Background: Globally, intensive care units (ICUs) are encountering emergence and spread of antibiotic-resistant pathogens, and for some pathogens, there are few therapeutic options available. Objectives: The study assessed prevalence, susceptibility pattern, and risk factors of carbapenem-resistant Enterobacteriaceae (CRE) infections among ICU patients in Kano, Nigeria. Materials and Methods: A descriptive cross-sectional study was used to study 190 patients admitted to the ICUs of two tertiary hospitals in Kano. Antibiotic susceptibility of isolated organisms was determined by disc diffusion technique. Suspected carbapenemase producers were further subjected to the modified Hodge test (MHT) method for confirmation. Results: A total of 76 out of the 190 samples yielded clinical isolates of Enterobacteriaceae as follows: 34 (44.7%) Escherichia coli, 19 (25%) Klebsiella pneumoniae, 3 (3.9%) Proteus mirabilis, 4 (5.3%) Enterobacter aerogenes, 3 (3.9%) Proteus vulgaris, 2 (2.6%) Citrobacter freundii, 2 (2.6%) Klebsiella ozaenae, 2 (2.6%) Klebsiella oxytoca, 2 (2.6%) Salmonella subsp. 3b, 2 (2.6%) Enterobacter agglomerans, 2 (2.6%) Enterobacter cloacae, and 1 (1.3%) Serratia odorifera. Screening the Enterobacteriaceae-positive samples for carbapenem resistance using ertapenem disc (10 μg) showed 8 samples (10.5%) as resistant while MHT gave a carbapenem resistance prevalence of 7.9% (6 out of 76). Based on multiplex polymerase chain reaction; the distributions of genotypes of the carbapenemase producers were as follows: Verona Integron Metallo-beta-lactamase (VIM) genes only (4 [50%]) New Delhi Metallo-beta-lactamase (NDM) genes only (2 [25%]), and 1 (12.5%) had Klebsiella pneumoniae carbapenemase (KPC) and VIM gene coexisting. Surgical procedure (P = 0.009) and history of recent admission (P = 0.001) were found to be risk factors for CRE. Conclusion: The study provided evidence of the presence of CRE infections among patients admitted to ICUs in the study centers. This underscores the need for effective infection prevention and control measures to avoid the spread of CRE in hospital setting.

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Background: Acne vulgaris is a common dermatological disease which affects a wide range of ages; however, it occurs more in the adolescent years with its attendant psychosocial effects. Aim: The aim of the study was to determine the prevalence and psychosocial effects of acne vulgaris among secondary school students in Egor Local Government Area, Benin City, South–South Nigeria. Materials and Methods: Four hundred and ten students (263 females and 147 males) from two secondary schools were enrolled in this descriptive cross-sectional study using a simple random sampling technique. A structured open- and close-ended interviewer-administered questionnaire was used and each student was examined and a clinical diagnosis was made by a dermatologist. Data were analyzed using the IBM SPSS Version 20 and P < 0.05 was set for statistical significance. Results: The overall prevalence of acne vulgaris was 37.3% with a slightly higher prevalence in females (37.6%) than in males (36.7%). A higher percentage of acne was observed among students in the private school (51.4%) compared to those in public school (32.2%). An increased prevalence (41.2%) was also observed in the higher age group (15–19 years) compared to (35.8%) in the 10–14 years age group. Psychological disorder was found in 170 (41.5%) respondents. The type of school (P < 0.001), class of student (P < 0.014), depression (P < 0.004), anxiety (P < 0.015), worry (P < 0.001), fear (P < 0.001), and anger (P < 0.001) were found to be statistically associated with acne vulgaris. Similarly, the type of school (P < 0.007) and marriage type of parents (P < 0.001) were found to be statistically associated with psychological disorder. Conclusion: School health education about this condition is imperative in order to significantly reduce its psychosocial effects.

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Background: Polycystic ovarian syndrome (PCOS) is a frequently encountered endocrine disorders in women of the reproductive age. Various studies conclude there is no uniform correlation between the phenotypes of the PCOS and serum anti-Mullerian Hormone (AMH) levels. Aim and Objective: The objective of the study to estimate the association between different phenotypes of PCOS and the serum AMH level. Materials and Methods: This was a cross-sectional analytical study which included sixty subjects with PCOS according to Rotterdam's criteria. After procuring the detailed history, clinically examination and ultrasound scan subjects were classified into one of the phenotypes of PCOS. Auto-analyzer was used to measure serum AMH levels and was correlated with the various phenotypes of PCOS. Results: The study group categorized 28 patients under phenotype D, which was a predominant form. Serum AMH mean was 6.1 (±3.2) ng/ml. The mean serum AMH levels for phenotype A was 7.5 ± 3.0 ng/ml which was higher than the other phenotypes. Phenotype A had high mean body mass index which was significant ( 29.1 ±6.6) kg/m² (P = 0.046). Phenotype B had significantly higher Hirsutism score 19.8 (±1.7). Phenotype A had significantly higher mean follicular count (19.7 ± 5.1). The difference of mean or median among the phenotypes was compared using Kruskal–Wallis test or ANOVA. P < 0.05 was considered as statistically significant. Conclusion: A positive correlation was seen between the serum AMH levels and the phenotypes of the PCOS. Thus, AMH levels can be used as an adjunct tool in the diagnosis and monitoring of PCOS.

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Introduction: Majority of Nigerians are not aware of their personal genotype, and the knowledge about sickle cell disease is quite low. We hypothesize that health education will improve the knowledge and awareness of sickle cell genotype among adolescents. This study aimed to determine the effect of health education on knowledge and awareness of sickle cell genotype among adolescents. Materials and Methods: Adolescent students of Federal Government College were recruited, and necessary data on sociodemography, knowledge, and awareness of sickle cell were obtained through a pretested sickle cell knowledge assessment questionnaire. Following health education, the same questionnaire was re-administered to the participants for assessment of any change in knowledge. Results: Majority (58.1%) of the respondents heard about sickle cell during lessons in class, while mass media was the next common source (16.5%) of knowledge and awareness. Following health education, there was an improvement in all the specific knowledge questions, especially the prevalence of sickle cell trait in Nigeria (28.1% vs. 75.2%) and the probability of carrier couple having a child with sickle cell anemia (SCA) (10.3% vs. 48.2%). There was a statistically significant increase in mean knowledge score (t = −14.203, P < 0.001), as well as a significant increase in high knowledge level (χ² = 105.13, P < 0.001) after education. Conclusion: Health education improved the knowledge and awareness of sickle cell among adolescents in secondary schools, especially the chances of having children with SCA in carrier couples. Inculcating health education on sickle cell in secondary school curriculum will help in informed decision on marriage and birth, ultimately reducing the birth of children with SCA.

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Background: Ischemic stroke is known to be one of the foremost causes of long-term disability and death, and platelets play a pivotal role in its pathophysiology. However, the platelet indices having a role in ischemic stroke are not routinely reported in the available literature. Objective: The objective of the study was to evaluate the potential role of mean platelet volume (MPV) and platelet distribution width (PDW) in the development of ischemic stroke, especially in the South Indian region. Materials and Methods: This case–control study was conducted on 80 patients who were broadly divided into two groups: the case group (patients with ischemic stroke) and the control group (patients without ischemic stroke). Platelet indices were measured using Mindray BC-5200 auto hematology analyzer, and the results were analyzed using Student's t-test and Wilcoxon rank-sum Test. Results: There was a statistically significant difference (P < 0.001) in the MPV and PDW values between the two groups. The difference between the area under the curve for both MPV and PDW was also found to be statistically significant (P < 0.001) in the receiver operating characteristic curve. However, the differences in the values of MPV and PDW across different age groups, genders, and various comorbid conditions were not found to be significant. Conclusion: The elevated platelet indices may be associated with the development of ischemic stroke. The MPV and PDW can be prospective biochemical markers for predicting the onset of ischemic stroke.

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Perineal injuries are uncommon. More uncommon are severe perineal injuries. This is attributed to the relative protection of the perineum by the bony pelvis. Common causes of perineal injury include injuries from motor vehicular accidents, fall from height, foreign body insertion into the perineum, injuries from rape, and penetrating external trauma. The management of severe perineal injury entails addressing any life-threatening condition in the patient first and, subsequently, the perineal injury. The perineal injury can be repaired primarily with or without colostomy or colostomy carried out alone without primary repair. We present four cases of severe perineal injury managed by colostomy alone without primary repair of perineal soft tissue or anal sphincters. The anal sphincters and perineal soft tissues healed secondarily and sealed without any need for repair with good outcome.

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Background: Feeding a newborn infant with his or her mother's breast milk only or from a wet nurse without giving other liquids up to the age of 6 months is called exclusive breastfeeding (EBF). The promotion of EBF for the first 6 months of infant's life is the most effective way to reduce morbidity and mortality, especially in low- and medium-income countries. Despite several efforts to promote EBF, its practice has remained poor in many Sub-Saharan African countries including Nigeria. EBF practice is to a large extent influenced by the maternal knowledge and attitudes as well as sociodemographic and cultural factors. Objective: To determine the knowledge, acceptance, and practice of EBF among caregivers in Aminu Kano Teaching Hospital, Kano, Nigeria. Methods: This was a cross-sectional, descriptive study involving mothers who were currently breastfeeding at the time of the study or who had stopped breastfeeding not later than 2 years. Questionnaires were administered to breastfeeding mothers or fathers who knew the breastfeeding attitude of their wives during visits to the outpatient unit or immunization clinic. The age, sex, educational status, occupation, awareness, understanding of EBF, acceptance, practice, and benefits of EBF, and distance from health facility were explored from the caregivers. Results: Two hundred and seventy caregivers were studied of which 30 (11.1%) were male and 240 (88.9%) were female. The male-to-female ratio was 1:8 and the age ranges from 19 to 60 years with a mean of 29.4 and standard deviation of ±7.36. Majority of the caregivers (134, 49.6%) had tertiary level of education, while 79 (29.3%) had secondary education. Majority of the caregivers had good awareness and perception of EBF (77% and 51.5%, respectively). The EBF practice rate among the respondents was 68.52%. Caregivers with tertiary and secondary levels of education had good awareness and perception of EBF (χ² = 48.628, P = 0.000; and χ2 = 49.106, P = 0.000, respectively). They also had good acceptance and practice of EBF (χ² = 35.897, P = 0.000; and (χ² = 17.999, P = 0.001, respectively). There were more awareness and perception of EBF among health workers and teachers (χ² = 33.972, P = 0.000; and (χ² = 12.925, P = 0.005, respectively). They also accepted and practiced EBF significantly (χ² = 16.867, P = 0.001; and χ2 = 16.736, P = 0.001). Proximity to health facility had a significant impact on awareness, acceptance, and practice of EBF by the caregivers (χ² = 17.391, P = 0.002; χ² = 14.263, P = 0.007; and χ² = 9.802, P = 0.044, respectively). Conclusion: Educational level, occupation, and proximity to health facility have positive impact on awareness, perception, acceptance, and practice of EBF among caregivers in Kano. Therefore, there is need to educate and empower women and make health facilities accessible to them to support, promote, and protect EBF in our communities.

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Background: There is obvious change in the pattern of psychoactive substance use in this part of the world. The habit which was previously prerogative of adult males has now been extended to women. Women of reproductive age group, including pregnant ones now engage in the use of psychoactive substances, thereby exposing them and their unborn babies to various risks and dangers. Objectives: This study was carried out to determine the prevalence rate of use of psychoactive substances among pregnant women attending clinic in a teaching hospital, in a North-eastern State of Nigeria. Materials and Methods: It was a cross-sectional questionnaire-based survey. The Alcohol, Smoking and Substance Involvement Screening Test questionnaires were administered to 320 pregnant women that came for antenatal care (ANC) by research assistants. Results: The prevalence of substance use among the respondents was 13.3%. Tobacco products in form of snuff and cigarette (34.7%), sedatives and over the counter sleeping pills (32.8%) were commonly abused substances. Opiates in form of tramadol and codeine-containing cough syrups were also common (14.0%). Proportions of respondents that consume alcoholic products were 12.4%, whereas the remaining percentages were for other substances such as cannabis and solvent. Fathers' uses as well as partners' uses of psychoactive substances were variables that were significantly associated with the substance use by pregnant women in this study. Conclusion: The proportion of pregnant women that uses psychoactive substances was high in this study, especially when the fathers or partners also abuse substances. Efforts should therefore be made to screen women coming for ANC to diagnose those with substance use habit and manage them appropriately.

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Background: Foreign bodies (FBs) in the ear, nose, and throat are frequently encountered clinical entities among the children. These ear, nose, and throat FBs are often seen by pediatricians, primary care physicians, and otolaryngologists. Aim of the Study: The objective of this study is to analyze various types of FBs in the ear, nose, and throat among children and its clinical profile with its treatment in the pediatric age group. Materials and Methods: This descriptive retrospective study was carried out at a tertiary care teaching hospital. During 10-year period from April 2010 to May 2020, 452 pediatric patients with FB in the ear, nose, and throat were managed. The clinical profile and management of these children were analyzed. The clinical data were collected from the admission charts and clinic tickets. Results: In this study, the majority of the FBs were found in the nasal cavity, which constitutes 30.53%, whereas 28.31% found in the external auditory canal, 11.72% in the pharynx, 13.49% in the esophagus and 15.72% in laryngotracheobronchial (LTB) tract. The age ranges from 0 to 16 years, with a mean age was 7.21 years. The majority of the ear, nose, and throat FBs were found in the age group of 0–5 years. Out of the 452 cases, 243 (53.76%) were removed under general anesthesia. Vegetable seed was the most common FB in the nose. Coin was the most common FB in the esophagus, whereas vegetable seeds were the most common FB found in the bronchus. The open safety pin is a hazardous LTB FB. Conclusion: FBs in the ear, nose, and throat of children are common. The accurate diagnosis and treatment of the FBs in the pediatric age is often challenging. These FBs can be associated with significant morbidity and complications if not removed immediately.

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Pleomorphic adenoma (PA) is the most common neoplasm of the large salivary glands. It derives its name from the architectural pleomorphism seen by light microscopy. It is also known as the mixed tumor salivary type, which describes its pleomorphic appearance as opposed to its dual origin from epithelial and myoepithelial elements. We present a case of an adult who presented with a palatal swelling, which computed tomography (CT) scan showed to be “intrabony” but after considering other planes of the CT scan It was finally considered to be an intrabony extension of the palatal PA. The mass was successfully removed and the residual palatal defect left to granulate. Following 2 years of patient follow-up, there was no recurrence but the presence of a oronasal defect about 1 cm in diameter in the palate.

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