Background: Infertility is a global health problem and a socially destabilizing condition for couples carrying several stigmas and a cause of marital disharmony. We determined the prevalence, causes, and clinical pattern of infertility at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: This was a prospective study conducted at the Gynecological Department of UDUTH Sokoto between 1 ^st January, 2011 and 31 ^st July, 2011. All the patients that presented with infertility within the study period were recruited into the study. Relevant demographic, clinical, and laboratory/radiological data were documented using a structured questionnaire. The patients had their case folders tagged and followed up to 31 ^st December 2011 (6 months). Data was analyzed using SPSS version 11. Results: A total of 1,264 new gynecological cases were seen during the study period, and 198 infertile patients were evaluated. The prevalence of infertility was 15.7%. Primary infertility constituted 32.8%, while secondary infertility was 67.2%. Previous history of evidence of genital infection including lower abdominal pain (78.8%) and vaginal discharge (76.6%) were common. Female gender-related causes of infertility accounted for 42.9%; male causes accounted for 19.7%. Both partners contributed to infertility in 16.7%, while no cause was found in 20.7% of patients. Conclusion: The study shows a dominance of secondary infertility with probable genital tract infection being a major contributor. Early presentation and prompt treatments of genital tract infections may reduce the prevalence of infertility in the study population.

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Background: Interpregnancy interval (IPI) offers an important period which allows the parturient to recover from the effects of pregnancy and to be in optimum health before the next pregnancy. Short IPI has serious health and economic implications. Objective: To determine the IPI among parturient attending the antenatal clinic of the University of Port Harcourt Teaching Hospital and the factors that determine this interval. Materials and Methods: This was a cross-sectional survey involving 340 eligible women who attended the antenatal clinic. A pretested interviewer-administered questionnaire was used to obtain relevant information from the participants. The Chi-square and Student's t-tests were used to determine association between predictor variables and the IPI with P < 0.05 as level of significance. Results: The mean age of respondents was 28.4 ± 3.9 years. The average IPI was 14.9 ± 8.5 months with a range of 3-28 months. The incidence of women with short IPI was 65.9% (224/340). Contraceptive use, the presence of a male child, perinatal death in the previous confinement, number of living children, previous history of infertility, duration of exclusive breastfeeding, and duration of postpartum amenorrhea showed significant association with the IPI. Conclusion: A significant proportion of our women had short IPI. Lack and failure of contraceptive use, absence of a male child, small family size, and perinatal death were among the factors that were significantly associated with short IPI. Knowledge of the of these factors would be of assistance to family planning counselors to understand the peculiar needs of our women and to offer appropriate contraceptive advice.

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Background: Hypertension is a leading cause of mortality in the world and is ranked third as a cause of disability-adjusted life years. Epidemiological studies have shown that sedentary life-style and stress are important risk factors for hypertension. The job of bank employees is both sedentary and stressful. Studies on hypertension among bank employees are sparse in India; hence, this study was undertaken to estimate the prevalence of hypertension and identify its risk factors in bank employees of Sullia. Materials and Methods: It was a cross-sectional study conducted among employees of 13 banks located in Sullia. Data was collected using a pre-tested, semi-structured questionnaire. Blood pressure was measured following Joint National Committee-7 criteria. Analysis of data was performed using the Statistical Package for the Social Sciences version 17. P < 0.05 was considered to be significant. Results: A total of 117 bank employees including 18 managers/assistant managers, 33 officers and 66 clerks participated in the study. The prevalence of hypertension was 39.3%. Increasing age, family history of hypertension, body mass index ≥ 25 kg/m ² and abnormal waist-hip ratio were significantly more frequent among the hypertensive than normotensive population. Conclusion: The bank employees had a high prevalence of hypertension and they must be considered an occupational risk group. We recommend periodic screening for early detection of hypertension in them.

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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.

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Background: Diabetes mellitus (DM) was previously considered to be rare in sub-Saharan Africa. However, the prevalence is on the increase mainly because of urbanization and changes in lifestyle. Aim: The aim of our study was to determine the prevalence of DM and its correlates in the suburban population of Northwest Nigeria. Materials and Methods: A cross-sectional community-based study was carried out. Two hundred and eighty participants were recruited using a multistage sampling technique. Interviewer-administered questionnaire was utilized in obtaining demographic data from the participants. Anthropometric variables, fasting plasma glucose (FPG), and blood pressure measured using standard guidelines. The diagnosis of DM was based on the WHO guidelines. Results: The mean age was 42.3 ± 10.7 years. The overall prevalence of DM was 4.3% (males 4.5% and females 4.0%). The mean FPG was higher in the females (5.9 ± 1.2 mmol/L) than males (5.8 ± 2.5 mmol/L) though the difference was not statistically significant (P = 0.81). Obesity and increasing age were the major risk factors for DM among the suburban population. Conclusion: DM is common in suburban areas of Northwest Nigeria. We recommend increased awareness of the epidemic potential of this public health problem even in suburban areas.

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Objective: This study identified the factors associated with the healthcare-seeking behavior of heads of households in a rural community in Southern Nigeria. Materials and Methods: A descriptive cross-sectional study was conducted in 2014 among 410 household heads in Ivhiunone, Fugar in Edo State, Nigeria using two-staged sampling technique. Data collection was by means of a structured interviewer-administered questionnaire. IBM SPSS version 20 and PEPI version 4.0 were used for data analysis. Results: Over three-quarters of the respondents, 357 (87.1%) and 346 (84.4%) were males and married. The mean age of respondents was 49.5 ± 15.9 years. The majority of the respondents, 180 (43.9%) and 208 (50.7%) had a secondary level of education and were in the skill level 1 occupational classification. Almost all 406 (98.8%) respondents sought healthcare when ill, and of these, 399 (98.3%) use medications given. The preferred place to seek healthcare when ill by 373 (91.9%) of the respondents was patent medicine stores. Predictors of healthcare-seeking behavior included marital status, level of education and income. Other associated factors were age, sex, and occupational classification. Conclusion: The sociodemographic predictors of healthcare-seeking behavior included marital status, level of education and income. Other associated factors were age, sex, and occupation. Most of the household heads preferred home treatment and sought healthcare in patent medicine stores and hospitals. Improved quality of care provided to clients/patients in healthcare facilities could address the inappropriate healthcare-seeking behavior in the community.

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Introduction: Provision of adequate safe blood is challenging in developing countries due to paucity of voluntary blood donors, poor facilities for storage and blood component preparation as well as inappropriate blood ordering and utilization. Appraisal of pattern of blood transfusion requests and utilization helps highlight shortcomings that could be addressed toward judicious use of blood. Aims: To determine the pattern of blood transfusion requests and utilization at a Nigerian Teaching Hospital. Materials and Methods: Blood request forms and cross-match worksheets at the blood bank of Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto were analyzed over a 3-month period. Number of blood units requested, cross-matched, or transfused and the cross-match to transfusion ratio (CTR) for clinical units were computed. Results: Of the 1703 units of blood requested for 986 patients, 94.42% (1608) were cross-matched but only 34.51% (555) were transfused giving a CTR of 2.90 for the hospital. The CTR for the various clinical units were: O and G - 3.40, Surgery - 3.11, Trauma center - 2.74, Emergency - 2.61, Medicine - 2.02, and Pediatrics - 1.97. Conclusions: The overall CTR of the hospital is high indicating suboptimal transfusion practice. Introducing transfusion guidelines and type and screen with abbreviated cross-match method can help toward apt requisition and utilization of blood thereby reducing wastages.

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Background: The rising burden of type 2 diabetes mellitus (T2DM) with its attendant's complication can be successively steamed in the face of appropriate self-care management. The latter is positively imparted by the level of knowledge of the disease itself, its impact on quality of life and available basic technique of its control. Aims: The study is, therefore, aimed to assess the level of glycemic control and its determinants among type 2 subjects attending a secondary hospital in Niger Delta. Subjects and Methods: Two hundred consenting adult type 2 diabetes patients of age more than 40 years and attended diabetes outpatient clinics at the Central Hospital Warri between March and August 2014 were used for this cross-sectional study. Two different questionnaires were administered to all the participants to collect the necessary information on diabetes knowledge as well as factors that might affect their glycemic control. Blood samples were collected for fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) for all the respondents. Weight and height were also measured to the nearest 0.5 kilogram and centimeter using standardized equipment. Body mass index was then calculated as the ratio of weight in kilogram and height in meters square (kg/m ² ). Statistical Analysis Used: Statistical Package for Social Science Version 16 was used to compute the data generated. Results: The mean age and diabetic duration of all participants were 54.8 ± 11.9 years and 8.5 ± 3.2 years, respectively. The overall mean knowledge score of the subjects was 6.90 ± 1.8 (69.0 ± 18.2%) The mean FBG level and HbA1c of respondents were 7.89 ± 3.6 mmol/L (range 4-20 mmol/L) and 8.2%, respectively, with 55% of the population having poor glycemic control and 45% good glycemic control. The diabetic knowledge scoring of those with poor glycemic control was significantly lower than those with good glycemic control. In addition, diabetics' with poor glycemic control HbA1c >7.0 had longer diabetic duration (1-19 years; 8.06 ± 4.30) when compared with those with good glycemic control, HbA1c < 7.0 (1-15 years; 6.44 ± 4.02). Conclusions: The proportion of poor glycemic control among patients with T2DM in Central Hospital Warri is relatively high with diabetic duration and inadequate diabetic knowledge identified as significant determinants.

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Background: The prevalence of type 2 diabetes (T2DM) is on the increase in developing countries due to urbanization, ageing population, physical inactivity and the high prevalence of obesity. Identifying the risk factors for T2DM is a necessary step in the planning of preventive measures to reduce the burden of the disease. The aim of this study was to determine the socio-demographic and anthropometric risk factors for type 2 diabetes in Maiduguri, northeastern Nigeria. Methods: We randomly selected 242 subjects resident in the study location. Trained interviewers obtained socio-demographic data from each respondent using a pretested questionnaire. Physical measurements for anthropometric indices were carried out using standard methods. Fasting blood samples were collected for the determination of fasting plasma glucose and diagnosis of diabetes. Data were analyzed using SPSS version 16 for windows and a P < 0.05 was considered significant. Results: All the 242 subjects recruited for the study responded. The mean (SD) age of 96 (39.7%) males and 146 (60.3%) females was 40.0 (14.6) years and 41.5 (12.0) years respectively, P > 0.05.The crude prevalence of diabetes was 17 (7.0%). The prevalence was 10(10.4%) in males and 7(4.8%) in females (M: F = 2.1:1), P < 0.05. The independent risk factors for diabetes identified were increasing age (OR = 3.72, 95% CI = 0.83-16.7, P = 0.007) and waist circumference in both males (OR = 1.65, 95% CI = 0.75-3.63, P = 0.036). and females (OR = 1.63, 95% CI = 0.56-4.78, P = 0.025). Conclusion: We identified increasing age and waist circumference to be the independent risk factors for T2DM in Maiduguri, Northeastern Nigeria.

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Aims: The aim of this study was to determine the prevalence of microalbuminuria (MA) in patients with type 2 diabetes mellitus (T2DM) and to identify the associated risk factors. Settings and Design: The study was a prospective, descriptive, cross-sectional study carried out in the medical outpatient department of the Central Hospital, Warri from March to August 2014 after approval by the hospital's health and ethics committee. Materials and Methods: Two hundred T2DM aged 45-80 years were randomly selected for the study after obtaining their informed consent. Three-morning urine samples collected at 1-month interval were tested for MA using the "MICRAL test" strip. A fasting blood sample was also drawn after 10-12 h overnight fasting for plasma glucose, hemoglobin A1c (HbA1c), lipid profile, and serum creatinine investigations. MA was diagnosed if the urinary albumin excretion ratio was between 30 and 300 mg/24 h from two separate urine samples. Statistical Analysis Used: Data was analyzed using Statistical Package for Social Sciences version 16. Differences at P < 0.05 were considered significant. Results: The prevalence of MA was 58%. The mean age, duration of T2DM, systolic blood pressure, fasting blood glucose, HbA1c level, serum creatinine of type 2 diabetes with MA were significantly higher when compared to T2DM patients without MA while the mean diastolic blood pressure body mass index and age did not differ significantly between the two groups. Conclusions: The overall prevalence of the MA among type 2 diabetes visiting a medical outpatient clinic in Central Hospital, Warri were high and similar to that reported in other studies.

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Background: Dengue fever is a serious public health problem in terms of its morbidity and mortality. It reports from almost all countries and it is endemic in the tropical countries. Aim: The present hospital study aims to describe  the frequency , distribution and case fatality of dengue fever based on the variables such as age, sex and year. Settings and Design: It is a hospital-based retrospective study of 5 years in tertiary care and teaching hospital in South India. Materials and Methods: The data were collected from the medical records department of the hospital and analyzed by using Microsoft excel. Result: Out of 341 reported cases of dengue, 60.70% were males and 39.29% were females. In both males and females, the high proportion of cases were reported in adult age groups (>20 years). Case fatality rate of dengue fever is 1.2%, with 0.97% in males and 1.49% in females. Out of 341 cases, 333 (97.65%) were Classical Dengue Fever and remaining 8 cases (2.34%) were dengue hemorrhagic fever. Conclusion: More cases of dengue fever were reported in the adult age group (20 years and above) and in males compared to low age groups (<20 years) and females. It highlights the involvement of work component in the occurrence of disease. Community-based action program is required for source reduction activities in the outdoor area for arresting the breeding and multiplication of Aedes mosquitoes and thereby to reduce the morbidity and mortality of dengue fever.

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Objective: The objective of this study was to determine the prevalence of uncorrected refractive error among students in three selected secondary schools in Birnin Kebbi metropolis as many children with poor vision due to refractive error remain undiagnosed and perform poorly in schools. Materials and Methods: This was a cross-sectional study that was conducted over a period of 2 months (May-June 2014). A total of 614 students were included from three randomly chosen secondary schools in Birnin Kebbi, Nigeria. Subjects were selected using random sampling technique from the list of students available through the help of their class teachers. Visual acuity (VA) was measured with a Snellen chart, while students with subnormal vision (VA ≤ 6/9) were examined using pinhole, and subsequently referred for detailed eye examination and retinoscopy evaluation. Results: The age range was from 11 to 20 years comprising 50.8% (n = 312) males and 48.2% (n = 302) females. Refractive error in either eye was present in 30 (4.8%) children. Of these, myopia was diagnosed in 18 (60%) children, and then hyperopia in 7 (23.3%), and astigmatism in 5 (16.7%) subjects. Spectacle coverage was low as only three pupils were found to be using glasses with lack of awareness and lack of access to eye care services as major barriers. Conclusions: Uncorrected refractive error is found among secondary schools students in Birnin Kebbi, and there is a need for the establishment of regular and effective school vision screening program to detect and refer patients for treatment.

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Background : There is paucity of literature on childhood diabetes mellitus (DM) from developing countries, especially North-Western Nigeria. We describe the clinical presentation and outcome of childhood DM as seen in Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, Nigeria. Materials and Methods : This was a 10-year retrospective review of case files of children aged 15 years and below with childhood DM seen between September 1 ^st 2001 and August 31 ^st 2011. The age, gender, presenting features, complications, laboratory features, and outcome of the patients were extracted and analyzed. Results: Eight out of the 23,931 children admitted during the study period were diagnosed with type 1 (T1) DM, giving a case prevalence rate of 0.33/1000 (3/10 000). The male-to-female ratio was 1:1. The mean age at presentation was 11.8 ± 3.1 years. The mean duration of symptoms before presentation was 6 ± 4.9 weeks (range 1.2-12 weeks). The most prevalent symptoms were polyuria and weight loss, 7 (87.5%) each, polydipsia, 6 (75%), polyphagia, 5 (62.5%), and weakness, 4 (50%). Five (62.5%) patients presented with diabetes ketoacidosis (DKA). The mean random blood sugar (RBS) was 22.6 ± 12.01 (range 13-49.5) mmol/L. Five (62.5%) patients were discharged while three (37.2%) left against medical advice. Four (80%) of the discharges were lost to follow up. Conclusion: Childhood DM is relatively uncommon in UDUTH, Sokoto. There is a high frequency of DKA, late presentation, and default to follow up. We recommend increased awareness campaigns and health education on childhood DM.

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Introduction: Satisfaction evaluation is an excellent opportunity to involve clients in the process of assessing programs from users' perspective and is recognized as a component of quality of care. This study aimed to identify determinants of client satisfaction with the family planning (FP) services provided in government health facilities in Sokoto metropolis. Materials and Methods: A descriptive cross-sectional study was conducted among FP clients that patronized the FP commodity delivery point in selected health facility in Sokoto, Northern Nigeria. A multi-stage sampling technique was used to select the study respondents. List of the clients that attended each clinic was compiled and used as a sampling frame. A set of pretested exit interviewer-administered questionnaire was used to collect data from the clients. Ethical approval was granted for the conduct of the study, and individual informed consent was obtained from each client. Thereafter, the exit questionnaire was administered. Results: All the respondents were females and those aged 25-29 years constituted a larger proportion of 26%. Overall mean age was 30.8 ± 7.0 years. Large proportion (85%) expressed satisfaction with FP services provided. About 49% of the respondents reported waiting for 30 min before being attended to by service providers while 13% waited for more than 2 h. Average waiting time was 60.3 ± 21.3 min with clients mean desired waiting time of 35.2 ± 11.1 min. Clinic waiting time, being examined during the visit, and attitude of both service providers and other clinic staffs were found to be the key determinants of client satisfaction. Conclusion: Although, most of the clients waited for more than 30 min, majority were satisfied with the services offered. There is a need to reduce waiting time of FP clients at the clinic and ensure clients are appropriately examined.

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Background: Measles, a highly infectious viral disease, is endemic in developing countries with a peak of transmission from October to March. The case fatality rate of measles in the developing countries stands at around 3-5%; this could be as high as 10% during epidemics. Although natural infection with the measles virus confers life-long immunity, those vaccinated with the vaccine could get up to 10 years of protection. In spite of the availability of measles vaccines, there have been sporadic measles outbreaks, especially in developing countries, hence the need to know the underlying cause. Study Design: Systematic review. Method: Relevant literature was reviewed on trend of measles. The literature accessed from the W.H.O and UNICEF sites, and also using Google search include case-series studies, community-based studies on age-specific measles case fatality ratios (CFRs), and cohort analysis of surveillance data. Results: The review shows that lowest measles CFR is seen among the vaccinated children and highest seen among the unvaccinated children. Additionally, the broad range of case and death definitions of measles as well as the study population and geography, clearly highlight the complexities in extrapolating results for global public health planning. Conclusion: The outcome of several studies has shown that measles outbreaks are associated with factors that include: weak measles case-based surveillance in some areas, lack of awareness about the disease among parents, vaccine stock-out, and lack of adequate cold chain equipment to preserve the vaccine in remote hard-to-reach areas.

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Introduction: Breast cancer is a major global public health problem accounting for massive morbidity and significant mortality worldwide. Factors contributing to breast cancer mortality have been a topic of intense research and discussion in the scientific world. There is, however, a dearth of information on the incidence of breast cancer mortality in most resource-poor countries including Nigeria. Available data from most African workers on breast cancer focused on incidence, risk factors, and complications rather than mortality. The unique ethnic heterogeneity of Abuja and its peculiar lifestyle (as compared to other Nigerian cities) provides added impetus for assessing breast cancer mortality in one of the Nigeria's fastest growing cities. This study is carried out in a 400-bedded public tertiary hospital in Abuja, the capital of Nigeria. Materials and Methods: A retrospective review of all breast samples in the department of histopathology over a decade is performed supported by clinical information from the medical record archives. Results: Of 2292 breast samples received in the department, 35.3% (n = 810) are malignant out of which 10.6% (n = 86) died. Breast cancer incidence increased from 29 in 2005 to 141 by 2013 while mortality declined from 11 to 9 over the same period. A crude fatality rate of 3.7% is observed. The ages of the decedents ranged from 20 to 90 years with a mean of 43.5 years. Infiltrative ductal carcinoma accounts for the largest mortality with 87.4%. Conclusion: Breast cancer is an important cause of mortality among females and efforts at early detection and treatment should be intensified.

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Background: Hepatitis B virus is known to be endemic in Africa. The seroepidemiological studies of HBV have shown that infection commonly occurs in childhood in Africa resulting in an increased tendency to chronicity. This cross-sectional study was undertaken to determine the seroprevalence of hepatitis B surface antigen among pediatric patients with homozygous hemoglobin S. Materials and Methods: Three hundred sickle cell anemia children aged 6 months-15 years (both in steady state and in crises) attending the SCA clinic and on admission in emergency pediatrics unit and pediatrics medical ward, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, were screened for hepatitis B infection using HBsAg as marker of infection. The sensitive enzyme linked immunosorbent assay method was used for detection of the marker. Three hundred children with minor illness attending pediatrics outpatient department and on admission in EPU/PMW for various treatment in the same hospital served as gender- and age-marched controls cohorts. Results: The sero-prevalence of HBsAg seropositivity for hepatitis B virus infection among SCA children was 17.3% (52/300) compared to 10.7% (32/300) of the control (P = 0.0875). The peak prevalence age group for HBV infection among SCA children was in the age group 1.1-5.0 years (6%) compared to 10.1-15.0 years (4.7%) in the control. Risk factors for HBV infection such as blood transfusion, traditional scarification/circumcision/uvulectomy, and tattooing did not significantly affect the prevalence of HBV infection in both SCA children and controls. Conclusion: Hepatitis B infection is common in Sokoto. The need for strict adherence to HBV immunization and further community-based studies on the risk factors are recommended.

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Context: The abuse of psychoactive substances which is one of the most important global public health problems begins in adolescence. Adolescents usually start by abusing the gateway substances. They suffer social, economic, physical, and legal consequences on account of use of substances, and this is very worrisome because of the increasing prevalence of use. Aims: The aim was to identify the characteristics of adolescents that use gateway substances. This knowledge shall be utilized in preventive programs. Settings and Design: Cross-sectional study with secondary school adolescents as participants. Subjects and Methods: Multistage sampling technique was used to select 492 respondents and the questionnaire consisted of characteristics of the adolescents, their families and schools and the alcohol, tobacco, cannabis, and stimulant use sections of the World Health Organisation questionnaire for student drug use surveys. Statistical Analysis Used: The data were analyzed using the Statistical Package for Social Sciences, and Chi-square statistics was used. Results: Having a friend who uses substance was significantly associated with tobacco, alcohol, cannabis, and caffeine use while being a male, having a family member that uses substance were significantly associated with tobacco, alcohol, and caffeine use. Older age, lack of satisfaction with the relationship with the teacher and polygamous family background were significantly associated with tobacco use. And finally, lack of satisfaction with the relationship with parents/guardians and having parents or guardians who are not religious were significantly associated with alcohol use. Conclusion: A comprehensive approach is needed to prevent the use of substances; this should target individuals, schools, families, and religious institutions.

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Background: Snake bite with envenomation is a medical emergency. Children are at risk of severe manifestations due to small body mass. Unlike adult population, there is limited data on snake bite among children in Sokoto, North-Western Nigeria. We described the presentation and outcome of snake bite in children presenting to the Emergency Pediatric Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto. Materials and Methods: Case records of all children managed for snake bites from 1 ^st January 2003 to 31 ^st December 2012 were retrospectively reviewed. Demographic and other relevant information were retrieved and data analyzed using Microsoft Excel. Results: Out of 23,570 Pediatric admissions, 36 children had snake bites giving prevalence of 0.0015 (1.5/1000). Male: Female ratio was 1.6:1, with a mean (standard deviation) age of 9.6 ± 2.8 years (range = 1-14 years). Snakebites involved the lower limbs in 52.8%; and at home in 69.4%, and during the night in 58.3% of patients. The highest prevalence of bite was between April and July. Features of envenomation included local swelling (100%), prolonged clotting time (61.1%) and spontaneous hemorrhage (epistaxis and hematemesis) in 11.1%. One patient (2.8%) had seizure which may be incidental, though common causes such as hypoglycemia, malaria and meningitis were excluded by laboratory investigations. Polyvalent anti-snake venom was administered in 29 (80.6%) children, with adverse reaction observed in 13.8% (4/29) of the patients. Thirteen patients (36.1%) signed against medical advice while the remaining 23 (63.9%) were discharged home. Conclusion: Snake envenomation is associated with low morbidity and mortality in our study. Measures aimed at eliminating snake habitats around residential areas should be encouraged.

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Introduction: The pressure on couples and particularly women to have children is strong in developing countries where a childless woman is considered a social pariah. This study aimed to determine the predictors of fertility desire among people living with HIV. Materials and Methods : This is a descriptive cross-sectional study conducted among 400 HIV-positive clients receiving follow-up care at anti-retroviral (ART) clinic in a tertiary health facility in Sokoto. A list of clients that came to the clinic was compiled and served as sampling frame. A two stage sampling method was used to select study respondents from the sampling frame. Interviewer- administered closed-ended questionnaire was used to collect the required data from the respondents. Ethical approval was granted for the conduct of the study and informed consent was obtained from the respondents. Descriptive, bivariate and multivariate analyses were carried out. Results : Majority (56.2%) of the respondents were females. The overall mean age was 34.5 ± 0.4 years (male 38.4 ± 0.5 years), and (females, 31.4 ± 0.4 years). A large proportion of the respondents (67.7%) reported desire to have children in future. Using logistic regression analysis, younger age (adjusted odd ratio [aOR] = 2.0, P = 0.023), marital status (aOR = 1.9, P < 0.001) and number of living children (aOR = 0.7, P < 0.001) were the key factors influencing respondents desire for children. Conclusion : Many HIV-positive clients in the clinic reported desire to have children. It is recommended that full reproductive health services be provided in the clinic to help them achieve their reproductive goal without risk to their partners and new born.

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Background/Aim: The placenta plays a major role in fetal well-being, and fetal weight is very important to neonatal survival. There probably exists a relationship between placental dimension and fetal size. Data on ultrasound assessed placenta thickness and fetal weight are scanty in the Nigerian literature. This study aimed to establish a relationship between ultrasound estimated placental thickness and fetal weight. Materials and Methods: Four hundred and twenty apparently healthy pregnant women at gestational age 15-40 weeks were sonographically examined, with a 3.5 MHz curvilinear transducer of a Sonoace X6 machine (Medison Co., Korea). Placenta thickness, in millimeters, and fetal weight, in grams, was estimated for each subject. Correlation between the two parameters was assessed. P ≤ 0.05 were considered to be significant. Results: Mean placental thickness (PT) ranged from 22.6 ± 2.5 mm at 15 weeks to 40.9 ± 7.2 mm at 30 weeks, while estimated fetal weight (EFW) ranged from 147.0 ± 16.5 g at 15 weeks to 3.304.8 ± 284.6 g at 40 weeks. The mean values of placenta thickness and EFW throughout gestation were 35.5 ± 7.0 mm and 1555.0 ± 1004 g, respectively. There was significant correlation between placenta thickness and EFW r = 0.668; P = 0.000. Conclusion: The study established a fairly linear relationship between placental thickness and EFW. A normogram of ultrasound estimated placenta thickness and fetal weight is derived.

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Background: Human immunodeficiency disease (HIV/AIDS) is a chronic medical condition with many psychological complications, one of which is suicide behavior. Many studies of this behavior have been reported in the developed countries while only a few in Africa. One, therefore, wonders whether this behavior is not found or rare in African people. If found, how common are they in a treatment center in Kaduna metropolis? Aim: The aim of the study was to determine the prevalence of suicidality among HIV/AIDS patients receiving care at AIDS relief center of St. Gerard's Catholic Hospital, Kaduna, Northwest Nigeria. Methods: The study was a cross-sectional, descriptive study involving 250 HIV-positive patients who can read and write in English selected through a convenience sampling. A self-administered sociodemographic questionnaire was given to the patients to fill after receiving written consent. Thereafter, all the participating patients were interviewed for suicidality using suicidality module of the Mini International Neuropsychiatric Interview. Results: There were 96 males (38.4%) and 154 females (61.6%) who participated in the study. The age range of the patients was 18-64 years with a mean of 35.58 (standard deviation + 8.8). The prevalence of suicidality among these patients was 16%. Low risk of suicidality was found among 26 (65%) of the forty patients who had suicidality. Moderate risk was found in 5 (12.5%) while 9 (22.5%) patients had high risk of suicidality. Conclusion: The implication of this finding is that suicidality as one of the psychological consequences of HIV/AIDS is found among these infected patients in Nigeria. Therefore, there is need for prompt recognition and prevention of suicidal behavior among these patients.

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Background: Postpartum depression (PPD) is of public health importance. Estimation of it occurrence in other parts of the developed world showed prevalence rates of approximately 10%–25%. Previous prevalence studies in crisis-ridden areas showed prevalence rates ranging from 28% to 58%. However, since the entrenchment of relative peace in Jos, Nigeria there has not been any other study to the best of the authors' knowledge. Aim: The aim of the present study was to determine the prevalence of PPD in a postethno-religious crisis period among women attending the Postnatal and Children's welfare clinic in a tertiary hospital, Jos, Nigeria. Materials and Methods: In total, 550 women were recruited in a cross-sectional study that involved a two-stage procedure in a Tertiary Hospital in Jos, Nigeria. The Edinburgh Postnatal Depression Scale questionnaire and the Depression Module of the Structured Clinical Interview for DSM-IV axis I Diagnosis were used. Results: A weighted prevalence of 21.8% of PPD was found among the participants. Age (P< 0.001), marital status (P< 0.001), types of marriage (P< 0.001), and educational level (P< 0.001) were significantly associated with PPD. Conclusions: PPD was found in about a quarter of the studied sample in the postcrisis period. Therefore, screening of women in the postpartum period for depression will help in early detection and treatment of women of childbearing age.

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Introduction: Obstructed labor is a common cause of feto-maternal morbidity and mortality in Maiduguri, Nigeria. This study aimed to determine the prevalence, causes, risk factors, and outcome of obstructed labor at the University of Maiduguri Teaching Hospital (UMTH). Materials and Methods: This was a retrospective observational study of all cases of obstructed labor managed from January 2012 to December 2014 at the UMTH, Maiduguri, Nigeria. For each case, the next woman who delivered without obstruction was used as a control. Data were analyzed for sociodemographic variables, labor, delivery and postdelivery events using SPSS version 20.0. The Chi-square test and odds ratio (OR) were used and statistical significance set at P < 0.05. Results: The prevalence of obstructed labor was 2.13%. Cephalopelvic disproportion, persistent occipitoposterior position, and malpresentation were seen in 65.37%, 16.58%, and 11.71%, respectively. The risk factors were teenage pregnancy (χ²: 26.96, P < 0.0001, OR: 4.44, 95% confidence interval [CI]: 2.45–8.05), nulliparity (χ²: 50.70, P < 0.0001, OR: 4.63, 95% CI: 2.99–7.15), illiteracy (χ²:53.91, P < 0.0001, OR: 5.26, 95% CI: 3.31–8.33), and unbooked status (χ²: 113.26, P < 0.0001 OR: 11.9, 95% CI: 7.24–19.61). Complications were observed in 37.56% of the women with obstructed labor. The common morbidities were wound sepsis, ruptured uterus, and puerperal sepsis, seen in 16.59%, 13.17%, and 7.81%, respectively. The case fatality rate was 0.98% and perinatal mortality was 34.15%. Conclusion: Obstructed labor is common in Maiduguri. We recommend amelioration of the risk factors through advocacy, girl child education, and public enlightenment on the need for antenatal care and hospital delivery, identification, and referral of high-risk patients.

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Background: Patients with community-acquired pneumonia (CAP) who are admitted in a hospital but do not respond to initial antimicrobial therapy pose a challenge to the attending physician. The knowledge of the likely pathogens and their sensitivity pattern can help the clinicians to better manage such cases. Aims and Objectives: To study the spectrum of the bacterial isolates and to determine the antimicrobial sensitivity pattern obtained from the bronchoalveolar lavage (BAL) fluid of CAP patients who did not respond to initial antimicrobial therapy. Setting and Design: A retrospective study of 87 patients who were admitted in the medical wards of a tertiary care teaching hospital in South India with the diagnosis of CAP and were not responding to initial antimicrobial therapy. Materials and Methods: The patient-related data were obtained from the case records and entered on a pre-designed proforma. This included demographic characteristics and reports of relevant clinical tests. The BAL culture and sensitivity results were also noted on the proforma. Results: The mean age of the patients was 49.28 ± 16.61 years (mean ± SD, range 17-80 years). Fifty-seven patients (65.5%) of were male. Also, 98 bacterial isolates were obtained from the BAL fluid of 87 patients. The most prevalent bacterial isolates included Pseudomonas aeruginosa (n = 35, 35.7%), Klebsiella pneumoniae (n = 19, 19.4%), Staphylococcus aureus (n = 15, 15.3%) and Acinetobacter species (n = 11, 11.2%). Most bacterial isolates tested showed 100% sensitivity to meropenem except Acinetobacter species (25%). Conclusion: P. aeruginosa and K. pneumoniae were the most common bacterial pathogens isolated from the BAL fluid. The isolates tested showed 100% sensitivity to meropenem except Acinetobacter species. All the methicillin-resistant S. aureus isolates displayed sensitivity to vancomycin, linezolid and teicoplanin.

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