Context: The abuse of psychoactive substances which is one of the most important global public health problems begins in adolescence. Adolescents usually start by abusing the gateway substances. They suffer social, economic, physical, and legal consequences on account of use of substances, and this is very worrisome because of the increasing prevalence of use. Aims: The aim was to identify the characteristics of adolescents that use gateway substances. This knowledge shall be utilized in preventive programs. Settings and Design: Cross-sectional study with secondary school adolescents as participants. Subjects and Methods: Multistage sampling technique was used to select 492 respondents and the questionnaire consisted of characteristics of the adolescents, their families and schools and the alcohol, tobacco, cannabis, and stimulant use sections of the World Health Organisation questionnaire for student drug use surveys. Statistical Analysis Used: The data were analyzed using the Statistical Package for Social Sciences, and Chi-square statistics was used. Results: Having a friend who uses substance was significantly associated with tobacco, alcohol, cannabis, and caffeine use while being a male, having a family member that uses substance were significantly associated with tobacco, alcohol, and caffeine use. Older age, lack of satisfaction with the relationship with the teacher and polygamous family background were significantly associated with tobacco use. And finally, lack of satisfaction with the relationship with parents/guardians and having parents or guardians who are not religious were significantly associated with alcohol use. Conclusion: A comprehensive approach is needed to prevent the use of substances; this should target individuals, schools, families, and religious institutions.

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Background: Anemia in pregnancy affects about half of pregnant women and constitutes a serious health problem. Objectives: The aim was to determine the prevalence of anemia in pregnancy, as well as its pattern and determinants. Materials and Methods: This was a prospective cross-sectional study conducted at antenatal booking clinic of Federal Teaching Hospital Abakaliki from February to July 2012. Hemoglobin <11 g/dl was regarded as anemia. Estimation of hemoglobin concentration, HIV infection, blood group, genotype and blood film for malaria parasite and erythrocyte morphology were done. Stool analysis was also done. Results: Prevalence of anemia in pregnancy was 58%. Anemia in pregnancy was a common finding among primigravida 82 (66.1%), social Class II 14 (56.0%), social Class III 98 (53.6%), social Class IV 45 (61.6%), social Class V 117 (65.4%), antenatal booking at 14–27 weeks 211 (70.3%), and antenatal booking at ≥28 weeks 47 (74.6%). The significant predictors of anemia in pregnancy include HIV in pregnancy (odds ratio [OR] =4.88 [1.09–21.84]), P = 0.04, obstetric hemorrhage (OR = 2.97 [1.27–6.97]), P = 0.01, malaria parasitemia (OR = 4.28 [2.28–8.03]), P < 0.001, primigravidity (OR = 0.04 [1.03–2.41]), P = 0.04, and helminthiasis (P < 0.001). Conclusion: Anemia is still a common finding in pregnancy, and important contributing factors include malaria parasitemia, helminthic infestation and HIV in pregnancy.

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Background: Cerebrovascular diseases rank first in frequency and importance among all neurologic diseases. Acute ischemic stroke, a subtype of acute stroke is one of the leading causes of death and major cause of morbidity and mortality throughout the world. The incidence is increasing with a gradual increase in obesity, diabetes mellitus, dyslipidemia, hypertension, and some other cardiac problem. Aims: The aim of the study was to identify the risk factors, assess various clinical and radiological features with patients attending Gujarat Medical Education Research Society (GMERS) Medical College and General Hospital in capital city Gandhinagar in Gujarat state. Subjects and Methods: This is a retrospective study of all patients managed for ischemic stroke at GMERS Medical College and Hospital, Gandhinagar, Gujarat from January 1, 2012 to December 31, 2013. Results were analyzed with SPSS version 21 software. Results: The mean age was 60.20 years. Majority (32%) were in age group of 61–70 years young ischemic stroke (age ≤45 years) comprised of 17.14% of all patients. The male to female ratio was 1.6:1 with male predominance. Most of the patients (50.3%) were having right hemiplegia followed by left hemiplegia (40%). The common clinical presentation was hemiplegia (49.1%) followed by speech involvement (29.1%), altered sensorium (9.4%). Most common risk factor was hypertension (30.1%) followed by previous history of stroke (16.1%), dyslipidemia (15.6%), and smoking (15.1%). The frequent site of the infraction was parietal (33.3%) followed by frontal (16.2%) and basal ganglia (10.7%). Conclusion: Incidence of ischemic stroke was more in the age group of 61–70 years with male predominance and hypertension was the most common risk with affection of middle cerebral artery territory.

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Background: There is a paucity of data on the relationship between high-normal blood pressure (BP) and cardiovascular events in Sub-Saharan African countries including Nigeria. This study, therefore, primarily aimed to assess cardiovascular disease (CVD) risk factors among subjects with high-normal BP in comparison with hypertensives and subjects with optimal BP. Materials and Methods: The study was cross-sectional, and comparative conducted at Aminu Kano Teaching Hospital, Kano on eligible subjects aged 18 years and above. Three groups of randomly selected subjects (high-normal, hypertensives and optimal BP) each 100 in number were studied. High-normal BP was defined as systolic BP of 130–139 mmHg and/diastolic BP 85–89 mmHg. CVD risk factors including increased age, male gender, increased body weight, history of excess alcohol intake, cigarette smoking, sedentary lifestyle, family history of premature CVD, hypertension and diabetes mellitus (DM) were assessed and compared between the groups. Results: The most prevalent CVD risk factor was increased body weight found among 58% of subjects with high-normal BP, 63% of hypertensives and 16% of subjects with optimal BP. The study found a significant progressive increase in age, body weight, DM, dyslipidemia and sedentary lifestyle as BP increased across the groups (P < 0.05 for each variable). Conclusions: Subjects with high-normal BP had significantly higher CVD risk factors than those with optimal BP but significantly lower than for hypertensives. Age, body mass index and FBG were independent predictors of high-normal BP.

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Background: Diabetes mellitus is a well-recognized risk factor for stroke. Clinical features, as well as outcome of stroke, difference between diabetic and nondiabetic patients. The objective of this study is to determine the pattern and outcome of management in diabetes-stroke co-morbidity. Materials and Methods: This is a retrospective study where case folders of patient admitted from January 1 to December 31, 2009 with the clinical diagnosis of stroke were traced. A questionnaire was used to extract relevant data from case folders. Results: A total of 115 patients with the clinical diagnosis of stroke were admitted during the study period, but only 88 had complete information out of which 12 (13.6%) had type 2 diabetes. The mean age of the diabetic group (69.67 ± 12.7 years) was found to be significantly higher than that of the nondiabetic group (56.93 ± 16.06 years) (t = 2.615, P = 0.011). Ischemic stroke occurred more frequently in the diabetes stroke the co-morbid group. However, the difference was not statistically significant (χ² =0.079, P = 0.540). Outcome in terms of neurological recovery tended to be poor in the diabetes-stroke co-morbid group as compared to the nondiabetes stroke group (χ² =13.93, P = 0.006). Conclusion: Stroke pattern and outcomes are different in the diabetic patient compared to nondiabetic patient. There is more prevalence of ischemic stroke in the diabetic group of patients often with slow recovery.

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A case of a 13 year old unconscious girl who aspirated her molar tooth when she sustained a fall is presented. Chest radiograph demonstrated the aspirated tooth in the left main bronchus but it was unidentified by the attending pediatricians because the radiograph was not reported. The value of radiology in the diagnosis and management of such a case, the complications of this life threatening condition and the role of the pathologist is discussed.

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Background: The emergence of osseointegrated dental implants has resulted in several applications in diverse clinical settings. Hence, has contributed to the suitable replacement of missing teeth and the realization of an optimal facial appearance. This paper describes the benefits, applications, contraindications, and complications of dental implants in contemporary dental practice. Materials and Methods: An electronic search was undertaken in PUBMED without time restriction for appropriate English papers on dental implants based on a series of keywords in different combinations. Results: Fifty-eight acceptable, relevant articles were selected for review. The review identified the various components of dental implants, classification, and brands. It also looked at osseointegration and factors promoting and inimical to it. It also explored primary and secondary stability; and patients' selection for a dental implant. Complications of dental implants were also highlighted. Conclusion: With over 95% success rate, dental implants remain the gold standard for achieving aesthetic and functional oral rehabilitation.

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Hypoglossal nerve palsy posttonsillectomy is a rare complication that can occur following orotracheal intubation for general anaesthesia for surgical procedures. We present a case of hypoglossal nerve palsy occurring in a 38-year-old female medical practitioner. Possible mechanisms of this complication are discussed.

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Kartagener's syndrome (KS) is an autosomal recessive subgroup of primary ciliary dyskinesia (PCD) which presents as sinusitis, bronchiectasis, and dextrocardia .The deficit in the coordination of ciliary motion results in mucus retention and recurrent respiratory tract infections (sinusitis, otitis media and pneumonia. Kartagener patients are more or less troubled by repeated infection for which they have to seek medical attention which is largely the reason for their morbidity .An adult person commonly seeks medical help because of infertility .We present series of three cases of Kartagener syndrome with characteristic clinico-radiological features.

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Aims: This study was to evaluate the risk factors associated with tooth wear lesions in patients attending a dental clinic. Context: Tooth wear lesions entail the loss of dental hard tissues in the absence of caries or trauma. They include abrasion, attrition, and erosion. The etiology is often related to habits leading to insidious symptoms with similar presentations in both community and hospital patients. Materials and Methods: This cross-sectional study involved patients attending the outpatient dental clinic of a Nigerian Teaching Hospital over a 3-month period. A semi-structured questionnaire was used to elicit information from the respondents. Results: A total of 152 respondents aged 17–80 years and above, comprising 86 males (56.6%), and 66 females (43.3%) constituted the study population. The Binis were the most represented 34.2%, followed by the Esans 21.1%, while the least represented were the Yorubas (6.6%). The occupations represented in this study include civil servants (30.3%), unskilled workers (23.7%), and non-medical professionals (7.9%). Tooth wear lesions were present in 55.3% of the respondents. Attrition accounted for 29.6%, Abrasion (11.8%), combination of attrition and abrasion (4.6%), and abfraction (2.0%). There was a statistically significant association between tooth wear lesions and age, occupation, sensitivity or pain, tooth cleaning aids, toothbrush texture brushing technique, intake of carbonated beverages, and method of intake. Conclusion: Tooth wear lesions such as attrition and abrasion were prevalent among the respondents in this hospital setting and, therefore, represent an important group of dental problems among this population. It is, therefore, important to direct the appropriate oral health awareness program for the prevention, early detection, and management of these conditions.

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Background: The maxillary sinus is characterized by a significant inter-individual variation. Computed tomography (CT) measurement of sinus dimensions using provides a satisfactory assessment of the maxillary sinus and its conditions. Aim of the Study: To determine the size of the maxillary antrum and compare the depth, width, and height of the maxillary sinus between sexes and to establish a baseline for values in our environment using CT. Materials and Methods: One hundred and thirty subjects (79 males, 51 females), between 20 and 80 years, with normal maxillary sinus CT anatomy, from head CT scans done at the Radiology Department of the Usmanu Danfodiyo University Teaching Hospital Sokoto, were studied. Measurements were taken between the widest points of the sinuses, antero-posterior (AP) and transverse diameters from axial images, craniocaudal diameter from coronal and sagittal images, and volumes were determined by the product of these three-dimensional and slice thickness. Results: In males, the mean craniocaudal, transverse, AP diameters and volume on the right were: 32.21 ± 5.56 mm, 24.18 ± 5.80 mm, 36.94 ± 4.73 mm, and 14.98 ± 6.53 cm ³. On the left, it was 32.38 ± 5.33 mm, 24.12 ± 5.81 mm, 36.84 ± 5.31 mm, and 15.08 ± 6.66 cm ³ respectively. Similarly in females, values on the right were: 30.93 ± 6.09 mm, 23.14 ± 4.70 mm, 36.29 ± 4.71 mm and 13.26 ± 5.04 cm ³, and left was, 31.14 ± 6.00 mm, 23.69 ± 5.50 mm, 36.43 ± 4.64 mm and 16.06 ± 17.96 cm ³ respectively. Conclusions: CT measurements of the maxillary sinus dimensions are larger in males; however, females had higher left sinus volume.

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Background: Hydrocephalus among children is an important medical problem in view of its neurological sequelae in the growing child. This situation is compounded by the acute shortage of neurosurgeons in third world countries like Nigeria; hence, the need for its early detection and proper management. Objective: Evaluation of the ultrasound (US) appearances in children under 5 years of age presenting with clinical signs of raised intracranial pressure suggestive of hydrocephalus. Patients and Methods: A retrospective review of transfontanelle US scans done in 64 children (39 boys and 25 girls) attending the Department of Radiology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria over a period of 2 years was carried out. The patients had a mean age of 5.0 ± 4.6 months (range: 1–60 months) at the time of their US examination. Some of the clinical indications for US scan included: Congenital hydrocephalus, encephalocele, meningomyelocele, and meningitis. All scans were performed through the anterior fontanelle using SIUI Apogee 800 PLUS scanner with a curvilinear probe using multi-frequency transducer of 2–5 MHz. Results: Fifty-two patients (81.3%) had hydrocephalus of congenital origin. Eleven cases (17.2%) had postmeningitic hydrocephalus while only 1 case (1.6%) was posthemorrhagic. Twenty-five patients (48.0%) of the congenital cases were due to cerebral aqueduct stenosis. Eleven (21.2%) of the congenital cases were from obstruction at the exit foramina of Luschka and Magendie resulting in the communicating type of hydrocephalus. Conclusion: Hydrocephalus is a known cause of neurological morbidity among infants in developing countries. Majority of the cases are congenital in origin and most commonly due to cerebral aqueduct stenosis. Transfontanelle US is cheap, affordable, nonhazardous, and more accessible than other imaging modalities. It should serve as the first-line investigation of infants with suspected hydrocephalus for early detection and monitoring of progression to determine those cases that would require shunt operation.

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