Framing COVID-19 pandemic as mass killer and existential public health emergency/threat in Nigeria with 2,120 COVID-19-related deaths in over 14 months of the pandemic in the country is problematic, especially as other public health conditions kill more Nigerians annually. In 2018, for example, malaria and road traffic accident caused 97,200 and 38,902 deaths, respectively, while HIV/AIDS caused 43,000 deaths in 2019. Therefore, rushing into an extensive vaccination campaign projected to cost 540 billion naira when 76.03 billion naira was allocated for primary health services nationwide including other major immunization programs in the 2021 federal health budget could raise question of priority/effective spending. Especially with COVID-19 deaths relative to reported cases (case fatality ratio) declining to 1.30% by June 30, 2021 from 3.45% in April 2020 and daily mass deaths non-evident. Temporizing to understand how the pandemic evolves especially in jurisdictions with higher need could be cost-effective.

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Kwashi tremors or Kwashi shakes are uncommon neurological complications of unknown etiology seen in edematous forms of severe acute malnutrition (SAM) during rehabilitation phase of treatment. Four patients with SAM seen in our facility within a 30-month period who developed coarse tremors are presented. The aim was to highlight this uncommon presentation of SAM in our setting. Of the four patients, 3 were male and 1 was a female. Their age ranged from 19 months to 2 years and they weighed between 5.5 and 8.7 kg. Their common clinical presentation included body swelling, loss of appetite, fever, and tremors which developed after discharge. All the patients had increased/overzealous protein intake while at home. The tremors resolved completely in all the patients, but more slowly in two of the patients with hypocalcaemia. In conclusion, Kwashi shakes occurring during rehabilitation of edematous SAM with increased protein intake and appears to be worsened with hypocalcemia

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Background: Obstetric fistula (OF) continues to be a major health problem in developing countries such as Nigeria. It is a communication between the vagina and bladder/rectum following prolonged obstructed labor that leads to urine/and fecal leakage per vaginam. There is a paucity of information on cost of accessing care by women with OF. Objective: The study was to evaluate the cost implications of accessing care and treatment among women with OF in the National Obstetric Fistula Centre, Ningi Bauchi, state. Materials and Methods: A prevalence-based cost-of-illness approach was employed in this study to estimate the cost of fistula treatment from the patients' perspective. Data on costs of health-care utilization of services rendered to the patients in the facility and indirect costs were estimated. The data were analyzed with the Statistical Package for the Social Sciences (SPSS V21). Results: A total of 75 women participated in the study. The total costs incurred by all the 75 patients amounted to Nigerian Naira (NGN) 8211640.00 (USD 26923.41). The average cost of accessing care for fistula per patient was NGN109488.50 (USD 358.98). Direct cost accounted for 5751740.00 (USD 18858.16), whereas the indirect cost was 2785600.00 (USD9133.11). There was a significant difference in cost of care between patients that were teenagers compared to those who were not (P = 0.04) and the type of treatment (P < 0.001). Conclusions: The cost of illness of OF is high in the studied area, and the patients are from the low socioeconomic background. Both the direct and indirect costs were high relative to the national minimum wage in Nigeria. The age of the patients and the type of treatment received by the patient accounted for the differences in cost of illness between the patients.

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Background: Offspring of hypertensive parents have been reported to have alteration on their sympathovagal balance and have exaggerated response to stressful conditions. Many Christians observe a period of fasting at the beginning of every year, which imposes some stress on their bodies. Objective: This study aims to investigate the effect of 21-day intermittent fasting on some cardiovascular parameters in offspring of hypertensive and normotensive parents. Materials and Methods: Eighty young adults (20–28 years) were divided into equal number of male and female offspring of hypertensive and normotensive parents based on questionnaire. Their body weight, height, waist circumference (WC), body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded 1 week before the fasting period began and then weekly for 3 weeks, in which they fasted. Results: The weight, BMI, and WC reduced during fasting, but the reductions were not significant (P > 0.05). The SBP and DBP were higher in male offspring of hypertensive parents than all other groups. SBP was also significantly (P < 0.05) higher in males than females before fast and during fast. Fasting significantly reduced the SBP in the male offspring of both hypertensive and normotensive parents. The HR reduced in the females during fast but increased from a lower level in males to a value not significantly different from prefasting level. Conclusion: Fasting reduces the high SBP and DBP in male offspring of hypertensive parents, which is beneficial to their cardiovascular system.

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Background: Several atherogenic indices derived from the lipid profiles are postulated to better detect dyslipidemias and predict the risk of having cardiovascular events even in the presence of insignificant changes in individual lipid parameters. Objective: To compare the lipid ratios and atherogenic index of plasma (AIP) to conventional atherogenic indices among hypertensive type 2 diabetics to hypertensive nondiabetes (HND) controls. Materials and Methods: A case–control study in which 210 participants with type 2 diabetes mellitus with hypertension (hypertensive-diabetic [HD]) compared with 150 (n = 155) hypertensive without diabetes (HND) with similar ages were enrolled. Blood samples for fasting lipid profile were collected and analyzed, and the following indices and ratios were calculated: (TC/high-density lipoprotein-cholesterol [HDL-C]), (low-density lipoprotein-cholesterol [LDL-C]/HDL-C), (HDL-C/LDL-C), and AIP. The indices were compared in both the participants and control group. Results: There was no significant difference in the clinical characteristics of HD compared to the HND except the systolic blood pressure, weight, and HDL-C which were lower in the HND group. The frequency of dyslipidemia was found to be significantly higher in the HD group except elevated LDL-C in males (25.8% vs. 17.4%, χ² = 0.055, respectively). Furthermore, all the lipid ratios, except (Castelli risk index II [CRI– II] were found to be significantly different among HD as compared to HND group (P = 0.002, P = 0.045, respectively). Conclusions: This study concludes that Nigerians with both type 2 diabetes and hypertension have worse dyslipidemia and abnormal lipid ratios compared to those with only hypertension.

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Juvenile aggressive ossifying fibroma occurs in early life, and approximately 79% are diagnosed before the age of 15 years. Approximately 85% of cases were found in the face, while the calvarium and extracranial sites accounted for 12% and 3%, respectively. We present three females with psammomatous juvenile aggressive juvenile ossifying fibroma (JOF) of the maxilla diagnosed in our institution. While two of them were children of 11 and 12 years, the third was a 30-year-old. The histological type of JOF in all the three cases was the psammomatous type. They all had surgery with one of them having a radical maxillectomy.

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