Background: Little is known about the burden of stroke in the northern part of Nigeria as most studies in the country have been in the southern part. The objective of this study was to study the profile of stroke patients and predictors of outcome in a tertiary health centre in Katsina, North-Western Nigeria.. Patients and Method: In this retrospective study, case records of all stroke patients admitted to the hospital between July, 2003 and March, 2006 (33 months) were retrieved to obtain the necessary information using a structured questionnaire designed for the study. Results: There were 139 files retrieved but only 81 had complete information. The mean age of the patients was 61.40΁15.57 years. The peak age of occurrence of stroke was found to be in the seventh decade in females and eight decade in males. Systemic hypertension, present in 65.4% of cases, was the commonest risk factor identified. Overall mortality rate was 23.5% and factors that predicted mortality include level of consciousness at stroke onset (r=0.26, p=0.02) and presence of complications (r=0.38, p<0.001). Conclusion: Hypertension is the dominant risk factor for stroke in the northern part of Nigeria and predictors of outcome are level of consciousness at onset and presence of complications.

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Objective: With paucity of documentation of congenital clinical malaria in the world literature, we therefore aimed to review its rates, presentation, management and out come of this problem in neonates at the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Methodology: This prospective study was carried out in Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria over a 10- month period; (January 2006 to October, 2006). The study populations were the admitted neonates to the emergency paediatric unit and the Special Care Baby Unit that presented with fever and other clinical features suggestive of malaria and/or septicaemia. Diagnosis of malaria was by Giemsa stain on blood smears and that of septicaemia was by positive blood culture. Results: 162 babies [aged <28days] were admitted with fever amongst other clinical features during this period. 156 (96%) of the babies admitted, 82 (53%) were males, and 74 (47%) females, giving a M: F ratio of 1.2:1, and these were positive for malaria parasite alone. Of the babies with the specific morbidity of clinical neonatal malaria, 68(44%) were aged seven days or below, and were considered to be congenital. Our encountered Incidence was high; 50 per 1000 live births. The mean (SD) birth weight was 2.76(0.28) kg, mean (SD) gestational age, 39.24 (1.18) weeks and mean (SD) temperature 38.4(0.5) ΀ C. Plasmodium falciparum trophozoites were the only species observed in this study. There was no recorded case of transfusion malaria. The postnatal age group of 0-7 days was the commonest age group at which the neonates were admitted. The distribution of malaria density was In favour of malaria density (+), 39(57%). Fever was the commonest (100%) presentation followed by refusal of feeds (93%) and irritability (76%). Of the 68 babies in the study group, 32(47%) were delivered to pimiparas. The subjects were treated with arthemeter-lumenfantrine tablets for three days. No baby In the study group died. However, 6 babies that had both neonatal malaria and septicaemia died while, 5 babies that were negative for both malaria parasite and blood culture but with worsening clinical signs and persistent fever also died despite adequate treatment for possible septicaemia and malaria. Conclusion: Although no mortality occurred in congenital clinical malaria, however, a diverse pattern of morbidity was shown. There is the need for continuing health education to Increase the awareness amongst pregnant mothers of the importance of ante natal clinic visits for prescription of malaria chemoprophylaxis. The efficacy of artemether-lumefantrine combination in the treatment of clinical congenital malaria is strongly highlighted.

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Aim/Objectives: The objective of this study was to present the descriptive characteristics of non-neonatal tetanus cases seen in a teaching hospital in Northwestern Nigeria over a 10-year period and to discuss the implications of the study findings for anti-tetanus vaccination policy and implementation in developing countries. Methodology: Fifty-nine records of non-neonatal tetanus cases were reviewed. The socio-demographic characteristics of the patients, the source of infection, seasonal distribution and outcome of cases were investigated. The data obtained was compared for differences in proportions and case fatality rates between groups. Results: The annual prevalence of cases in this study was 5.9 per year. Most (82.7%) cases were aged <40 years while mortality was higher in patients >40 years. More males (76.9%) were affected but case fatality ratio was higher in females. The Hausa/Fulani ethnic group (88.1%) predominated. Majority (63.5%) of cases were from the rural area. Case fatality rates for the urban and rural areas were 26.3% and 72.7%, respectively, (p =0.0016) Farmers (30.5%), housewives and students (18.6% each) were most affected. Portal of entry of infection was mostly through injury wounds (49.1%), puerperal sepsis (8.5%) and post-surgery infection (3.4%). Only one (2.1%) of the cases was immunized. The overall case fatality rate was 52.5% while 44.1% survived. Conclusion: In view of the study findings, it is opined and hypothesized that a policy to expand and implement anti-tetanus vaccination campaign beyond maternal and childhood immunoprophylaxis, to cover the entire rural and farming populations, and school children will help to reduce considerably the burden of tetanus in Nigeria and other developing countries.

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Background: There is paucity of information about awareness of the risks of cigarette smoking in Northern Nigeria. Objective: To determine patients' smoking habits and their awareness of the risk of cigarette smoking. Method: Cross-sectional hospital-based survey carried out between November 2005 and January 2006 on adult Nigerians attending medical outpatient clinics of the State Specialist Hospital, Maiduguri. Each patient completed a questionnaire on smoking habits and associated risk. Results: One thousand two hundred and thirty-two patients comprising 805 men and 427 women were recruited into the study. Of the total respondents, 1074 (87.2%) were non-smokers, leaving 158 (12.8%) smokers comprising 4 females and 154 men. A majority of respondents were unaware of the effects of cigarette smoking. Conclusion: The level of knowledge of the risks of smoking was very low in the study population. A response to the public health problem of tobacco therefore needs to be Intensified.

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The objectives of the study were to establish the prevalence and intensity of infection with schistosoma haematobium which is a waterborne disease in a rural community, Katagum town. All the school children who attended the only primary school in the town made up the population studied. 11 out of 444 children studied were shedding ova of S. haematobium and that gave the prevalence of infection to be 2.5%. Varied intensities were noted in those shedding ova and that reflected in the degrees of haematuria and proteinuria. Though the prevalence is low compared to most earlier studies, the potential for spread is high considering the greater viability of schistosoma ova in younger children. In view of the potential complications, it was recommended that various tiers of government should be involved actively in control efforts.

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Introduction: Inappropriate blood transfusion has been reported from all over the world. Objectives: This survey examined the use of blood and blood products in Aminu Kano Teaching Hospital with a view of assessing appropriateness of transfusion, so as to suggest ways of minimizing inappropriate transfusion if they occur. Materials and Methods: Three year blood transfusion records were analysed using simple arithmetic methods and in some instances Microsoft excel was used for graphical illustration. Results: A total of 7788 requests for transfusion were made during the period under review. Request for whole blood consisted of 6702 (86.1%), Red Blood Cells 1006(12.6%), Cryoprecipitate 33(0.39%) Fresh Frozen Plasma 10(0.13%) and for platelet concentrate was 37(0.5%). The highest no of transfusions were seen in Adult Medical wards 2327(29.9%) and the lowest transfusion rate was in ICU 15(0.2%). There were three main indications for transfusions recorded with Anaemia being the major cause for transfusion 3835(49.1%), and others being for Surgery 1863(23.9%) and Haemorrhage 1634(21.0%). Four hundred and forty nine (4.95) units of blood were wasted with majority being due to expired units 208(42%) and others due to infectious markers [(HIV 120(24.3%) HBV 75(15.2%), HCV 11(2.25)] while some were from units punctured 62(16.2%) and not used. Conclusion: inappropriate transfusion was prevalent in our hospital and we need to develop guidelines that would be used to edit the transfusion service in due course.

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Background: Transfusion of blood products is a recognised way of transmitting infections particularly viruses. The extent to which blood transfusion contributes to hepatitis B virus (HBV) infections in transfused patients with sickle cell anaemia (SCA) has been found to be 20% in Lagos, Nigeria. Manxman in Zaria however reported a lower prevalence of 4.03%. This wide variation in prevalence might not be unconnected with patients' selection, methodology or differences in quality control at transfusion. Objective: This study was aimed at determining the prevalence of transfusion associated HBV infection among sickle cell anaemia patients in Kano, Nigeria. Materials and Methods: The study was a case control study in which patients with sickle cell anaemia were recruited from Aminu Kano Teaching Hospital (AKTH), Murtala Mohammed Specialist Hospital (MMSH) and Hasiya Bayero Paediatric Hospital (HBBH), all within Kano metropolis, Kano, Nigeria. A total of 135 consecutive patients with Sickle Cell Anaemia (SCA) {68 transfused (cases) and 67 non transfused (controls)} were studied. An interviewer administered questionnaire containing details of previous blood transfusion and other risk factors for HBV infections was administered to each of the patients. The presence of HBsAg was then looked for in both the transfused (cases) and non transfused (controls) patients with SCA using Monolisa ELISA according to manufacturers instructions. The association between multiple blood transfusions and the risk of HBV infection was determined by calculating the relative and attributable risks respectively. Results: There were 68 patients in the study group (cases) consisting of 41(60.3%) males and 27(39.7%) females while the controls were made up of 67 patients consisting of 24(35.8%) males and 43(64.2%) females. Eighteen patients (26.5%) in the transfused group and 3(4.5%) in the control group tested positive for HBsAg. Blood transfusion was significantly associated with HBV infection in patients with SCA (p<0.05) with a Relative Risk (RR) of 5.8 and an Attributable Risk (AR) of 22%. Conclusion: There still exist increased risks of infection with HBV in SCA patients who have received blood transfusion despite existing screening modalities. Therefore polices aimed at effective prevention like ensuring quality control, standardizing and centralizing blood transfusion services need to be put in place as a matter of urgency.

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A 60-year old woman presented with a 2-year history of abdominal distension, early satiety, weight loss, bilateral leg swelling and difficult breathing. Clinical examination had to be conducted in the semi-recumbent position, as the patient was very uncomfortable In the crpine position. A diagnosis of advanced intra-abdominal tumour was made, and the patient was scheduled for laparotomy. With the patient in the lateral decubitus position, induction of anaesthesia, endotracheal intubation and laparotomy were done. Laryngoscopy and intubation were relatively easy. A huge right ovarian mass weighing 29kg, was excised at surgery. Anaesthesia and surgery were successful, without adverse incidents. She developed postoperative pulmonary oedema, that resolved after 5 days of treatment. She was discharged on the 20 ^th postoperative day.

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