Background: Reports on Paediatric amputations are few in Nigeria. Though reports on adults abound, the peculiarities a child has in terms of anatomy and physiology with regard to amputation surgeries are different. This study aims to provide a profile of Paediatric amputations carried out at the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Methoas: Data regarding Paediatric amputations over a 5-year period between January 2004 and December 2008 were obtained. A retrospective analysis was done with regard to sex, indications and pattern of amputation as well as complications. Age limit of 16 years was used as this represents the cut-off for Paediatric admissions in our hospital. Results: There were 37 cases of Paediatric amputations in 37 patients representing 27% of all amputations done over the five year period. Boys accounted for 23(62%) and girls 14(38%) with M: F ratio or 1.6:1. The age range was between 1 and 16 years with a mean of 8.16 years and standard deviation of 4.01 years. Traditional bone setters gangrene was the commonest indication and accounted for 19(51%), while trauma accounted for 10(27%). Above elbow amputation was the commonest form as seen in 12(32%) patients, followed by above knee in 11(30%) patients. Anaemia, wound infections and tetanus were the common complications. The duration of hospital stay ranged from 1 to 48 days with a mean of 13.97 days and standard deviation of 10.7 days. One (3%) death was recorded. Conclusion: Community awareness campaign on misadventures of traditional bone setters would go a long way in reducing the rate of Paediatric amputations in our society.

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Background: Osteomyelitis is usually caused by many infectious agents but granulomatous osteomyelitis is rare in this setting requiring adequate research into the pattern of the few diagnosed cases. Aim: To study the frequency and pattern of granulomatous osteomyelitis. Design and Setting: A retrospective study in Port Harcourt, Nigeria (from 1 ^st January 1990 to 31 ^st December 2004). Method: The tissues were fixed in 10% formalsaline and decalcified with concentrated Nitric or sulfuric acid, and processed and embedded in paraffin wax. The tissues were then sectioned, mounted on glass slide and stained with hematoxylin and eosin (H & E) stains. In some cases special stains (Ziehl-Neelsen and Grocotte's) were used to demonstrate the acid fast bacilli (AFB) and the fungal elements respectively. Results: There were 13 specimens of which 8 (61.5%) were from males and 5(38.5%) in females giving a sex ratio of 1.6:1. Eight (61.5%) cases occurred in patients under the age of 30 years. The highest frequency of four (30.8%) occurred in patients aged 10 years and below. The youngest was a 3-year-old male while the oldest was a 62-year-old male. Tuberculous (Tb) osteomyelitis accounted for twelve (92.3%) of the cases while histoplasmosis accounted for one (7.1%). One of our patients was HIV positive. The common sites of predilection were the hip joint n-4 (30.8%) and the vertebral column n = 3 (23.1%). Conclusion: Granulomatous osteomyelitis is very uncommon in this environment. Though many organisms maybe associated, only TB and histoplasmosis were seen in this study.

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Aim: The objective of this study was to determine the attitude of medical students to ophthalmology during their clinical posting and as a career choice. Methods: A structured questionnaire was administered to 500 and 600 level medical students of the University of Benin, Benin City, Nigeria. Results: Three hundred students comprising 172 (57.3%) males and 128 (42.77%) females participated in the study. Seventy five students (25%) ranked ophthalmology 1st inpreference to other specialties. Two hundred and eighty six students (95.3%) found the posting interesting. One hundred and fourteen students (38%) wanted to specialize in ophthalmology. There was no significant difference between the males and females (p>0.05) in their choice of ophthalmology as a career. Conclusion: The number of students interested in choosing ophthalmology as a career at the University of Benin Medical school is high. An increase in the duration of the posting from 3 weeks to 4 weeks and increased lecturer -student interaction is recommended to further stimulate their interest. There is a need for provision of more places for residency training in ophthalmology in hospitals in Nigeria so that more doctors can specialize in it.

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Background : Until recently, motorcycles became major means of transportation in Nigerian cities because they are cheaper than cars and buses to engage. Unfortunately they are responsible for several road traffic accidents causing various types of injuries including blunt abdominal injuries. Although they have long been withdrawn from the roads in most cities in Nigeria, they are a menace in the cities where they are still operating. Aim: To report 13 cases of traumatic abdominal wall hernia as a result of blunt abdominal injuries secondary to motorcycle accidents, their management and the outcome of their management. Patients and Methods: As recorded in the Accident and Emergency departments of two tertiary hospitals in Port Harcourt - University of Port Harcourt Teaching Hospital and Braithwaite Memorial Specialist Hospital, 2472 patients who had blunt abdominal trauma following motorcycle accidents were seen and treated between 2005 and 2010. Out of this number, 13 patients were admitted and treated for suspected traumatic abdominal wall hernia. Their demographic data, treatment and treatment outcome were retrieved from their case notes. Results: There were 13 cases of suspected traumatic abdominal wall hernia, who were admitted for emergency exploration. There were 10 (76.9%) males and 3 (23.1%) females with a male/female ratio of 3.3:1. The patients aged between 26 and 56 years. The mean age at diagnosis was 40.6 years. The presenting symptoms were related to the road traffic accident and the impact of the handles of the motorcycle on the anterior abdominal wall. They are abdominal pain, severe bruising of the abdominal wall, herniation of abdominal contents and scrotal haematoma. Eleven (84.6%) cases were diagnosed correctly pre- operatively while 2 (15.4%) cases were diagnosed during surgery. Conclusion: We recommend a high level of clinical suspicion for traumatic abdominal wall herniation in all patients with traumatic abdominal wall injuries. It is instructive that the area be explored with primary repair of the hernia and other tissue planes of the abdominal wall.

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Introduction: There is a marked discrepancy in the reported frequencies of the electroencephalography (EEG) abnormalities in migraine. Aim: To evaluate EEG abnormalities in migraine patients and compare their EEG findings with those of normal age-matched control group. Methodology: EEGs of 40 symptom-free unmeditated migraineurs that satisfied the International Headache Society criteria for migraine with aura and migraine without aura were recruited from neurology clinic of Aminu Kano Teaching Hospital, Kano and Murtala Muhammad Specialist Hospital, Kano for the study. EEG was also carried out on age-matched control group using the same, standardized, protocol. Analysis was done using SPSS version 16. Fisher exact test was employed for comparison of categorical variables. P-value was set at 0.05. Results: Overall, 17.5% of the migraineurs as opposed to10% of the controls had abnormalities including epileptiform spikes, sharp waves, sharp and slow wave complexes as well as slow wave activity, the odd ratio (OR) = 1.99; 95% Cl=0.31-14.9. More migraine patients had focal, generalized and paroxysmal discharges than the control, however, the difference was not significant.. Comparing subjects with migraine preceded by aura and migraine not preceded by aura, 20% of the former as opposed to 15% of the later had EEG abnormalities, the difference not being statistically significant. Conclusion: In conclusion, focal, generalized and paroxysmal EEG abnormalities were found in migraine patients. However, frequencies of inter-ictal EEG abnormalities, which is higher in migraine patients when compared to age-matched control, did not differ significantly.

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Background: In Nigeria, leprosy still remains a condition that attracts attention, both by the government of the country, and particularly so by the Non-Governmental Organisations (NGOs), due to its disabling and disfiguring consequences. Thus given the difficulties that control programs are often faced with, leprosy still remains a public health problem in Nigeria. Method: The Royal Tropical Institute (KIT) Biomedical Research developed the mycobacterium leprae (ML) flow test and evaluated its performance on standard sets of serum and blood samples. Databases and forms for data collection and evaluation were developed and health centres and workers were selected for participation in the project. They were trained in the use of the ML flow and the ML flow test was then used for 18 months as part of routine leprosy control activities in the selected health centres. Results: A total of 186 patients and 529 contacts were tested with the ML flow test in 28 health facilities located in 10 Local Government Areas (LGAs) in Jigawa State. Thirty four health workers participated in the anthropological study. There were 117(62.9%) patients found positive with the ML flow test. Conclusion: Despite that the ML flow test currently makes no sizeable contribution to the classification of leprosy patients in Jigawa State, it was still felt that the test could make a contribution in contact tracing and in classification, if the World Health Organization (WHO) definition of multibacillary (MB) would be followed.

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Background: Compartment syndrome (CS) is a limb-threatening and a life-threatening condition that occurs when pressure within a musculofascial compartment exceeds tissue perfusion pressure. Morbidity and mortality from CS stem from delay in diagnosis and treatment. Aim: To highlight the various clinical and experimental aspects of CS, in order to increase the awareness of clinicians and reduce unnecessary morbidity and mortality resulting from this condition. Methods: A review composed through Medline Internet search, literature search and contributions from our individual and collective experiences over the years, as well as shared experiences from colleagues. Results: The compartments of the lower leg, foot and the volar forearm are particularly prone to developing CS. Many aetiological factors have been implicated, but the diagnosis is based on clinical, manometric, radiological and laboratory parameters. Although medical treatment may suffice in early cases, surgical decompression should be performed appropriately where necessary. Tendon transfers and stabilization may be indicated as late treatment. Conclusion: CS constitutes a threat to both limb and life. Prompt recognition of this condition is necessary in order to institute the appropriate management schedule.

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Background: This is a report of a 45-year old multiparous woman that presented with severe anaemia following a 6-month history of heavy, painful menses, intermenstrual bleeding and mass protruding per vaginam. She was managed as a case of complete non-puerperal chronic uterine inversion. She had blood transfusion and was taken to the theatre where she subsequently had reduction of the inverted uterus and total abdominal hysterectomy. She made good recovery and was discharged in good condition. Aim: To highlight a rare condition of chronic non-puerperal uterine inversion following the extrusion of a benign fundally-located submucous uterine myoma. Method: A Case report. Results: There was reduction of the inverted uterus and total abdominal hysterectomy was performed. Conclusion: Chronic non-puerperal uterine inversion may present with life-threatening haemorrhage. It requires prompt stabilization of the patient and subsequent reduction of the inversion.

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