Background: Since the discovery of Helicobacter pylori (H. pylori) by Robin Warren and Barry Marshall in 1982 and its subsequent association with diseases like antral (type B) gastritis, peptic ulcer disease (PUD), gastric cancer and gastric Mucosal Associated Lymphoid Tissue (MALT) lymphoma, various invasive as well as non-invasive methods of detecting the bacterium have been developed. The choice of a particular method usually depends on availability, cost, reliability and convenience of diagnostic facility. Non­availability and high cost of commercially prepared rapid urease test kits have led to the development of locally prepared reagents to serve same purpose. This study compared a locally prepared ("in-house") rapid urease test solution with standard culture in detecting the presence of H. pylori in gastric biopsies to determine the validity of the former. Materials and Methods: This was a prospective cross sectional study carried out over a 6 months period (April-September 2001) to determine the validity of a locality prepared rapid urease reagent in detecting H. pylori infection among dyspeptic patients at the Jos University Teaching Hospital (JUTH), Jos. Two pairs of antral gastric biopsies were obtained from patients at endoscopy and a pair each was used for rapid urease test using a locally prepared urease reagent and cultures on a horse blood agar. The results of the two methods (cultures being the standard) were analyzed using SPSS (version 11.0) statistical programme and tests of validity carried out. Results: A total of 39 patients made up of 24(61.5%) males and 15(38.5%) females in which rapid urease test were done and culture carried out were studied. The ages of the patients studied ranged from 15 to 70years with mean age of 38.4+12.08 years. 34 (87.2%) and 36 (92.3%) of the patients tested positive to H. pylori using the local rapid urease test and culture respectively. Five (1.3%) and 3 (0.8%) of the patients were negative by rapid urease and cultures respectively. The results of the local rapid urease test were then compared with that of culture. A sensitivity and specificity of 91.7% and 66.7% respectively were obtained for the local rapid urease test. The positive and negative predictive values were 94.1% and 40% respectively. Conclusion: With a sensitivity of 91.7%, the locally prepared rapid urease test is comparable to cultures in detecting H. pylori in gastric biopsy specimens. With this finding and with commercially prepared rapid urease kits either not available or expensive, and cultures cumbersome, the use of locally prepared rapid urease test reagents is appropriate, practicable and sustainable in low resource settings like ours.

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Background: Ovarian tumours even though uncommon and benign in the majority of cases in children, delayed presentation, wrong diagnosis and inappropriate treatment may result in complications of an otherwise benign tumour and spread of malignant ones. Aim: We aimed to evaluate or experience with the management of childhood ovarian masses in two Tertiary Hospital in Nigeria. Methodology: Between July 2002 and June 2008, 36 children who were treated with ovarian masses at the University of Benin Teaching Hospital and Irrua Specialist Teaching Hospital in Edo State, Nigeria, were retrospectively studied. Results: Ovarian masses accounted for 36 (1.3%) indications for paediatric operations and 15.1% children with paediatric surgical tumours during the period. Benign ovarian cyst 17 (47.2%), teratoma 11 (30.6%) and follicular cyst 8 (22.2%) were the causes of ovarian masses. Extra-pelvic location of many masses, late presentation, traditional treatment and the presence of complications before arrival were compounded by lack of sophisticated imaging facilities. Consequently, few cases 11 (30.6%) were correctly diagnosed preoperatively. Surgical treatment alone was curative in all children with benign lesions while a large proportion, 5 (45.5%), of those with teratoma succumbed to the illness despite combination therapy, giving 13.9% overall mortality. Conclusion: Ovarian mass should be a differential diagnosis of mobile childhood abdominal mass irrespective of intra-abdominal location. Early referral should be encouraged as the importance of early diagnosis and treatment cannot be overemphasized.

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Background: Scientifically proven evidences exist that the risk for developing cancer can be significantly reduced through exercise, adequate nutrition diets, avoiding cigarette and alcohol and among others. Youths are strategic in cancer prevention because they are in their habit formative years, have longer years to live ahead, and might not have had damage to their DNA yet. Objective: This study aimed to determine knowledge of undergraduates about the relationship between lifestyle changes and development of cancer, and how much of it they practice, if at all. Methodology: Pre-tested, self-administered questionnaire was used to collect data on sociodemographic features, knowledge, attitudes and practices of 400 undergraduates selected by multistage sampling technique about cancer. Data was analyzed using descriptive and inferential statistics. Results: The study revealed a poor knowledge about cancer and/or its prevention: two-third did not know there is a relationship between fruits intake, exercise and diet with the development of cancer. It was also reported by 30% of the respondents that cancer can be cured. However, more than half reported good attitude towards lifestyle changes to prevent cancer. Less than one-third reported good practice of cancer prevention. Conclusion: The students had poor knowledge about cancer and/or its prevention though they reported strong willingness towards positive behavioural change for cancer prevention. This might be responsible, for the low proportion of respondents with good practice of cancer prevention habits and lifestyles. Health campaign about cancer prevention could improve the behaviour.

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Background: Inhalation or aspiration of foreign bodies especially in children, poses diagnostic and therapeutic endoscopic challenges mainly because of high mortality rate if not identified and treated immediately. Materials and Methods: This is a retrospective study of clinical pattern of laryngeal and tracheo-bronchial foreign bodies over an eight year period (July 1999 to June 2007) from a tertiary health institution in north western Nigeria. Results: A total number of 23 patients were seen with inhalational or aspirated foreign bodies. Nine (39.13%) were lodged in the larynx, one (4.34%) in the trachea while 13(56.52%) were lodged in the bronchus. There were 19 males (82.6%) and 4 females (17.4%) with a male to female ratio of 4.8:1.Their ages ranged between 7months and 9years with a mean age of 2.9years. Fifteen of the patients (65.2%) were less than 5years old. Organic or vegetative foreign bodies (78.3%) such as agricultural seeds accounted for 56.5%), followed by fish and meat bones (17.4%). The commonest clinical presentation was sudden respiratory distress with recurrent bouts of cough (100%).The duration of symptoms varied from a few hours to 9 days. Direct laryngoscopy and rigid bronchoscopy were carried out for impacted laryngeal and bronchial foreign bodies. Tracheostomy was carried out in 4(17.4%) patients to relieve airway obstruction before endoscopy. Only 14(60.9%) patients had a positive history of foreign body inhalation or aspiration and in 13(56.5%) cases foreign body was detected radiologically or showed radiologically changes highly suspicious of foreign body impaction. Mortality was recorded in two (8.7%) patients with bronchial foreign bodies. Conclusion: Inhalational or aspirated foreign bodies mainly affected children with a mean age of 2.9 years in this study and presented with sudden episodes of severe respiratory distress or persistence of respiratory symptoms requiring endoscopic evaluation and removal without which will be fatal. Organic or vegetative objects such as agricultural seed, fish and meat bones were the commonest laryngo-tracheo-bronchial foreign bodies should always be excluded where there is persistent respiratory symptoms or if it is of sudden onset.

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We report the case of a 45-year old woman with a six-month history of persistent headache, right nasal obstruction, recurrent epistaxis and right eye swelling. Examination revealed obvious facial asymmetry, enophthalmos, right maxillary and zygomatic swelling with an intranasal mass exhibiting contact bleeding. Plain roentgenograms revealed erosion of the surrounding bones. Patient had right lateral rhinotomy to clear the tumour and arrest epistaxis. Histological examination of the biopsy revealed a polymorphic neoplasm composed of a mixture of small lymphoid cells and atypical large histiocytoid cells with foci of necrosis. These features were consistent with midline malignant reticulosis. This is a relatively rare condition and this is the first case recorded in this centre.

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Background: Rhabdomyosarcoma may be histologically indistinguishable from other undifferentiated childhood tumours occurring in the head and neck region on routine heamatoxylin and eosin staining. Aim: aimed at assessing the usefulness of employing immunohistochemistry, as an adjunct to routine H&E staining, in the histogenetic diagnosis of childhood rhabdomyosarcoma. Methodology: This was a 5-year retrospective study of twelve cases of childhood head and neck rhabdomyosarcoma at the Department of Pathology, University College Hospital, Ibadan, Nigeria. Antibodies used included antibodies to desmin, myoglobin, leukocyte-common-antigen (LCA), vimentin, cytokeratin, neuron-specific-enolase(NSE), neurofilament and retinal-S-antigen. Results: A change was made in the diagnosis of 4(33.3%) cases. Of these 4 cases, 3(25%) cases showed immunoreactivity for LCA and were designated lymphoma. The 4 ^th case co-expressed NSE and retinal-S-antigen and was therefore diagnosed as retinoblastoma. The average survival of patients with final immunohistochemical diagnosis of rhabdomyosarcoma was 43.8 months while patients with changed diagnosis had an average survival of 7.5 months. Conclusion: Immunohistochemistry should be made available for the routine diagnosis of these undifferentiated tumours in reference laboratories in developing countries.

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Cocoyam can be processed in several ways. It contains digestible starch, protein and other valuable nutrients. Consumption of cocoyam is very high all over Nigeria. This study was undertaken to determine the glycaemic response of diabetic and healthy subjects to equal amounts of carbohydrate in the form of boiled cocoyam with glucose serving as the reference food. Ten type 2 diabetic subjects and seven healthy subjects volunteered to participate in the study. Blood was taken before and after consumption of the food every 30 minutes until two and half hours. The blood glucose concentration peaked at two and one hour in the type 2 diabetic and healthy subjects, respectively. The glycaemic indexes in both groups were 81 and 80 while the glycaemic load was 40 and 40.5, respectively. Boiled cocoyam therefore is of high glycaemic index and should be combined with low glycaemic index food for it to be suitable for diabetic subjects.

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The total number of gynaecological emergencies that were scanned was 700, and early pregnancy related conditions among them were 378, giving an incidence of 54.0%. The highest number of patients 175 (46.3%) was seen in the 21-35 years age group, followed by 36-50 years age group 124 (32.8%), which are the active and productive period in the female reproductive life. Threatened abortion accounted for the highest number of patients with 154 patients (40.8%), followed by incomplete abortion with 78 patients (20.6%), complete abortion 46 (12.2%), missed abortion 36 (9.5%), ectopic pregnancy 36 (9.5%), and hydatidiform mole 28 (7.4%). Correlation of the final diagnoses with ultrasound diagnosis i.e. accuracy of ultrasound scan was very high, which showed that ultrasound scan is a valuable tool in making early diagnosis and important in the institution of appropriate management in cases of early pregnancy related gynaecological emergencies, which is the hallmark of success. We recommend that 24 hours ultrasound scanning service should be made available in centers that manage early pregnancy related gynaecological emergencies, in order to reduce morbidity and mortality from these cases.

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