Background: Infertility is a global public health problem affecting an average of 8 - 12% of couples with severe social implications. The perception of a disease often influences the efficacy of its preventive strategies as well as management outcome. Methods: A cross sectional descriptive study of 289 undergraduates of Bayero University Kano was conducted between January and February 2009 using a multi-stage sampling technique to assess their perception regarding the causes of infertility and its management. Results: Majority of the respondents were between the age of 18 and 29 years, and most (67%) were single. Though there was largely high awareness about infertility, the knowledge regarding the causes was poor. There was positive attitude towards infertile couples and infertility in general. Conclusion: Improved health education on the awareness, causes and prevention of infertility among students and the wider public is recommended.

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Background: Out of office blood pressure has been shown to be a better representation of an individual's blood pressure. This prospective school-based study was designed to investigate the normal range of out of office blood pressure and its associated factors in adolescents. Methods: A total of 718 adolescents (309 males and 409 females) were recruited and their blood pressures taken 6 times over 2 days. The prevalence of hypertension and the relationship between blood pressure level and height, body mass index, age and socio-economic status were determined. Results: The mean systolic blood pressures for males and females were 109.5 ± 13.9, and 112.2 ± 13.0 mmHg, respectively [p=0.01], while the mean diastolic pressures were 71.4 ± 9.2 and 74.19 ± 9.6 mmHg for the males and females, respectively [p<0.001]. Both systolic and diastolic pressures increase with increase in height and BMI in both genders. Multiple linear regression analysis identified body mass index, height and socioeconomic status as independent predictors of rise in SBP. These variables, as well as age similarly predicted rise in diastolic blood pressure. Going by the definition of hypertension of equal greater than the 95 ^th percentile for the individual's sex and height, prevalence rates of 3.6% and 5.1% for mates and females, respectively were observed. Conclusion: These data suggest that height, BMI, weight and socioeconomic status are predictors of out of office BP in adolescents.

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Background: Hypertension is a leading cause of cardioxasular morbidity and mortality in Nigeria. The main aim of this study was to deterine the prevalence of left ventricular hypertrophy and left ventricular geometric patterns among hypertensives in Kano, Nigeria. Methods: The study was cross-sectional in design, and carried out in 3 echocardiography laboratories within the City of Kano, Nigeria. Patients with hypertension without other cardiac disorders were serially recruited and studied after obtaining informed consent. Results: A total of 186 patients were studied over 7 months; 89 males (47.9%) and 97 females (52.1%). The prevalence of left ventricular hypertrophy was 61.8%. Thirty five patients (18.8%) had normal left ventricular geometry and these were predominantly females and had the lowest mean age and shortest duration of hypertension. Sixty eight patients (36.6%) had eccentric hypertrophy, 47 (25.3%) had concentric hypertrophy and 36 (19.4%) had concentric remodelling. Independent predictors of the various geometric patterns were identified. Conclusion: A high prevalence of left ventricular hypertrophy was observed with eccentric hypertrophy being the most common geometric pattern. Gender influenced the pattern of left ventricular geometry.

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Background: Ovarian tumours are the 2 ^nd most common female genital tract tumour in Sokoto, north­western, Nigeria. We determined the histo-pathological features of surgically removed ovarian tumours. Methods: A 12-year retrospective study of all surgically removed ovarian tumours at the Gynaecological department of Usmanu Danfodiyo University Teaching Hospital UDUTH) Sokoto, North­western Nigeria. Results: The highest incidence of ovarian tumours was within the age range of 20-45 years. Of the 125 cases of surgically removed neoplastic ovarian tumours seen during the study period, 83(66.4 %) were benign, 40(22.4%) were malignant and 2(1.6%) were of borderline malignancy. Epithelial tumours were the commonest neoplasms 54(43.2%), while germ cell tumours were present in 47(37.6%) cases. Mucinous cystadenocarcinoma was the commonest malignant ovarian tumour 14(35%) and was closely followed by granulosa cell tumour 10(25%), dysgerminoma 17.5%), serous cystadenocarcinoma (12.5%), malignant teratoma 2(5%) and endodermal sinus tumour (5%). There were 2 cases of metastatic tumours: one from Burkitts lymphoma, and the other from gestational choriocarcinoma. Conclusion: The high frequency of malignant ovarian tumours in the young age group type in this study underscores the need for histology of all surgically removed tumours irrespective of age.

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Background: Distal symmetrical polyneuropathy is a debilitating illness seen in more than 30% of antiretroviral naive Acquired immune deficiency syndrome patients and 4% of those on stavudine and didanosine, current first-line antiretroviral drugs in Nigeria. This study determines the influence of stavudine-based antiretroviral therapy on: Distal symmetrical polyneuropathy in Human immunodeficiency virus/acquired immune deficiency syndrome patients. Methods: We carried out prospective cross-sectional study of 220 antiretroviral-naΟve Human immunodeficiency virus/acquired immune deficiency syndrome adult patients referred to the antiretroviral human immuno deficiency virus care and treatment clinic in Ahmadu Bello University Teaching Hospital, Shika Zaria between August 2005 and May 2006 They were evaluated using a protocol modified from the subjective peripheral neuropathy screen and the Leeds assessment of neuropathic symptoms and signs pain score. Each subject was then put on capsule stavudine 30/40 mg (based on body weight) twice daily + tablet lamivudine 150 mg twice daily + tablet nevirapine 200 mg (daily for 2 weeks and twice daily thereafter). After 3 months they were re-evaluated using same baseline protocol. Subjects with diabetes, renal or liver disease, prior ART-experience, and on antituberculous therapy were excluded from the study. Results: After 3 months of antiretroviral therapy the median symptoms and signs was significantly reduced from 31.4% (range 3.2% to 42.3%) to 18.2% (range 0.5% to 25.5%) and 18.2% (range 0.5% to 84.1%) to 5.9% (range 0.0% to 83.6%), respectively. Conclusion: Significant reductions in the frequencies of DSP symptoms and signs were observed with stavudine-based ART. Our findings as well as the long term neurotoxic effects of this relatively affordable regimen in a resource depleted setting needs to be confirmed in a larger scale and multi-centered study.

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Though birth injury is common, neonatal perineal injuries are rare. They may be associated with high morbidity and mortality if not identified and adequately managed. Few reports of neonatal perineal birth injuries are found in literature. No neonate with this condition to our knowledge has been reported following caesarean section in our setting. We report our experience of a neonate with severe anterior perineal laceration managed in our centre with good outcome.

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Background: Occupation may affect health seeking behaviour. Very little is known about this behaviour in labourers. This study assessed the health-seeking behaviour of the female manual labourers to fever in Jos, Nigeria. Methods: A community-based cross-sectional survey was conducted among 300 female manual labourers from a randomly selected cluster in Jos, using a pre-tested interviewer-administered semi-structured questionnaire. Data was analyzed using Epi info. Results: Fever episode was reported by 85 percent of respondents during the last one month before the survey. Forty-seven percent 'observed' the fever and hoped for self resolution. Home treatment was reported as the first response to fever by 23% and 49% of the labourers sought treatment for fever within the first 24 hours of onset. Early treatment-seeking pattern was reported among those who self-medicate, followed by those that visited pharmacy stores. Cost was the major reason for delay in seeking timely and appropriate care. Conclusion: Female manual labourers had poor health seeking behaviour.

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Background: Gender consideration is not factored into guidelines for management of hypertension. We determined whether there is gender disparity in drug treatment of hypertension in a poor resource setting hypertensive population. Methods: Two hundred and sixty indigenous Nigerians (females, n=191, males n=69) aged 50.7 ± 11.3 years who were being managed for hypertension in the outpatient unit of three health care institutions (one tertiary and 2 secondary) were selected by simple random sampling during their clinic visits. Demographic data, baseline blood pressures and antihypertensive treatment regimens were obtained from their case records. Patient's adherence to therapy was assessed using 30 days self reports. Anthropometric parameters including heights and weights, and blood pressure at last clinic visit were measured. Results: Males and females did not differ significantly in baseline blood pressures (P>0.2), Higher rates of blood pressure control (P=0.02) and adherence rate to antihypertensive therapy (P = 0.002) were observed among males compared to females. Females were more likely than men to receive a three - time daily regimen (P<0.001), and cite financial constraint as a reason for non-adherence (P=0.01). Angiotensin converting enzyme inhibitors and alpha methyldopa were more freguently prescribed in males (P=0.02) and females (P<0.001), respectively. Conclusion: Gender disparity occurs in the utilization of certain antihypertensives and blood pressure control in the study population. This may be related to biologic, cultural and economic factors.

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