Background: About 30 million women living in malaria endemic area become pregnant each year. We determined the prevalence, determinants and consequences of malaria parasitemia in pregnancy in Maiduguri, North-eastern Nigeria. Method: Four hundred healthy pregnant women were randomly selected for the study. Packed cell volume estimation and blood film examination for malaria parasite were done at booking and delivery. Cord blood and placental tissue were also examined for malaria parasite. Risk factors and consequences of malaria parasitemia were determined. Results: The prevalence of malaria parasitemia at booking was 60.3% with mean parasite density of 701.04±382.22 parasite/μl. These dropped to 28.8% and 405.17±310.43 parasite/μl, respectively at delivery. The factors associated with malaria parasitemia were young maternal age (p<0.001), low parity (p<0.001), late booking (p=0.029) and non-usage of Intermittent Preventive Therapy (IPT) (p<0.001). Compared to pregnant women who had no malaria parasitaemia at delivery, those who had were more likely to have maternal anemia (OR = 3.5, 95% CI = 2.2-5.5), preterm delivery (OR = 2.5, 95% CI = 1.12-5.2), low birth weight (OR = 10.5, 95% CI = 4.4-25.1), placental malaria (OR = 6.00, 95% CI = 3.7-9.6) and cord parasitemia (OR = 16.9, 95% CI = 8.5-33.6). Conclusion: There were high prevalence of malaria parasitemia and parasite density in pregnancy at booking. However, both declined remarkably at delivery as a result of intermitten preventive therapy.

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Background: Lung hamartomas are rare tumours with compressive effects on lung parenchyma and bronchi. This is a report of our experience in the management of this condition. Methods: We retrospectively studied the records of patients with lung hamartomas managed at Alexandria University Hospital between 2001 and 2007. Information on presentation, treatment and outcome were obtained. Results: Five patients aged 35.6±14.4 years had lung hamartoma. Two patients were asymptomatic, 2 had cough and 1 presented with haemoptysis. Pre-operative diagnosis was lung carcinoma in 4 patients. Four patients had lobectomy while 1 had wedge resection. Histology confirmed fibrochondromatous hamartomas in all patients. Conclusion: Lung hamartomas should be a consideration in solitary coin lesions.

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Background: Patent medicine vendors are major providers antimalaria treatment in Nigeria. The management of malaria by this informal sector of healthcare delivery is however dominated by negative practices. This study determines the influence of training on antimalaria treatment practices of patent medicine vendors. Methods: Fifty-five patent medicine vendors selected through a multistage sampling technique in Birnin-Kebbi were recruited into the study. Their baseline treatment practices were determined and the negative ones identified. Intervention training was instituted and its impact assessed using a interviewer-administered questionnaire. Simulated visit mystery client survey which involved direct observation of patent medicine vendors practice was conducted after the intervention and the results compared with self reported post intervention practices. Results: The negative practices identified included inappropriate dosage regimen, frequent unnecessary use of injectables and alteration of physicians' prescriptions. Following the intervention training of the patent medicine vendors, the overall appropriate treatment practice score rose from baseline value of 3.6% to 45.5% (p<001). However, direct observation of treatment through mystery client survey showed no improvement, the appropriate treatment practice score being comparable to pre-intervention value (5.5% versus 3.6%; p>0.05) and significantly lower than the post training values (p<0.001). The results of the mystery client survey were comparable only to pre-intervention values, (5.5%) versus 2 (3.6%); p>0.05) and was significantly lower than the post intervention values (p<0.0001). Profit was the core factor underlying the negative practices among the patent medicine vendors. Conclusion: Though single intervention training improves the knowledge of patent medicine vendors on the treatment of malaria, gaps persisted between knowledge and practice. Continuous training of this group of informal healthcare givers is recommended.

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Background: Antiphospholipids antibodies has been associated with non-thrombotic neurological conditions such as migraine. We set out to estimate the concentration of antiphospholipids antibody among patients with migraine and normal population. Methods: This is prospective case-control study of 158 subjects including 82 migraine patients who fulfilled the International Headache Society criteria for the diagnosis of migraine headache and 76 age and sex-matched controls who were mostly hospital staff and medical students. Blood samples were taken for quantification of antiphospholipids antibodies. Results: There were 28 males and 54 females among the migraine patients and 30 males and 46 females among the controls. Their mean ages were 28.8 ± 8.4 years and 26.4 ± 3.9 years, respectively. Migraine patients had increased level of aPL (IgG anti β₂ GP1) 27.76 ± 14.47IU/ml compared to the normal healthy adults (21.43 ± 9.4IU/ml) (p<0.05). Similarly, antiphospholipid antibodies was significantly elevated in migraine patients with aura compared to those without aura, (χ =0.037; p<0.05). The frequency of migraine attacks correlated positively with the concentration of IgG anti β₂ GP1; ( p<0.05). Conclusion: We demonstrated increased serum level of IgG anti β₂ GP1 among migraine patients. The frequency of migraine attacks correlated positively with the concentration of IgG anti β₂ GP1.

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Background: The pattern of diseases in many resource-poor countries has changed in recent decades due to improving socio-economic status. While infectious and nutritional disorders continue to predominate, there has been increasing incidences of non-communicable diseases. We studied the pattern of paediatric diseases and outcome as seen in a children emergency unit. Methods: A retrospective study of children admitted between January 2002 and December 2006 at University of Uyo Teaching Hospital, Uyo, Nigeria. Results: A total of 3,678 children were admitted during the period of study, of which males were 2090(56.8%) and females 1588(43.2%). Malaria was the most frequent diagnosis, constituting 56.6% of admissions. Others in decreasing frequency included broncho-pneumonia 336(9.1%), diarrhoeal diseases 314(8.5%), trauma 105(2.9%), measles 82(2.2%), septicaemia 82(2.2%), sickle-cell disease 79(2.1%), surgical emergencies 77(2.1%), meningitis 37(1.0%), tetanus 28(0.8%), and poisoining 25(0.7%). Children under 5 years of age had the highest frequency of all causes for admission. Conclusion: Malaria is the most predominant cause for hospital admissions in children. Trauma is an increasingly common cause for hospitalisation.

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Background: The Ministry of Health in Zamfara State organised a cataract outreach program with the aim of operating 700 patients in 14 local government areas of the state. The programme is described and evaluated in this study. Methods: An outreach team comprising of 8 personnels of diverse background screened and operated on patients in Zamfara State. Patients with mature age related cataracts, briskly reacting pupils, accurate four quadrant light projection and normal intraocular pressures were selected for surgery. All patients were planned for extra capsular cataract extraction with posterior chamber intra-ocular lens implantation (ECCE + PC IOL) unless contra indicated. Post operative visual acuity was measured with Snellen's or Illiterate acuity chart at 2 weeks follow up. Results: A total of 784 patients between the age of 40 and 80 years consisting of 479 males and 307 females were operated. Six hundred and ninety four patients (88%) had PCIOL inserted. Post operative visual acuity of 6/18 or, better was obtained in 322(41 %) patients. Conclusion: Cataract outreach is an effective tool of eye care services in the underserved rural areas.

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Background: In Nigeria, data on traumatic injuries of paediatric patients in hospitals outside the teaching hospitals are very scanty. We studied the pattern of paediatric traumatic orthopaedic injuries in a secondary health care level hospital in Northern Nigeria. Methods: A total 106 traumatic paediatrics orthopaedic cases at ECWA Hospital Egbe, a mission hospital located in rural part of Northern Nigeria from 1 ^st September, 1990 to 31 ^st December, 1993 were reviewed retrospectively. Results: One hundred and six patients with traumatic orthopaedic injuries were treated were retrospectively reviewed during a period of 3 years and 4 months. There were 60 males (56.6%) and 46 females (43.3%). The age groups involved were 10-14 years (40.6%), 6-9 years (31.1%) and 1-5 years (25.5%). The group 0-1 year old is rarely involved in trauma (2.8%). The sites involved in fractures of the upper limb were supracondylar part of the humerus (20.0%), radius and ulna (12.3%) and humeral shaft (6.6%). The commonest bones involved in fractures in the lower limbs were femur (9.4%), tibia and fibula (9.4%). Traumatic injuries of the hands and feet were rare in this study. The flat bones were not affected. The left upper and lower limbs were more involved in trauma (55.7%) than the right upper and lower limbs (39.6%), a ratio of 3:2. There were more cases of the upper limbs trauma (69.8%) than to the lower limbs (29.2%) giving a ratio of 5:2. Conclusion: Children are most vulnerable to trauma as they get closer to adolescence. Preventive measures against all forms of trauma should be available for children during this period.

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Background: In the last two decades, the incidence of Kaposi's sarcoma has increased due to acquired immune deficiency syndrome epidemic. This study was designed to highlight the characteristic features of Kaposi's sarcoma in our centre before this epidemic. Method: In a retrospective study, all histologically diagnosed cases of Kaposi's sarcoma at Pathology Department, Ahmadu Bello University Teaching Hospital, Zaria, before acquired immune deficiency syndrome epidemic (1971 - 1980) were retrieved from histopathology register and analysed. Results: A total of 37 cases of Kaposi's sarcoma were diagnosed during the period of study, constituting 0.73% of the total number of histologically verified cancers from all sites during the same period. Male to female ratio was 5:1. Two cases occurred in children while the peak age of occurence was the third and fourth decades. Lower limb and the lymph node were the most frequently involved site by the disease. Conclusion: Kaposi's sarcoma was relatively rare in the Northern region of Nigeria in the pre-acquired immune deficiency syndrome epidemic and could present clinically as lymphadenopathy.

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Background: The high maternal and infant mortality in sub-Saharan Africa has been associated with unplanned pregnancy, high parity and short birth intervals. Use of effective contraceptive methods significantly reduce maternal and infant mortality and improved quality of life. This study determines the contraceptive practice among clients in a tertiary hospital. Method: The record cards of all clients that accepted contraceptive methods in the family planning clinic at the University of Uyo Teaching Hospital, Uyo over a 7-year period were reviewed. Results: There were 1094 new contraceptive acceptors during the study period. The modal age group of the clients was 25 - 34 years (59.3%); majority of the clients were multiparous (59.8%), Christians (99.6%) and 71.0% had at least secondary school education. The most commonly accepted contraceptive methods were the intrauterine contraceptive device (45.0%) and oral contraceptive pills (28.1%), while clinic personnel (63.1%), and friends and relatives (20.1%) were the most common sources of information on contraception. Conclusion: Intrauterine contraceptive device and oral contraceptive pills were the most frequently accepted methods of contraception. We advocate increase in the contraceptive options including implants. The print and electronic media should be more involved in the awareness programs on contraception.

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