ninety six consecutive patients were reviewed prospectively between, September 2004 and December 2007. The location, size, multiplicity, shape, surface, and presence of calcification of the bladder tumour as well as the pathological types were described. Results: There were 5 cases of multicentric tumours. Tumour size ranged from 24 mm to 113 mm (mean = 59.6 ±19 mm. The tumour involves the bladder base (31.3%), right anterolateral wall (261.8%) and left anterolateral wall (17.7%). The posterior and anterior wall involvements were (12.5% and (4.2%) respectively, while lateral and right posterior lateral had (1.0%) and 7.3%, respectively. Calcified foci are seen in 7(7.3%) of the bladder masses. The bladder mass surfaces was regular 5(5.2%) and irregular in 67 (69.5%) of the masses, and sessile/polypoidal in 2 (2.1%). Pathologically, squamous cell carcinoma(59.0%) outnumbered transitional cell carcinoma(27.3%) . Conclusion: Most bladder tumours were single, arising from the bladder base and of squcmous cell type on histology

Background: Normal vision is a universal requirement for safe riding of motorcycles. This study aims to determine the prevalence of visual impairment among commercial motorcyclists in Benin City, Nigeria. Method: This is a prospective cross sectional study carried out in Oredo Local Government Area (LGA) of Benin City. Each motorcycle park was taken as a cluster, and all motorcyclists in that park had structured questionnaires administered to them. One hundred and forty three commercial male motorcyclists in eleven motorcycle parks in Oredo LGA were subsequently examined with Snellen's chart or illiterate E chart as applicable. The main outcome measures eligibility for driver's licence on account of vision test as required by the Federal Road Safety Corps of Nigeria. Results: Ninety eight point six percent (98.6%) of those examined had acceptable driving vision requirement according to Federal Road Safety Corps. One point four percent (1.4%) had subnormal visual acuity, while 5.3% had refractive errors. Ocular pathologies were found in 11.5% of the eyes examined. Conclusion: Most commercial motorcyclists may pass the Federal Road Safety Corps. However Colour vision and visual field testing may give a more reliable result.

Background: Chronic renal failure (CRF) is a major cause of premature death and morbidity in Nigeria. Majority of patients with end stage renal disease (ESRD) are in the productive age bracket. Haemodialysis is the most commonly available mode of renal replacement therapy. The quality of life of the few that can afford the cost of haemodialysis is poor when compared to the transplanted patients. A survey is carried out to assess factors affecting attitudes towards kidney donation in llorin, Nigeria. Methods: A total of 600 self administered, semi-structured questionnaires were distributed amongst asymptomatic adults (aged ≥ 17years) with a response rate of 88%. Data analysis was done using statistical package for social studies (SPSS) version 14. Results: There were 282 males (53.4%) and 246 females (46.6%) with age range of 17-65years and a mean of 34.76±14.9. Two hundred and ninety two (55%) were willing to donate a kidney (165 males, 127 females). Majority of the willing donors (86%) were between 30 and 50 years of age. Though educational level positively influenced the knowledge about the kidney failure, it did not influence willingness to donation of a kidney. There was religion related gender disparity in the willingness to donate a kidney as more male Christians and Muslims were willing to donation than their females. Conclusions: The main constraints to kidney donation were fear of surgical pains, belief in life after death and uncertainty of donor outcome. This calls for awareness programmes on the safety of kidney donation for transplantation.

Varicoceles have long been associated with infertility. Despite this long history, there remains much controversy regarding their aetiology and management. The aim of this review is to present the most current information on the management of varicoceles and to highlight some of the management controversies: Association of varicocele with male infertility; Management of varicocele in adolescent; safety and effectiveness of varicocele embolization and management of subclinical varicoceles. It is hoped that this review study will stimulate further research into this condition in order to find a more common ground regarding its management.

Lymphomas are malignant neoplasms of the lymphoid lineage which are broadly classified as either Hodgkin disease or as non-Hodgkin lymphoma (NHL). Burkitt lymphoma, a variety of NHL, is most common in sub-Saharan Africa, where it accounts for approximately one half of childhood cancers. A case of paravertebral high grade non Hodgkin's lymphoma (Lymphoblastic Lymphoma) 'masquerading' as Pott's disease in a 13-year old child is reported. A brief appraisal is provided of the clinical parameters of Burkitt's lymphoma and strategies and challenges in its management.