This is a case report of a 21-year-old woman who presented with a large hematoma of her right labia minora after consensual sexual intercourse that resolved following nonsurgical intervention.

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Objective: This study identified the factors associated with the healthcare-seeking behavior of heads of households in a rural community in Southern Nigeria. Materials and Methods: A descriptive cross-sectional study was conducted in 2014 among 410 household heads in Ivhiunone, Fugar in Edo State, Nigeria using two-staged sampling technique. Data collection was by means of a structured interviewer-administered questionnaire. IBM SPSS version 20 and PEPI version 4.0 were used for data analysis. Results: Over three-quarters of the respondents, 357 (87.1%) and 346 (84.4%) were males and married. The mean age of respondents was 49.5 ± 15.9 years. The majority of the respondents, 180 (43.9%) and 208 (50.7%) had a secondary level of education and were in the skill level 1 occupational classification. Almost all 406 (98.8%) respondents sought healthcare when ill, and of these, 399 (98.3%) use medications given. The preferred place to seek healthcare when ill by 373 (91.9%) of the respondents was patent medicine stores. Predictors of healthcare-seeking behavior included marital status, level of education and income. Other associated factors were age, sex, and occupational classification. Conclusion: The sociodemographic predictors of healthcare-seeking behavior included marital status, level of education and income. Other associated factors were age, sex, and occupation. Most of the household heads preferred home treatment and sought healthcare in patent medicine stores and hospitals. Improved quality of care provided to clients/patients in healthcare facilities could address the inappropriate healthcare-seeking behavior in the community.

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Background: Unintentional injury remains the leading cause of morbidity and mortality among children worldwide. This study assessed the knowledge, attitude, prevalence, and practices toward the prevention of domestic accidents and injuries among caregivers of under-five in Kano, Nigeria. Materials and Methods: Three hospitals located within Kano metropolis were chosen because they are the main referral hospitals located strategically in three local government areas and well patronized by the populace as evidenced by their patient turnover. Respondents (caregivers) were selected for administration of the questionnaires using systematic sampling technique based on the order of their presentation at the emergency pediatric unit (EPU). Results: Overall prevalence of domestic accidents in the three hospitals in the study was 13.7%. The mean age of caregivers was 29.6 ± 9.7 years and the majority of them were female 81.3%. Nearly 64.6% have formal education out of which 27.8% have up to tertiary education and most with at least five and above under-five under their care, with mean ages of the under-five children of 2.87 ± 2.82 years. Only 7.7% of the respondents had an overall good knowledge of domestic accident and injuries. Kerosene poisoning was the commonest domestic accident reported (34.4%) followed by falls (17.5%). Significantly, 30% of respondents had good practice toward domestic accident prevention largely due to preventive behaviors such as self-motivation (9.7%) and perceived danger (41.5%). Conclusion: This study demonstrates that domestic accidents especially those involving kerosene is common among children aged less than 5 years in a large sized family.

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Background: Urinary tract infection (UTI) is one of the factors implicated in morbidity among patients. Early diagnosis and treatment of UTI could be pivotal in overall treatment outcome. Aims: The aim of this study was to determine the prevalence of UTI, identify common isolates in UTI cases, and their in vitro sensitivity and resistance patterns to common antibiotics. Materials and Methods: This was a retrospective descriptive study of 181 patients with microbiological indications for UTI conducted between April 2014 and September 2015. Results: Out of 181 patients aged 20–86 years with a mean age of 51.43 ± 17.2 years, 79 (43.6%) had positive bacterial growth for uropathogens. Most common predisposing factors were urethral catheterization (32.5%), diabetes mellitus (23.7%), and urinary tract obstruction (18.7%). UTI was found to be more predominant among females (55.7%). The common isolates were Escherichia coli 30 (37.9%), Klebsiella pneumoniae 27 (34.2%), Pseudomonas aeruginosa 10 (12.7%), Proteus mirabilis 8 (10.1%), Enterococcus faecalis 3 (3.8%), Acinetobacter baumannii 1 (1.3%). The isolates were sensitive to nitrofurantoin and ciprofloxacin and ofloxacin while they were highly resistant to cotrimoxazole and tetracycline. Conclusions: UTI is common among patients affecting 43.6% of the participants in this study with E. coli being the most common uropathogen. ciprofloxacin, ofloxacin, and nitrofurantoin could therefore be recommended as the first line of drugs to clinicians for empirical treatment while awaiting sensitivity results. To prevent the emergence of resistant strains, rational use of drugs is encouraged.

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Background: Hyperprolactinemia is an extremely common disorder, especially among reproductive age women, affecting about one-third of infertile females. There is a paucity of data on the pattern of clinical presentation of hyperprolactinemia among infertile female patients in Nigeria. This study, therefore, aimed to determine the pattern of clinical presentation of hyperprolactinemic infertile female patients in Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Northern Nigeria. Materials and Methods: Blood sample of 120 infertile female patients aged 15–45 years attending the infertility clinic at ABUTH over 9 months was taken. Data on clinical signs and symptoms were collected using interview-administered questionnaire. Serum prolactin was assayed by microwell enzyme-linked immunosorbent assay technique based on the noncompetitive sandwich principle. Data obtained were analyzed using SPSS version 20 (Syntron Bioresearch. Inc. California, United States of America (USA)). Results: The mean serum level of prolactin concentration at presentation was 31 ng/ml (range, 2.5–109 ng/ml). Sixty-two patients (51.7%) had hyperprolactinemia and 58 (48.3%) had normal prolactin level. The majority of those with hyperprolactinemia 58.6% were in the 25–34 years' age group. Of those with hyperprolactinemia, majority (27.4%) presented with galactorrhea and others presented with symptoms such as menstrual abnormalities, recurrent abortion, hirsutism, and mixed presentations. However, 25.8% of them were symptomless. Conclusion: Galactorrhea was the most common mode of presentation among infertile hyperprolactinemic females in ABUTH, and a larger proportion were symptomless.

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Background: Postpartum depression (PPD) is of public health importance. Estimation of it occurrence in other parts of the developed world showed prevalence rates of approximately 10%–25%. Previous prevalence studies in crisis-ridden areas showed prevalence rates ranging from 28% to 58%. However, since the entrenchment of relative peace in Jos, Nigeria there has not been any other study to the best of the authors' knowledge. Aim: The aim of the present study was to determine the prevalence of PPD in a postethno-religious crisis period among women attending the Postnatal and Children's welfare clinic in a tertiary hospital, Jos, Nigeria. Materials and Methods: In total, 550 women were recruited in a cross-sectional study that involved a two-stage procedure in a Tertiary Hospital in Jos, Nigeria. The Edinburgh Postnatal Depression Scale questionnaire and the Depression Module of the Structured Clinical Interview for DSM-IV axis I Diagnosis were used. Results: A weighted prevalence of 21.8% of PPD was found among the participants. Age (P< 0.001), marital status (P< 0.001), types of marriage (P< 0.001), and educational level (P< 0.001) were significantly associated with PPD. Conclusions: PPD was found in about a quarter of the studied sample in the postcrisis period. Therefore, screening of women in the postpartum period for depression will help in early detection and treatment of women of childbearing age.

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Background: Drug-induced hemolytic anemia can be life threatening and may pose a threat to the management and disease progression of some illnesses. The aim of this work is to evaluate changes in hematologic parameters and glucose-6-phosphate dehydrogenase (G6PD) activity in psychotic patients undergoing antipsychotic chemotherapy. Materials and Methods: A total of 70 participants comprising of 35 psychotic patients (21 males and 14 females) with mean age of 40.5 ± 5 years as test participants and 35 apparently healthy nonpsychotic individuals (20 males and 15 females) with mean age of 25.5 ± 1.5 years as controls were used for this study. G6PD was estimated spectrophotometrically using Randox G6PD assay kit while the hematological parameters were determined using the Erma hematology autoanalyzer. Morphology of the blood samples was manually done by making a thin film stained by Leishman stain and examined microscopically using the oil immersion objective. Results: G6PD activity was found to be higher in test participants (P = 0.075) when compared to the control group. Its activity was also observed to be higher in females when compared to the males (P = 0.051). Hemoglobin concentration, hematocrit, values, mean cell volume, and mean cell hemoglobin were observed to be lower in test participants when compared to the controls (P< 0.05, P = 0.001, P = 0.022, and P = 0.044, respectively). There were no significant differences in total white blood cell counts (WBCs), lymphocytes, granulocytes, platelet count, and red cell distribution width in test participants when compared to controls (P = 0.177, P = 0.665, P = 0.086, P = 0.159, and P = 0.060, respectively). Conclusion: There are changes in hematologic parameters using antipsychotic drugs, and these changes may predispose an individual to iron deficiency anemia and to hemolytic episodes.

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Background: Solanum torvum, commonly known as turkey berry, is used majorly as a medicinal plant, especially in Africa. Thus, this research investigated the effects of aqueous leaf extract of S. torvum on the status of liver (alkaline phosphatase [ALP], alanine transaminase, aspartate transaminase, plasma total protein, plasma albumin, plasma globulin, plasma total bilirubin, plasma conjugated bilirubin), hematological profile, as well as on the histology of the liver, spleen, lungs, and bone marrow of treated rats. Methods: Assays were done using ready to use Randox® kits and photomicrographs of various tissues were prepared after histological staining. Results: The results indicated that at the highest dose, there was an activation of the hepatic Kupffer cells and a significant increase in white blood cells (WBCs) and lymphocytes depicting potent immunomodulation in the various tissues. Alanine transaminase and aspartate transaminase increased but decreased at the highest administered dose, while ALP followed an opposite trend. WBCs and platelets level increased significantly. Conclusion: S. torvum aqueous leaf extract possesses potent immunomodulatory and Hepato-protective properties.

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Background: Urinary tract infection (UTI) is identified by presence of both pyuria and at least 50,000 colonies/mL of a single uropathogenic organism in an appropriately collected specimen of urine. In young children, the only presentation of a UTI may be fever. Young children may show nonspecific signs such as irritability, feeding poorly, vomiting, sleeping more, or show signs of jaundice. Aim: To study the prevalence of UTI in febrile children <2 years of age presenting to the hospital and to compare urine analysis with urine culture in detecting UTI early in young febrile children with no localizing signs. Materials and Methods: All consecutive children from 1 month to 2 years of age with fever (rectal temperature of 38°C or 100.4°F) without any focus reporting to outpatient department or admitted to the ward of Paediatric Department in our hospital were included in the study. Further evaluation was performed based on the American Academy of Paediatrics and Indian Society of Paediatric Nephrology guidelines. Statistical Analysis Used: Data were analyzed using SPSS Software version 15. Results: Out of 1000 cases of febrile children with no localizing signs who were included in the study, 370 (37.0%) were females and 630 (63.0%) were males. In 86.6% of cases, Escherichia coli was the predominant cause of febrile UTI. In these cases of febrile patients, urine analysis was positive in 7% of cases only whereas urine culture was positive in 15% of cases suggesting UTI. Conclusions: Urine culture should form an essential part of evaluation of a young febrile child with no localizing signs.

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Ochronosis is a rare disease characterized by speckled and diffuse pigmentation symmetrically over the face, neck, and photo-exposed areas. It can present in exogenous or endogenous form. Endogenous ochronosis or alkaptonuria is an autosomal recessive disease caused by a deficiency of homogentisic acid (HGA) oxidase, which results in the accumulation of HGA, a hydroquinone (HQ) metabolite of tyrosine. Some evidence suggests that it is not HGA itself but a by-product of its oxidation, a benzoquinone acetic acid, that can polymerize to a melanin-like pigment by unknown mechanisms and accumulates both inter and intracellularly in connective tissue, most commonly the joints, cardiovascular system, kidney, skin, and glands, a pathological condition known as ochronosis (Development of an in vitro model to investigate joint ochronosis in alkaptonuria. Tinti L, Taylor AM et al. Rheumatology 2010; Oct 15: 1-7. doi: 10.1093/rheumatology/keq246). Exogenous ochronosis (EO) is a rare, cosmetically disfiguring condition, resulting from the long-term use of topical HQ in the treatment of melasma. It manifests as grey-brown or blue-black macules in HQ-exposed regions, characterized histologically by banana-shaped ocher-colored deposits in the dermis. HQ the topical bleaching agent of choice is widely prescribed by physicians and often used by patients without a prescription. The principal adverse effects of its chronic use are confetti-like depigmentation and rarely EO. EO is an avoidable dermatosis that needs to be recognized early with immediate discontinuation of HQ as treatment is difficult. Sun exposure facilitates the formation of EO and must be strictly avoided. We report case of a 65-year-old man who had chronic kidney disease but developed EO while using topical HQ.

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Background: Chronic kidney disease (CKD) is one of the important complications of human immunodeficiency virus (HIV) infection. The prevalence of CKD in HIV-infected Nigerians at presentation is currently unknown. Materials and Methods: This was a comparative study of 400 antiretroviral drug naïve HIV-infected patients attending the HIV clinic of a teaching hospital in North Central Nigeria and 140 apparently healthy individuals. CKD was defined as estimated glomerular filtration rate (eGFR) <60 ml/min and/or proteinuria ≥1+ according to standard guidelines. Results: Proteinuria was found in 119 (29.8%) of the HIV group compared to only eight (5.7%) of the control group (P< 0.0001). eGFR <60 ml/min was found in 12 (3%) of the HIV group compared to none of the control group (P< 0.0001). CKD (eGFR < 60 ml/min/+proteinuria) was found in 123 (30.8%) of the HIV group compared to eight (5.7%) in the control group (P< 0.0001). A multivariate analysis showed that male sex, low body mass index, low CD4 + T cell counts, and higher viral load copies in the HIV population correlated independently with CKD. Conclusion: The burden of renal disease in drug naïve HIV-infected patients is high. Early diagnosis and treatment of HIV may stem this tide.

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