Background: The accuracy of Body Mass Index (BMI) in relation to actual levels of body fat is easily distorted by such factors as fitness level, muscle mass, bone structure, gender and ethnicity. Design: A prospective study of the BMI of apparently healthy adults Hausa-Fulani subjects was undertaken in Sokoto metropolis. Methodology: A random sampling method was used to select volunteers whose BMI was studied from March to June 2007. Health-O-Meter Scale (Balance Beam) and Stature Measurement Board were used to measure the weight and height respectively. The weight of every volunteer was scaled according to his/her height. Results: A total of 400 subjects were involved in this study. Of this figure, 288 (72%) were males, and 112 (28%) were females (m: f ratio =2.6:1). The range of measurement of BMI for all the subjects used in the study was USSkg/m ² . The lower boundary of BMI for males (11 kg/m ² ) found in this study was lower than that for females (15 kg/m ² ). The upper boundary of BMI obtained for males (34 kg/m ² ), again, was lower than that of females (68 kg/m ² ). The mean BMI obtained for all the subjects was 21.13 kg/m ² ±4.37). However, the mean BMI for males (20.68 kg/m ² ±3.57) was significantly (p<0.05) lower than that obtained for females (22.28 kg/m ² ±5.81). Conclusion: From this study it is concluded that the BMI of adult male Hausa-Fulani in northwestern Nigeria is significantly lower (p<0.05) than that of their female counterparts.

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Background: Significant progress has been made in the past two decades in the surgical correction of the various types of anorectal malformations in early childhood. Objective: To report our ten year experience in the management of anorectal anomalies in children in a retrospectively evaluated series in a teaching hospital in Nigeria. Patients and Methods: A total of 65 children were studied: 38 (56.5%) were males while 24 (41.5%) were females. Age at presentation ranged from 12 hours to seven years. Within 3 days of birth 28 (73.7%) males while 8 (29.6%) females presented. The types of anomalies were; 35 (53.8%) low, 11 (16.9%) intermediate, and 19 (29.2%) high. Other associated anomalies occurred in 9 (13.8%) patients. Initial treatment included nasogastric tube suction, intravenous fluids and in 25 (38.5%) defunctioning colostomy. Definitive repair was performed on 53 (82.8%) patients. The operations performed included posterior saggital anorectoplasty (PSARP) in 28 (52.8%) patients, cutback anoplasty in 6 (11.3%), perineal transplant in 3 (5.5%) and abdominoperineal pull-through with PSARP in 5 (9.4%) patients. Postoperative anal dilatation was commenced in the ward in all patients. Outcome of Treatment: Postoperative complications that required reoperation included anal stricture, in 3 (5.3%) excessive mucosa in 5 (9.4%) faecal incontinence in 3 (5.3%) and rectal reservoir syndrome which occurred in 3 (5.3%) patients. Bowel control was assessed after three years in 48 patients and classified as good control in 39 (81.3%) and fair in 9 (18.8%) patients. No patient had poor bowel control. The overall mortality was 12 (18.8%). Conclusion: The impact of modern techniques may be seen in our low mortality and high success rate. Our results can improve further with early presentation of patients, accurate definition of anomalies, careful choice of available techniques and reduced utilization of neonatal colostomy.

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Background: The simplest of the parameters in anthropometry, including, height, weight, length, thickness and widths of various parts of the body vary from tribe to tribe and from one race to the other. On the other hand, these measurements also differ amongst different age groups and between the two sexes as well. Design: A retrospective study of the measurements of Bony External Auditory Meatus (BEAM) was undertaken using normal lateral skull radiographs of Nigerians examined in the department of Radiology, Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, from 2002 to 2004. Methodology: All available lateral skull radiographs of subjects over a 3-year period from 2002 to 2004 were retrieved from the Radiology Department of the Usmanu Danfodiyo University Teaching Hospital, Sokoto for the study. Radiographs were mounted on the viewing boxes and BEAM diameters were measured. Results: A total of 202 subjects were involved in this study. Of this figure, 148 (73%) were males, and 54 (27%) were females (m: f ratio =2.7:1). The age range of all the subjects was 1-60 years (mean 24.6, SD 15.6 years). The vertical diameter ranged from 3mm to 14mm, and the horizontal diameter ranged from 2 to 11mm. The mean BEAM diameters obtained from all the radiographs of the subjects studied were 10.2mm (±1.7) for vertical and 7.0mm (±1.6) for horizontal diameters. The BEAM diameters for males were greater than those of their female counterparts, and the differences were statistically significant (p< 0.05 for both vertical and horizontal diameters). The BEAM diameters increase with age (R ² =0.805 and 0.571 for vertical and horizontal diameters respectively). There were statistically significant age related differences (in all the six decades of life) in both vertical and horizontal diameters (p<0.05). Conclusion: It is concluded that the BEAM diameters of male Nigerians are greater than those of their female counterparts, and these differences are statistically significant. The BEAM diameters seem to increase with age, with statistically significant differences (p<0.05). Further studies on this topic should be undertaken on a larger scale to corroborate our findings.

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Congenital anterior abdominal wall defect occurs commonly and requires specialized management. Thirteen cases of gastroschisis treated at the University of Benin Teaching Hospital, Benin City over an 8-year period is presented. There were nine males and four females (male/female ratio 2.3:1). Time lag before presentation ranged between 5 and 36 hours (mean 16.8 ± 9.9 hours). Only six (46.15%) presented in the unit within 12 hours of birth, while seven (53.85%) presented after 12 hours with varying degrees of complications. Of the six that presented within 12 hours, one death (16.65%) was recorded whereas six deaths (85.71%) were recorded among those that presented after 12 hours (P = 0.0291, Fisher's exact). The causes of deaths were fluid and electrolytes derangement, hypothermic. overwhelming sepsis, respiratory failure and inanition. Two were too ill for surgical intervention and died during resuscitation. Eleven were operated between 4 and 8 hours on presentation. Of the Six that had digital stretching of abdominal cavity, gastric suctioning/rectal irrigation and primary abdominal closure, three died and three survived. The two who had bowel gangrene for which resection/anastomosis and primary abdominal closure were done, survived. Of the three that had improvised prosthetic silo closure, two died and one survived. Overall, six (46.2%) survived while mortality of seven (53.8%) was recorded. This study shows that delay in presentation resulted in high morbidity and mortality rates.

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Background: We evaluated the role of the Malament suture in the development of Madder neck stenosis and in reducing transfusion requirements following transvesical prostatectomy for benign prostatic hyperplasia. Methodology: This was a retrospective study done at the Jos University Teaching Hospital, a tertiary health institution in North Central Nigeria. Results: There were 100 patients in the study, consisting of 41 who had and 59 who did not have the Malament suture applied during transvesical prostatectomy. Their ages ranged from 45 to 90(mean of 65.6 years). There were 26 complications in 17 patients (17% complication rate). Two patients who had the Malament suture applied and one patient who did not, developed bladder neck stenosis (p>0.05) after a mean follow up period of 5.5 years. Five patients in each group had clot retention (p>0.05) and a total of seven patients had excessive post operative haemorrhage (3 Malament, 4 without Malament, p>0.05). Twenty-five patients required blood transfusion (13 Malament, 12 without Malament, p=0.2 Yates corrected). Conclusion: From our study, the Malament suture does not increase the incidence of bladder neck stenosis; neither does it reduce the need for blood transfusion. Prospective studies are required to further investigate these and find out if the Malament suture reduces the volume of fluid required for irrigation or the need to regularly review the patients.

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Background: Fasting Muslim patients often make arbitrary modifications to their medications and minimize uptake of hospital services during the month-long annual Ramadan fast. Aim: To ascertain the modifications in ophthalmological care desired by fasting Nigerian Muslim patients and draw implication from these on their care during Ramadan. Method: Semi-structured questionnaires which captured information on Muslim patients' preferences for appointment, schedules, inpatient and surgical care, drugs dosage regimen (oral, topical and injectable) were administered on fasting outpatient Muslim patients, who were on routine follow-up clinic visits. Results: The overwhelming majority of the 117 respondents preferred that their routine appointment (95,81.2%), routine in-patient care (108, 92.37%) and elective surgery (109, 93.2%) be re-scheduled to outside the month of Ramadan. Eighty respondents (68.4%) would raise no objection to undergoing a venepuncture procedure during the daylight fasting hours, but only 46 (39.3%) would not object to their having an injectable drug administered on them at that same period. Majority of the patients preferred that the dosage regimen of their topical eye medications (96, 82.1%) and oral drugs (110, 93.9%) be adjusted to not more than twice daily regimen. Conclusion: Fasting Nigerian Muslim patients prefer that their routine ophthalmological care be re-scheduled to outside the Ramadan month whenever possible, and that their drug dosage regimen be minimized to not more than twice daily so as to avoid having to take medications during the daylight (fasting) hours.

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Malignant pleural effusion is one of the late manifestations of breast cancer. Of 141 patients admitted for breast cancer in the University of Benin Teaching Hospital, Benin-City, Nigeria, over a six year period (January 2000 - December, 2005), 10(7%) were admitted for the management of moderate to massive pleural effusion. They were all females aged between 32 and 66 (mean 50 years) and had clinical features of advanced disease. Management consisted of relief of dyspnoea by thoracentesis and oxygen administration, analygesics and chemotherapy with the CAF regimen (cyclophosphamide, adriamycin and 5 fluorouracil). They all died within one year of presentation. Malignant pleural effusion from breast cancer signifies advanced disease and carries a poor prognosis.

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Aims: This study was designed to evaluate Pterygium surgery and intra-operative mitomycin C application in Warri, Nigeria. Methods: Case files of all patients who had pterygium surgery and intra operative application of 0.4 mg/ml of Mitomycin C; and were followed up for a minimum of 12months at DDS Eye Surgery in Warri, Nigeria between January 1998 - June 2002 were reviewed. Results: One hundred and two eyes (87patients) had pterygium surgery and mitomycin C application intraoperatively. Fifteen eyes (14.7%) had recurrence after a minimum follow up period of 12 months. The male to female ratio was 1.4:1. The mean age of all the patients was 41.6 years. The mean age of the patients with recurrence was 39.6 years while that of the non-recurrence was 43.3 years. Main complications encountered were conjunctival granuloma thirteen (12.8%); delayed healing nine (8.8%); scleral melt three (2.9%). None of the eyes with delayed healing or scleral-melt had recurrence of their pterygium, but four out of thirteen eyes (31%) with conjunctival granuloma had recurrence of their pterygia. Use of native medication (cocktail of herbal extracts) and duration of pterygium before surgery had no bearing on recurrence. Most of the recurrences occurred between the 4 ^th and the 6 ^th months (73.3%). Conclusion: Single intra-operative application of 0.4mg/ml of mitomycin C was found to be effective in reducing the incidence of recurrence of pterygium below 15% (14.7%) in African eyes. Ophthalmologists are advised to give patients the maximum benefit of pterygium surgery by using intra-operative mitomycin C.

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