Background: Attention-deficit/hyperactivity disorder (ADHD) affects children worldwide. In Nigeria, there is paucity of information on the socio-demographic associates of this important childhood condition. Methods: Across-sectional study was conducted between February and August 2006 among 1473 public primary school pupils aged 6 to 12 years, selected randomly among pupils drawn from Egor Local Government Area of Edo State. The subjects were screened using Disruptive Behaviour Disorder (DBD) Rating Scale to identify children with ADHD symptoms. Identified subjects were further evaluated with questionnaires to ensure that they met the other explicit non-symptom criteria contained in the DSM-IV manual, such as functional impairments. Children who were confirmed to have ADHD were compared with randomly selected controls to determine the association, if any, between the prevalence of the condition and some socio-demographic characteristics. Results: The prevalence of ADHD was 7.6%. There was no statistically significant difference in the prevalence of ADHD amongst the different age cohorts. No significant association was found between the prevalence of ADHD and socioeconomic background, size of family, age of parents and characteristics of the child's primary caregiver. The children with ADHD had significantly lower school aggregate than that of selected control (Mean aggregate score of 51.7+16.1% versus 63.7+ 16.5%, p<0.001). Conclusion: The prevalence of ADHD in this study is relatively high. Community screening under the umbrella of the School Health Programme is required. Appropriate medications, educational support and psychotherapy when incorporated in the national health system will go a long way in redirecting affected children's developmental lives.

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Background: Injuries to the chest are usually associated with increased mortality as compared with injuries to other regions of the body due to significant respiratory and hemodynamic disturbances. We aimed at determining the predictors of mortality in thoracic trauma patients in lle Ife, Nigeria. Method: This retrospective study included all patients with chest trauma who presented at the Accident and Emergency Unit of The Obafemi Awolowo University Teaching Hospital, lle Ife between 2005 and 2007. Data was analyzed using Stata version 9. Results: There was a male preponderance (M: F = 3.5: 1) in the 118 patients. Death occurred in 9.3% of patients. The mean age was 37.6 ΁ 16.6 years with a median age of 35 years. About a third (38 of 118) sustained penetrating chest injuries while others had blunt chest injuries. The causative agent included motor vehicle accidents 66 (55.9%), gunshot injuries 28 (23.7%) and falls 12 (10.2%). Others occurred as a result of stab wounds to the chest in 10 patients (8.5%) and domestic assault in 2 (1.7%) cases. Age above 40 years and complications of chest trauma such as pulmonary contusions and adult respiratory distress syndrome were positive predictors of mortality using multiple logistic regression analysis (p- 0.041 and 0.001 respectively). Conclusion: Patient's age above 40 years and the presence of pulmonary contusions are independent predictors of mortality in chest trauma in south western Nigeria.

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Background: About 12.9 million children under the age of 5 years die annually from diseases in which 63% are preventable and easily treated. This study determines the major causes of morbidity and mortality of the children admitted into EPU, UDUTH, Sokoto over a year period and identify the strategy for reducing childhood mortality. Method: The register of admitted cases into EPU over a 1-year period (1 ^st June 2009 to 31 ^st May 2010) was reviewed and analyzed. Extracted from the register, were age, gender, diagnosis, outcome and causes of deaths. Results. There were a total of 1,900 admissions made up of 1,081 (56.9%) males and 819(43.1%) females (male: female=1:3:1) during the study period.. Those aged 5 years and below were 1, 489 (78.4%) while the remaining 411(21.6%) were aged above 5 years. The main causes of morbidity were malaria 520 (26.8%), sickle cell disease 269 (14.2%), protein energy malnutrition (PEM), 209 (11.0%), diarrhea disease 192(10.1%), pneumonia 157 (8.3%) and vaccine preventable diseases (VPD) 153 (8.1%). Of the 1,900 cases that were admitted, 131 (6.9%) died. The major causes of deaths were malaria 32(24.4%), VPD 23(17.6%), pneumonia 13(9.9%), neonatal secpticaemia 13(9.9%), diarrhoea 11 (8.4%) and PEM 10(7.6%). Conclusion: The major causes of childhood mortality in this environment are preventable. Strong political will by the governments is recommended to produce positive effect and ensure realisation of the 2015 target of MDGs.

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Background: Surgical site infection is of great concern to the surgeon hence preventive measures such as prophylactic antibiotics in widely used for clean contaminated and contaminated surgical procedures. This study seeks to evaluate any advantage gained by administering antibiotic in uncomplicated appendicitis. Method: A prospective randomized trial done on 70 patients admitted with appendicitis without features of peritonitis. Records were taken preoperatively and updated at the point of discharge and first clinic visit. Results: Wound infection occurred in 1 of 34 patients (2.9%) who had no antibiotic appendectomy against 2 of 36 who had metronidazole and ciprofloxacin. Mean age of patients was 22.8 years, and a mean hospital stay of 4.6 days. Conclusion: Routine antibiotic therapy is not necessary for adult Nigerian patients undergoing appendectomy for uncomplicated appendicitis.

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Chloroquine is a 4-aminoquinoline discovered over five decades ago for treatment of uncomplicated malaria. It was widely used as first line treatment and prophylaxis for individuals going into malaria endemic regions. It was initially highly effective against the four Plasmodium species (P. falciparum, P. malaria, P. ovale and P. vivax) infecting human. It is also effective against gametocytes except those of P. falciparum. Resistance of P. falciparum to chloroquine is widespread and led to discontinuation of chloroquine in malaria treatment by most countries. In recent times, evidences are emerging for chloroquine to probably secure its original place in treatment of acute uncomplicated falciparum malaria. This would be a welcome idea since chloroquine is readily available, relatively safer and cheaper than most currently use antimalarial drugs. Thus, researchers should intensify efforts on periodic in vitro monitoring of chloroquine efficacy; clinicians should further discourage use of chloroquine until efficacy is remarkably restored and pharmaceutical industries should look into potential chloroquine and chloroquine-resistance reversal fixed and non-fixed doses combinations.

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Background: Many students in higher institutions tend to be exposed to environmental tobacco smoke. This work was designed to survey the exposure to environmental tobacco smoke and awareness of the dangers associated with it among undergraduates of university of llorin. Method: It was a cross-sectional study among undergraduates of the University of llorin, Kwara State in Nigeria. Results: The overall rate of self-reported regular environmental .tobacco smoke exposure was 48.6%. Exposure was significantly higher in males than females. It was commonest at homes/hostels 473 (59.9%), followed by viewing centres 376 (47.7%) and bars/restaurants 288 (36.5%). Two hundred and twenty-one (95.3%) medical students and 1221 (85.9%) non medical students (χ ² =11.80, p=0.001) think that environmental tobacco smoke exposure was harmful to them. Most of the students think that active smoking can cause lung cancer, heart diseases, erectile problems and stroke in smokers but on the contrary, they did not think that environmental tobacco smoke exposure can cause these diseases in non smokers. Majority of the students 221 (95.3%) medical students and 1275 (89.7%) non medical students support ban on smoking in the public places. Conclusion: Many of the students who were regularly exposed to environmental tobacco smoke did not know that it can result in fatal diseases.

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Background: The aim of the present study was to assess the resting electrocardiograms (ECG) in apparently healthy pregnant women in a Northern Nigerian rural settlement, and to compare with a control group comprising of non - pregnant women in their reproductive ages. Methods: Electrocardiogram (ECG) recordings at rest of 238 women in their reproductive ages, comprising of 123 pregnant subjects and 115 non- pregnant controls were obtained. The study was cross-sectional in design and carried out at Kura Comprehensive Health Center, Kura Local Government in Kano State, Nigeria. Results: Significant differences in some of the electrocardiogram (ECG) variables and baseline characteristics were observed when the pregnant subjects were compared with the controls: lower systolic blood pressure (115.20± 8.13 Vs 120.43±9.02 mmHg), diastolic blood pressure (73.65±9.24 vs 80.44±4.85mmHg), QRS duration (71.87±13.99 vs 78.61 ±13.71ms), and P-wave, mean QRS T-wave axes (p<0.05). In addition, QRS duration was significantly reduced as pregnancy advanced from 2 ^nd to 3 ^rd trimester (75.8ms vs 69.7ms; p=0.015). Conclusions: Several differences were identified when the resting electrocardiogram of pregnant women were compared with non-pregnant controls. These findings should be taken into consideration in the interpretation of electrocardiogram of pregnant women in Nigeria.

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Background: Medical emergency is a unit where patients with life threatening conditions receive urgent medical attention. This study determines the pattern and outcome of medical emergencies seen in a tertiary hospital. Methods: All patients seen in the Accident and Emergency Unit of Aminu Kano Teaching Hospital, Kano in December 2008 were recruited. The demographic data of each patient, assessment of severity of illness on presentation and action taken as well as the outcome of the patients were recorded. All the data generated were analysed. Results: Though there were more young people who attended the emergency unit, the elderly had a higher rate of attendance in relation to their absolute population in the general public. About a third of the overall patients did not require medical emergency services. While malaria and acute gastroenteritis had higher overall frequency, stroke and heart failure were more frequent among the older population. Conclusions: Malaria and acute gastroenteritis are the most frequent emergency conditions. In the elderly however, stroke, congestive cardiac failure and hypertension are more common. Overall, stroke recorded the highest mortality rate, followed by chronic liver disease and diabetic complications.

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Background: The provision of antenatal care is regarded as the cornerstone of maternal and perinatal health care especially in developing nations and is expected to have a significant impact on achieving the fifth millennium development goal. The aim of this study was to assess the determinants of utilisation of maternity services in Gidan Igwe, Sokoto. Methods: The study was a cross-sectional descriptive one involving 300 women of child bearing age selected through a systematic sampling technique. Data was collected using a set of semi-structured interviewer and self administered questionnaires. Results: Majority, 214 (71.3%) of the respondents had no formal education, visited a health facility for antenatal care during their last pregnancy, 218 (72.7%) and had their last delivery at home, 190 (63.3%). Of the 190 subjects that delivered at home, 165 (85%) were assisted by Traditional birth attendants (TBAs). Education was statistically significantly associated with ANC attendance and hospital delivery (P=0.0012). Conclusion: Although, a high proportion of the respondents visited health facilities for ANC, only a few of them delivered in these facilities. There is need to increase public awareness on the use of antenatal care services and delivery by skilled attendants.

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Background: Implications of continuing HIV/AIDS pandemic in Nigeria is very grave for children. Lack of financial resources means care of children with HIV/AIDS is exceedingly difficult to provide. We described the clinical pattern and highlight the problems in the management of HIV/AIDS in children seen in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria over a two-year period. Methods: This prospective study was carried out between 1 ^st January 2001 and 31 ^st December 2002. The clinical presentation of each patient satisfying the WHO diagnostic criteria for paediatrics HIV/AIDS, admitted consecutively into our Emergency Paediatrics Unit (EPU) was documented. Laboratory diagnosis was by Enzyme linked immunosorbent assay (ELISA) for HIV- I and HIV- II in affected children and their mothers while confirmatory test was by Western blot. Treatment of each patient was individualised. Results: A total of 41 children with HIV/AIDS were admitted into EPU over the study period. There were 22 males and 19 females with ratio of 1.2:1. Age ranged from 0.25 years to 14 years with mean (SD) of 1.5 (2.2) years. Forty - one (97.6%) patients were aged 5 years and below. Modes of transmission were vertical in 40 (97.6%), while 1 (2.4%) was by homosexual abuse. The commonest clinical feature was weight loss in 41 (100%), followed by fever (>one month) 39 (95%), chronic diarrhoea 39 (95%), recurrent cough 37 (90%) and oro-pharyngeal candidiasis 35 (85%) in that order. Thirty- six (87.8%) patients had protein - energy malnutrition (PEM), marasmus constituting 58%. Thirty-two (78%) patients were in WHO clinical stage 3 while the remaining 9 (22%) patients were in stage 4. The main types of infections were oral candidiasis, pneumonia, malaria, septicaemia, urinary tract infections, and tuberculosis. Case fatality rate was 91%. Highly active antiretroviral therapy (HAART) was not freely available to children during the period of our study. Conclusion: The mortality of these antiretroviral naive HIV/AIDS children was very high. It is anticipated that current availability of HAART to children free of charge would improve the outcome of HIV/AIDS in this group.

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