Gambiense sleeping sickness is a parasitic disease that is difficult to diagnose due to insidious clinical signs and transient parasitaemias and it poses a major pubic health problem in the Abraka area of Delta State, Nigeria. Passive case detection (PCD) is defined as sleeping sickness cases diagnosed in patients who present voluntarily to the health institution for attention. PCD has remained the mainstay of intervention and control of the disease in this area. This study was conducted to obtain relevant information based on PCD in assessing current situation of the disease and to highlight some challenges evident from the baseline data. The Baptist Medical Centre, (BMC) Eku is located in the Abraka Sleeping Sickness Focus (ASSF). The case records of 73 patients (38 males and 35 females) admitted to the Medical Wards of BMC, Eku between June 1999 and May 2004, with a diagnosis of gambiense sleeping sickness were reviewed for reporting. Five milliliters of venous blood was obtained from each patient into Ethlyene Diamine Tetraacetic acid (EDTA) bottle for microscopy. Lymph node fluid and tissue biopsies were taken from those with lymphadenopathy and CSF collected for screening from all the patients. Buffy coat layer (BCL) and deposits of lymph node fluid (LNF) and CSF were examined for trypanosomes. All patients received three courses of intravascular Melarsoprol at a dose of 2 to 3.6mgkg^-1 day ^-1 for three days for a course, with one week interval between the courses. Trypanosome parasites were detected in blood samples of 2(2.7%) and in the lymph node fluid of 8(11%) patients. All patients were positive by CSF microscopy. The highest prevalence of infection was among patients aged between 26-35 years with 35.6% infection rate, 23.3 percent was recorded among those aged 36-45 years. Of all the 73 cases treated at the BMC, only 10(13.7%) were previously treated in hospital while 44(60.3%) were in traditional centers. Thus traditional care for sleeping sickness is widely practiced in the study area.

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Background: Protein energy malnutrition (PEM) is a common condition in our environment, and still associated with high morbidity and mortality. Objective: The aim of the study was to evaluate the outcome and management of children with PEM in Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Methods: The records of all malnourished children admitted into the Paediatric unit of Aminu Kano Teaching Hospital (AKTH) were retrieved over five year period (January 2002 December 2006). Demographic data, predisposing factors, clinical types of PEM, outcome of management and time of discharge or death were also extracted from the case notes. Results: There were 169 children with PEM. The male to female ratio was 1:3:1. The prevalence rate was 5.4%. Marasmus was the commonest type of PEM (39.1%). Poverty, poor weaning practices and communicable diseases such as measles (26.6%), HIV (22.6%) and tuberculosis (10.7%) were the common associated factors. Ninety eight (58%) of the patients were discharged after full recovery. The case fatality rate was 29%. Conclusion: The mortality rate of severe PEM is still high. There is the need for close monitoring of all cases throughout admission. It is also advocated that special wards for this group of patients should be carved out in Paediatric units.

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Background: Despite the significant roles that school teachers are expected to play in school eye health programmes, their perceptions on their pupils' eye health have not been adequately determined. Objective: The study aims to ascertain the perceptions of elementary school teachers in llorin, Nigeria, of some factors that could influence their pupils' eye health. Materials and Methods: A knowledge-attitude-practice (K-A-P) survey using structural self-administered questionnaires was conducted from May to July 2005 on 172 consenting teachers. The teachers were selected by proportionate sampling from 6 randomly selected primary schools in llorin. Results: Majority of them (98.8%) rated good eye sight as important or very important to pupils' leaning, and identified good nutrition (84.9%) and adequate lighting (74.4%) as requirements for optimal eye health. During an outbreak of epidemic keratoconjunctivitis among pupils, close to two-thirds of the teachers would send home affected pupils (61.6%). Pupils with defective eyesight would have their parents informed (77.9%) and seated closer to the writing-board (77.7%). Eye injuries had been observed among pupils during recreation (42.4%) and following fights among themselves (51.2%). Conclusion: Majority of the teachers appeared to have an adequate knowledge of, the correct attitude to and correct practices of, the factors that have positive bearings on their pupils' eye health. Eye care specialists should find it easy to train this pool of qualified teachers for some roles in screening pupils for eye defects and diseases in school eye health programmes.

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Background: The world burden of trauma is increasing more so in developing countries with increasing incidence of road traffic accidents, urban and rural violence, as well as natural and man-made disasters. A key determinant of outcome following trauma is the level of preparedness of the health care system. This study evaluated the preparedness of doctors and hospitals in Nigeria for trauma care. Methods: Questionnaire survey among all 100 participants at a National Conference of Surgeons. Results: The response rate was 68%. 55(80.9%) of respondents had never attended an ATLS course while 13(19.1%) had but only 1(1.5%) was currently ATLS certified. 38(55.9%) felt confident managing acute trauma cases, 39(57.4%) with endotracheal intubation, 33(48.5%) with laryngeal mask airway insertion, 33(48.5%) doing a crico-thyroidotomy and 43(63.2%) with tracheostomy. Respondents who reported trauma drills in their hospitals were 20(29.4%), standing trauma team 27(39.7%), disaster management team 19(27.9%) and ambulance emergency help line 14(20.6%). Conclusion: Doctors and hospitals in Nigeria are ill-prepared for trauma care.

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Background: Anorectal abscesses are surgical emergencies that demand early and appropriate intervention. However, perianal symptoms and local inflammation that are the main features in majority of cases may be lacking to localize and diagnose this condition thereby leading to a diagnostic conundrum with delayed or improper treatment and dire consequences. Objective: This study reviews the aetiology, various modes of presentation of this disease entity and its treatment to facilitate an early diagnosis and intervention. Method: A review of literature on the subject was carried out using internet, pubmed medline seach and review of journals. Outcome: Those patients with unusual and subtle presentations are more likely to suffer the dire consequences of the disease. Conclusion: There is the need for awareness of the various modes of presentations and management of this entity. It should also be considered as a differential diagnosis of causes of low back and pelvic pains to stem the consequences associated with mis-diagnosing and treating this condition.

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Objectives: This study aimed at determining the relationship between plasma lipids, body mass index (BMI) and fertility status, in husbands of women undergoing investigation for infertility. Methods: Fourty-seven men, who were the husbands of women that attended our Infertility Clinic, were recruited for this study. The subjects seminal fluid were analysed using standard criteria. Fasting blood samples were also analysed for plasma total cholesterol and triglyceride. Body Mass percentage were compared using student t-test and chi square, respectively. Results: Twenty-three subjects (48.9%) had oligosperimia, while 11 (23.4%) were azoospermia. The mean plasma total cholesterol and triglyceride were 3.8mmol/L ± 0.8 and 0.9mmol/L ± 0.6 respectively. The mean BMI was 24.0Kg/m ² ± 4.0. Subjects with low or high BMI had poorer spermogram. This was worse in those in the 30-39 years age bracket. However, the differences in mean values of seminal fluid analyses in the different age groups were not statistically significant. Conclusions: In conclusion, subjects with both extremes of BMI had poor spermograms. There were no abnormalities in the plasma TC and TG.

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A 5-day-old boy who was referred from University of Benin Teaching Hospital to the University College Hospital Ibadan with features of oesophageal atresia which was confirmed by barium swallow study. He had successful surgical anastomosis of the proximal and distal oesophageal loops with resection of the tracheo-oesophageal fistula. The literature has been, reviewed.

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