Background: Moderation in feeding habits are cardinal components of both Ramadan fasting and diabetic management. The study determines the effect of Ramadan fast on glycaemic control and anthropometric indices in persons with type 2 diabetes mellitus. Methods: Consecutive patients with type 2 diabetes mellitus (DM) on oral hypoglycaemic drugs who were willing to fast were recruited as study subjects. Data were collected over eight weeks at two weekly intervals beginning from two weeks before commencement and ending two weeks after Ramadan and analysed using statistical package software for social sciences (SPSS) version 12.0. Results: Two hundred and forty eight subjects (92%) completed the study. They consisted of 112(45.2%) males and 136(54.8%) females with an age range of 30-69 years and mean age of 46.9 ±8.9 years. The mean fasting blood glucose were 7.7, 7.3 and 7.4 mmol/L before, during and after Ramadan, respectively, with no significant difference in the values during these periods. However, there were significant decreases in mean weight and waist circumference during Ramadan compared to pre and post Ramadan periods (p<0.05). No episode of hypoglycaemia was observed. Conclusion: Ramadan fasting appeared to have no effect on blood glucose homeostasis in the study type 2 diabetic population.. Beneficial effects on anthropometric indices were however observed.

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Background: Results from several studies suggest a global trend of sleep insufficiency among the youths. This study determines the sleep pattern of medical students. Methods: In a cross-sectional study, we used a modified self-administered questionnaire adapted from Pittsburg Sleep Quality Index to determine the sleep pattern of students in College of Health Sciences, University of llorin, Nigeria. Responses were submitted anonymously. Results: A total of 399 students participated in the study and their age ranged from 16 - 35 years. Males constituted 64% of survey sample. The mean sleep duration of students were 6.4±0.84 hours during weekdays and 7.4±0.96 hours at weekends (p<0.05). Students went to bed later (23;15±1;30 hour) at weekends than during weekdays (22:58±1:30 hour). They also got up later from bed at weekends (6:42±1:28 hour) than during school days (05:36±1:09 hour) (p<0.05). Female students had significantly shorter sleep duration (6.9±0.98 hour) than males (7.4±0.9 hours) at weekend (p<0.05). About 30% of the respondents had problem falling asleep. Only 3.4% of the respondent had ever been involved in a sleep related accident, while 4% and 14% of students took cigarette and alcohol, respectively. Conclusion: The study population had shorter sleep period than that recommended for their age. Gender had significant influence on their sleep habit. We recommend sleep educational programme from medical undergraduates.

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Background: Phyllodes tumour of the breast is a rare and potentially aggressive tumour. Little information is available regarding the optimal management of this tumour and rarer still, are data regarding survival. We report our experience in the diagnosis, management and outcome of phyllodes tumour. Patients and Methods: The hospital case notes of adolescent female patients found to have phyllodes tumour from 1997 to 2007 were identified from the medical records department of the hospital. Data extracted included sex, age, presenting symptoms, anatomical site of lesion and clinical evaluation including approximate size of the breast masses. Results of investigations including haemogram, urea and electrolytes, chest xray, ultrasonography, tru-cut and excision biopsy, surgical treatment and outcome of treatment were obtained. The follow up visits to the outpatient clinic were also noted. Results: There were 17 females aged between 25 and 30 years. Five patients had previous excision biopsy of fibrodenoma from the ipsilateral breasts when they were teenagers. The median tumour size was 17.5 cm in diameter. There were no clinical features suggestive of malignancy. The chest radiographs were within normal limits. Histopathological findings showed that ten (58.82%) patients had the benign variety while seven (41.18%) had the borderline variety. All had a wide excision of the tumour but were not offered any adjuvant therapy. Conclusion: Early diagnosis and treatment with adequate surgical margins are essential in the successful management of phyllodes tumour.

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Background: Human immunodeficiency virus/acquired immune deficiency syndrome and tuberculosis are commonly called the "deadly duo", because human immunodeficiency virus increases susceptibility to tuberculosis which inturn accelerates its progression to acquired immune deficiency syndrome. This study describes human immunodeficiency virus/ tuberculosis co-infection in Sokoto State, Nigeria. Methods: Data were extracted from medical records of human immunodeficiency virus infected patients on antiretroviral therapy in health facilities that offer comprehensive care for human immunodeficiency virus infected patients in Sokoto State, and analysed. Results: Majority of the 353 study subjects were females (60.6%) aged 30-39 years (37.4%) and living in Sokoto state (78.5%). Care entry points were Medical Outpatient Department (36.8%), General Outpatient Department (35.4%) and voluntary counseling centre (23.5%). Enrolment for human immunodeficiency virus care was highest in May (13.4%) and lowest in March (5.1%). The functional status of majority (75.8%) of the study subjects was asymptomatic normal activity. Thirty-three (9.3%) of the study subjects were human immunodeficiency virus/Tuberculosis co-infected. Human immune deficiency virus only cases and human immunodeficiency virus/Tuberculosis co-infected cases were similar with respect to age and sex but differed significantly with respect to WHO clinical stage, CD4 count and functional status. Conclusion: Human immunodeficiency virus only and human immunodeficiency virus/tuberculosis co-infection cases have similar demographic characteristics but differ with respect to the stage of acquired immune deficiency syndrome.

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Background: Amoebic Liver abscess is a tropical disease with a wide spectrum of clinical presentation. This study describes its clinical and ultrasonographic features in a teaching hospital setting. Methods: Records of all patients aged 18 years and above with amoebic liver abscess admitted in the medical wards of University of Port Harcourt Teaching Hospital between May 2005 and June 2007 were identified from the in-patient ward register. These were retrieved from the medical records department and analysed. Data obtained included age, sex, occupation, social history, presenting features, ultrasonographic features and laboratory results. Results: Twenty two patients were seen over the period. Their age ranged from 20 to 59 years with a mean of 36.4 ± 8.6 years. There were 18 (81.8%) males and 4 (18.2%) females. The most frequent clinical features were fever (100%), hepatomegaly (100%) and jaundice (50%). Ultrasound scan showed that 16 abscesses were solitary. Two abscesses were found on each of 4 patients, and 3 on each of 2 patients. Of the solitary abscesses, 11 were on the right lobe of the liver while 5 were on the left lobe. Entamoeba Histolytica were absent in the stool of 17 patients with amebic liver abscess. Conclusion: The triad of fever, hepatomegaly and jaundice remains the classical presentation of amoebic liver abscess.. Response to metronidazole monotherapy was quite clinical effective.

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Brain abscess is rare in infancy and potentially life threatening. This report emphasises the importance of monitoring the head circumference at post neonatal outpatient follow up. An ex-preterm baby who was treated successfully for staphylococcus aureus septicaemia and skin abscess in the neonatal period represented at the age of 13 weeks (corrected gestation 41 weeks) with gradual enlargement of the head size. A diagnosis of multiple staphylococcus aureus brain abscesses was made. She was treated with systemic antibiotics and aspiration of abscess in the frontal lobe, and made satisfactory recovery. At 4 years of age she developed status epilepticus and currently has left sided hemiparesis and focal seizures. Early diagnosis and prompt management of cerebral abscess may avoid the need for surgical intervention. We recommend monitoring of head circumference and determination of the cause of any deviation from normal centiles particularly in infants treated for septicaemia.

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Background: Teratomas are neoplasms which originate from pluripotent stem cells. They are composed of a wide variety of tissues foreign to the organ or anatomic site in which they arose. This study sought to determine the clinical manifestations and outcome of treatment of childhood teratomas. Method: A retrospective analysis of the case files of children treated for teratoma at the University of Benin Teaching Hospital Benin City, Nigeria between January 1999 and December 2008 was done. Results: Fifty-three children aged between 5 days and 16 years, comprising 15 males and 38 females with male.female ratio of 2:5 were treated for teratoma; gonadal 27(50.9%) and extragonadal 26 (49.1%). Ovarian, 23 (43.4%) and sacrococcygeal, 17 (32.1%) sites were frequently involved. Other sites included testicular, 4 (7.5%), retroperitoneal, 4 (7.5%) and renal, 2 (3.8%), while posterior mediastinal, cervical and breast involvement were 1 (1.9%) each. Despite late presentation, no frankly malignant primary teratoma was diagnosed. Benign cystic teratomas with malignant elements comprising yolk sac tumour and immature neuroepithelial elements (mixed germ cells tumour) were the major histological types. Complete tumour resection that included total coccygectomy, oophorectomy and orchidectomy, plus combination chemotherapy using vincristine, actinomycin, and cyclophosphamide was curative in 25 (47.2%) children. Eighteen (34%) cases of recurrence were all malignant. They presented very late with rapid disease progression that resulted in 10 (18.8%) deaths during the five years of follow-up. Conclusion: Although all primary teratoma were benign, recurrent malignant tumours with rapid progression to carcinomatosis, multiple organs failure and deaths were common in childhood teratoma. We advocate close follow-up of all children with teratoma to detect and commence early treatment.

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Though largely considered a disease of the so called dry and hot "African meningitis belt," meningitis is assuming a global public health problem. Recent emergence of resistant strains of bacteria has resulted in increased morbidity of and mortality attributable to meningitis. This review addresses recent developments in the pathogenesis and diagnosis of this largely neglected disease as well as their implications for its management. A preventive strategy, particularly mass vaccination is advocated. The possible impact of climate change in the epidemiology of meningitis is highlighted.

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