1BABADOKO AA, TAKAI IU, KAWUWA MB

Background: Blood groups antigens and haemoglobin genotypes are genetically controlled and are specific to an individual. Blood groups remain unchanged throughout life and are important to avoid fatal blood transfusion reactions. Haemoglobin phenotypes are necessary for the laboratory detection of most common clinically important haemoglobin variants as it determines the transfusion demand which is necessary for setting up and planning of a blood transfusion unit. Objectives: To determine the distribution of ABO, Rh D blood groups and haemoglobin phenotypes in pregnant women attending antenatal care at the Federal Medical Centre (FMC) Nguru, Yobe state, North-Eastern Nigeria. Methods: A retrospective chart analysis of 5,519 records of pregnant women who were sequentially booked in antenatal care clinic at the permanent site of FMC Nguru, over a 2 year period, from January 2009 to December 2010. The ABO and Rh D blood groups and haemoglobin electrophoretic pattern were obtained from the haematology antenatal record register and analyzed. Results: Overall, a total of 5474 and 5508 records were analyzed for ABO/Rh D blood groups and haemoglobin electrophoretic pattern respectively. The mean age of the study subjects was 24.6 ± 5.84 years and a mean packed cell volume of 32.6 ±4.51%. Blood group O was commonest accounting for 49.2% followed by blood group B (26.0%) and A (21.3%) while blood group AB had the lowest distribution of 3.5% (O>B>A>AB). Rhesus Rh D positivity (RhD/RhDd) rate was 95.4% while RhD negativity (Rhdd) accounted for 4.6%. Five haemoglobin phenotypes (electrophoretic pattern) were recorded in the order of HbAA (76.12%) > HbAS (23.4%) > HbAC (0.27%) > HbSS (0.16%) > HbSC (0.05%). HbAA and HbAS occurred more frequently than other haemoglobin variants. Conclusion: Although our study included only pregnant women, the finding of this study is consistent with the previously published data in Nigeria. This study will serve as a baseline data for FMC Nguru to determine and formulate an effective and efficient blood transfusion services amongst pregnant women and also it will serve as a guide for premarital counselling in this community.

Background: Cord blood provides data on problems of neonates including factors that may serve as indicators of future disorders. Objectives: To determine the values of growth hormone, testosterone and estradiol using cord blood. Methods: Cross-sectional study using Cord blood of babies born in the labour ward of the University of Maiduguri Teaching Hospital (UMTH) Borno State, Nigeria. The samples were analyzed in the Department of Medical Laboratory Science, Chemical Pathology Unit, University of Calabar, Nigeria. Enzyme- linked immunosorbent assay (ELISA) specific for the analysis of growth hormone, testosterone and estradiol was used. Results: Two hundred and eighty nine babies comprising 152 (52.8%) males and 137 (47.2%) females cord blood were analyzed. Nineteen were preterm and 270 were full term babies. The mean serum levels of estradiol and testosterone in both male and female babies were similar (2.47±0.31ng/ml male, 2.54±0.29ng/ml female and 1.73±0.60ng/ml male, 1.62± 0.64ng/ml female) respectively. The mean serum level of growth hormone in male was higher than that of female but not statistically significant (50.92±34.42ng/ml male and 45.95±30.87ng/ml). Conclusion: Cord blood Growth Hormone, testosterone and estradiol of male and female babies do not differ significantly at birth.

EBEIGBE JA, OVENSERI-OGBOMO GO

Background: Visual impairment and blindness due to ocular diseases are significant public health problems in developing countries, including Nigeria. Evidence suggests that poor uptake
of available eye care services by potential beneficiaries is a major barrier to attaining universal access to eye care services. Objectives: To determine the factors that prevents utilization of eye care services in rural communities. Methods: This was a cross- sectional community based survey. Three rural communities in three different Local Government Areas- Obe, Evboneka and Orior of Edo State were selected by convenient sampling. One hundred subjects were selected by systematic random sampling from each of the three villages visited. This made a sample size of 300. There were 132 (44%) males and 168 (56%) females. The age range was between 40 to 75 years, with a mean age of 55.2 ± 2.1 years. Results: The barriers identified were felt need for eye care services (33.3%), cost of treatment (26.7%), the need for escort (8.3%). and social engagement/belief (8.3%). Sixty-eight per cent of the sample population had never had their eyes examined in a hospital before. Of the thirty-two per cent of those who had gone to the hospital for eye care services, 21% were females. This resulted in a statistically significant difference in gender utilization of eye care services ( p<0.0001). There was also a significant association between the level of education and health care seeking behaviour of the sample population (p = 0.008). Conclusion: The findings of this study suggest that ignorance, poverty and gender are major barriers to utilization of eye care services by communities. Health promotion programmes need to incorporate community based health education and explore ways of making eye care services affordable in rural areas. Also, enlightenment programmes and workshops targeted at men should be carried out to educate and encourage better eye care seeking behaviour among them.

GWALABE SA, YUSUPH H, MUSTAPHA SK, IGE OM, GONI BW, BAKKI B, TAHIR A

Background:tuberculin, a Purified Protein Derivative (PPD), is introduced into intradermal tissues using a small-gauge needle. The amount of induration is measured in mm after 48-72 hours. In the setting of malnutrition, DTH responses are markedly depressed. 8 The significance of these effects depends on previous nutritional status of the individual, and the nature and duration of infection. 9 Malnutrition is observed frequently in patients with PTB 10 and it has a profound effect on cellular immune function. It is an important risk factor for TB, given that CMI is the key host defence against TB. The aim of the study was to determine the relationship between the intensity of Mantoux responses and serum albumin in HIV-negative sputum smear positive PTB patients in Maiduguri, Borno State, Nigeria

YERIMA MM, WAKIL MA, IBRAHIM AW

Background: There are many studies on the knowledge of, attitude towards and practices of mental health workers towards mental illness in Nigeria. However, there are few studies on the knowledge of, attitude towards and practices of traditional mental health practitioners towards mental illness. Objectives: The present study investigated the knowledge of, attitude and practices of traditional mental health practitioners towards mental illness. Methods: We recruited four traditional mental health practitioners (in a traditional mental healing house) into
the study, and used focus-group discussion to explore the knowledge of, attitude towards and practices of traditional mental health practitioners in Gombe, Nigeria. Results: All the
participants were married Muslims, aged between 39 and 53 years (mean age of 47 years). They attributed the causes of mental illness to Aljannu (evil spirit/demons), febrile illness and
disorientation. Sleep deprivation and “increased power of the blood” were the mechanisms for the causation of mental illness. Conclusion: Traditional healers in Gombe treat most of the
patients with mental illness, despite their poor knowledge of the causes and principles of treatment of mental disorders. This calls for increased public awareness of mental illness

MUSTAPHA Z, ABUBAKAR A, MODU AA, PINDIGA UH, OKEDAYO M, ANNONGU IT

Background: BIRADS 5 breast lesions are greater than 95% suggestive of malignancy according to the ACR-BIRADS lexicon. Objectives: To review histological outcome, positive predictive values, and specificity of BIRADS category 5 breast lesions. Methods: This retrospective study reviewed all the demographic and histopathologic results of patients with BIRADS 5 breast lesions diagnosed in university of Maiduguri teaching hospital, North Eastern Nigeria over a period of one year with their 2 year follow-up mammogram. Results: Twenty three patients, aged 17 – 60 years, with mean age of 40+ 10.1 years were diagnosed with BIRADS 5 breast lesion during the study period. The lesions were bilateral in one (4.3 %), on the right side in 9 (39.1 %) and on the left side in 13 (56.5%) patients. Nineteen (82.6%) had malignant lesions, with invasive ductal carcinoma being the commonest malignancy (69.6%) and fibroadenosis was the commonest benign lesion 2 (8.7 %). The specificity and Positive Predictive Value were 50% and 82.6% respectively. Conclusion: The cancer rate in our study is about 82.6 % which is lower than the BIRADS lexicon of 95%, therefore we recommend a detailed verification of the BIRADs categorisation in our environment.

YAUBA MS, AIKHIONBARE HA, OGUNRINDE GO, BUGAJE MA

Background: Screening for urinary tract infection (UTI) among children with SCA can lead to early detection of UTI in childhood. This may necessitate further evaluation and early effective interventions with reduction in the number of individuals who develop end-stage renal disease (ESRD). Objectives: To evaluate the usefulness of nitrite test in screening for UTI in children with SCA. Methods: Two hundred and seventy two children with SCA both in steady state and in crisis (anaemic and vaso-oclusive), aged 6 months to 15 years were screened for significant bacteriuria. The study was conducted over a period of 8 months (February to September, 2012). Urine samples were aseptically collected and incubated aerobically at 37°C for 24 hours. The study was conducted in the paediatric medical ward, emergency paediatric unit and institute of child health, Banzazzau all of the Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria. Children whose urine samples yielded =105cfu/ ml of urine on two consecutive cultures were regarded as having significant bacteriuria. Results: Bacterial isolates were detected in 22 (8.1%) of the 272 subjects with SCA. Of the 272 children with SCA, 66 (24.3) had positive nitrite test. The nitrite test has the sensitivity, specificity and positive and negative predictive values of 68.2%, 79.6% and 22.7% and 96.6% respectively. Conclusion: Nitrite test is not a useful screening tool for the diagnosis of UTI in SCA children..

MUSTAPHA Z , MINOZA K , OKEDAYO M , ABBA ALI A , NGGADA HA , KYARI M

Background: Male breast diseases are uncommon and male breast cancer is rare, constituting about 1% of breast cancers seen worldwide. Previous studies have shown that gynecomastia and carcinoma are the commonest conditions affecting the male breast, with increasing incidence of both in recent years. Imaging studies of male breast diseases constitute only about 1% of overall breast imaging in most centres. Objectives: To determine and document the pattern of male breast diseases seen in the mammography unit of Department of Radiology, University of Maiduguri Teaching Hospital. Methods: A retrospective study of all male patients with complaints of breast swelling referred for imaging at the department of Radiology, University of Maiduguri Teaching Hospital over a six year period from September 2007 to December 2013. The medical records, imaging and biopsy results were reviewed. Results: Ten male patients were referred for breast imaging, ranging in age from 14 to 58 years with mean age of 31.3 + 13 years. Nine (90%) had gynecomastia, of which five were histologically-proven, and one had acute mastitis. Carcinoma was not diagnosed in any of these patients. The left breast was affected in 80% of cases. Conclusion: Gynecomastia is the commonest male breast lesion in our environment. Awareness of the usefulness of imaging studies of male breast lesions needs to be encouraged..

PINDIGA UH, ABDULLAHI YM, 1ADOGU IO, SULEIMAN IE

SUMMARY:Bronchogenic cysts are uncommon and occur along the trachea-bronchial tree, lungs and mediastinum and even more uncommon in the skin tracheo-bronchial tree especially the anterior chest wall. It is a congenital abnormality that arises as a result of abnormal budding along the foregut in early embryogenesis. The diagnosis is usually missed clinically and majority of the cases are histologically diagnosed. The diagnosis in our case was histologically made and revealed a fibromuscular cyst wall lined by pseudostratified ciliated columnar epithelium with few goblet cells and sub-epithelial mucinous glands. We report a case of cutaneous bronchogenic cyst that occurred in the skin of the anterior chest wall over the manibrium sterni.

IBRAHIM AG, ALIYU S, ADAMU S, SALIM MU

SUMMARY Cryptoorchidism or undescended testis is the most common congenital genitourinary disorder in boys. The true undescended testis has stopped along the path way of normal descent, while ectopic testis is in an aberrant location, such as the base of the penis, superficial inguinal pouch, medial aspect of the upper thigh, or the contra lateral scrotal sac. The undescended or ectopic are both referred to as maldescended testis. We report a case of a 30 months old child with ectopic right testis at the dorsum of the base of the penis who was managed by orchidopexy

Ibinaiye PO, Lawan RO, Polite O, Hamidu HU, Igashi B

Background:Structural abnormalities are amongst the important causes of female infertility. Hysterosalpingography (HSG) is an invasive but safe method of detecting both cervical and uterine pathologies. Objectives: The objective of this study was to determine the relationship between types of uterine and cervical abnormalities and fertility outcome. Materials and Methods: A prospective study of 220 consecutive women who underwent hysterosalpingography using ionic water-soluble contrast media (urografin) between 1st December, 2011 and 31st May, 2013, at department of radiology, Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. Clinical notes and radiological findings were analyzed for demographic data and abnormal uterine cavity and cervical canal findings. Abnormal findings were correlated with treatments and fertility outcomes. Fertility outcome in women with normal and abnormal findings were compared. P- Value of less than 0.05 was considered as statistically significant. Results: The mean age and duration of infertility were 27.37years ± 4.50 and 4.48years respectively. Women with secondary infertility were 133 (60.50%) while 87 women (39.5%) suffered from primary infertility. The uterine cavity was normal in 167 (75.9%) of the women while 53 (24.1%) women had uterine cavity abnormalities; among these were 16 (30%) with primary infertility and 37 (70%) with secondary infertility. Cervical canal was normal in 210 (95.5%) of the women while 10 (4.5%) women had abnormalities among whom are 5 (50%) that suffered from primary infertility and 5 (50%) that suffered from secondary infertility. The fertility outcome after one year follow up showed 7 (11.1%) of the 63 patients with abnormal findings (cervical canal and endometrial cavity) got pregnant, while 25 (34.72%) of the 72 patients with normal findings (cervical canal, endometrial cavity, tubal and pelvic peritoneum) got pregnant. The difference noted was statistically significant (p – value = 0.001). High (12: 34.3%) spontaneous pregnancy rate was noted in patient with normal HSG, hormone and semen analyses. Conclusion: Fertility outcome among women with uterine cavity and cervical canal abnormalities but with normal hormone and semen analyses was low. The high spontaneous pregnancy rate in patients with normal HSG, hormones and semen analyses may be due to therapeutic effect of HSG.

Background:A high prevalence of subclinical hypercortisolism has been suggested in patients with type II diabetes mellitus with poor metabolic control and several observations have suggested that in type II diabetes patients, subclinical hypercortisolism may be more frequent than previously expected, however, results are inconclusive. Objectives: This study investigated the effect of glycemic control on serum cortisol levels in type II diabetics. Materials And Methods: The levels of serum cortisol, fasting plasma glucose and glycated haemoglobin were estimated in fifty five (55) type II diabetic patients attending the Diabetic Clinic of University of Calabar Teaching Hospital, Calabar and thirty three (33) non-diabetic controls. Consecutive sampling method was used. Serum cortisol was determined using enzyme immunoassay; fasting plasma glucose using colorimetric method and glycated haemoglobin using cation-exchange resin separation method. Results: The mean serum cortisol levels were significantly higher in diabetics as compared to the controls. The diabetics with poor glycemic control had significantly higher mean fasting plasma glucose and glycated haemoglobin compared to those with good glycemic control. However, there was no significant difference in the mean cortisol levels between the diabetics with poor control and those with good control. Conclusion: The diabetics in this study had elevated levels of serum cortisol. Cortisol levels in the diabetics were not affected by glycemic control..

ADAMU S , AKINOSUN OM , ABBIYESUKU FM , KUTI MAO , JIBRIL M. EL-BASHIR, OLUWATOYIN GO, ALAYA RO MARAFA B.

Background:Occupational exposure to toxic chemicals is a major public health concern worldwide. Gasoline, especially the leaded form is a leading cause of this occupational exposure in developing countries such as Nigeria. Exposure to gasoline has been shown to generate oxygen free radicals which are implicated in the pathogenesis and progression of many diseases including renal dysfunction. The objective of the study is to evaluate the possibility of increased risk of renal dysfunction among roadside petrol dispensers in Gombe, Nigeria. Objectives: To determine the risk of renal dysfunction among road side petrol dispensers in Gombe. Materials And Methods: A cross sectional analytic study, where serum levels of uric acid, urea and creatinine were compared between 90 road side gasoline dispensers and 90 matched controls. These were measured using standard colorimetric methods. Results: The mean age of the exposed and control groups are 29.03 ± 3.7 and 29.24 ± 3.5 years respectively. The plasma level of uric acid (5.35± 0.9mg/dl) of the exposed group was significantly (p< 0.05) higher than the control (4.48± 0.9mg/dl). There was no significant difference in the plasma levels of urea and creatinine in the two groups studied. Conclusion: This study has shown that road side gasoline dispensers may be at a higher risk of renal impairment. Creating awareness of this risk among roadside gasoline dispensers could help reduce the burden of renal disease associated with exposure to gasoline.

OKHIONKPAMWONYI O & OKONTA PI

Background:Hysterectomy is a common gynaecological surgical procedure which improves womens's quality of life. Objectives: To determine the indications and complications of Total abdominal hysterectomy (TAH) at the Central Hospital, Warri (CHW). Materials and Methods: This was a retrospective descriptive study of TAH performed at the CHW from 1st January 2007 to 31st December 2011. Medical records of all patients that had TAH were reviewed. Results: Two hundred and thirty six patients had TAH. It constituted 11.6 % of all gynaecological surgeries at the CHW. The mean age was 44.78 ± 1.28 years. The mean parity was 3.79 ± 1.08. Uterine fibroids accounted for majority of cases (66.1%). About 54.2% of patients had TAH with bilateral salpingooophorectomy (BSO). Fifty patients (21.2%) had complications. Wound sepsis/breakdown, anaemia, prolonged hospital stay, urinary tract infection and pyrexia were the common morbidities. Conclusion: The indications for, and surgical outcome following TAH is comparable to that from other public hospitals across the country.

ASKIRA BH, WAZIRI MA, MUSA ZY, RIBADU DY, KYARI FA.

Background:Glaucoma is second only to cataract as the leading cause of preventable blindness in the world. The devastating effect of this disease is often neglected. Most people with glaucoma are usually unaware that they have the disease until significant loss of vision has occurred. Objectives: The aim of the study is to establish the level of awareness to glaucoma among staff of University of Maiduguri Teaching Hospital. Materials and Methods: This cross sectional descriptive study conducted as part of glaucoma awareness campaign to mark the World Glaucoma Week. The entire staff of the University of Maiduguri Teaching Hospital that voluntarily consented to the study were recruited. A structured questionnaire was designed and administered in the clinic during the screening exercise. Results: A total of 285 participants were recruited. The ratio of male (M) to female (F) was 1.4:1. The most frequent age group was 40-49. Glaucoma awareness was found to be 60.4% .The sources of awareness of glaucoma were 41.8% from doctors, 29.7% from news media and 14.0% from nurses. A total of 40.7 % know that glaucoma can cause blindness and 32 % know that glaucoma blindness is irreversible. Conclusion: In this study the awareness of glaucoma is high. Further studies to determine the knowledge and adverse affect of glaucoma on vision are advocated.

KOLO ES

Background:Choanal atresia is a rare congenital failure of communication of the nasal cavity and the nasopharynx. The technique for the surgical repair of choanal atresia has evolved from the blind transnasal puncture to the currently favored endoscopic transnasal approach. This study aims at
assessing the technique of endoscopic transnasal choanotomy; and highlight if any its benefits in our practice. This is an on-going study of all consecutive patients with choanal atresia, who had endoscopic transnasal choanotomy at the Otorhinolaryngology department of Aminu Kano Teaching Hospital from January to October, 2014. Four patients were recruited into the study and they all had endoscopic transnasal choanotomy with stenting of the neo- choanae. There were 3 females and 1male and their ages ranged between 12days and 18years. They all presented with varying degrees of persistent nasal obstruction, rhinorrhea and respiratory distress. Diagnostic nasal endoscopy and CT scan confirmed 1 patient had a bilateral membranous type atresia, 1 had bilateral bony atresia and 2 had right sided mixed membranous/bony atresia. Post-operative complications included rhinosinusitis, stent extrusion and granulation tissue formation. Follow ups at various intervals revealed 3 patients had adequate neo-choanal patency and 1 had a restenosis and was re-operated. This study found endoscopic choanotomy safe and effective in the treatment of choanal atresia in our practice

GABKIKA BM, MANGDAH BE, KAIMBA Bm, ADOUM T

ABSTRACT:-Rupture of a gravid uterus is a rare complication of motorcycle accident. We report the case of a 33-year old woman, gravida 6, referred as a case of uterine rupture with intrauterine fetal death at 36 weeks gestation, following a motorcycle accident. Emergency laparotomy revealed an anterior - lateral uterine rupture on the right side about 11 cm which involved the ipsilateral uterine artery. A conservative surgical treatment was employed. Splenectomy was also performed.

PINDIGA UH, ABDULLAHI YM, ADOGU , GUDUF M , TAHIR NM

ABSTRACT:-Collision cancers of the gastrointestinal tract involving lymphomas are very rare. We report a case of collision cancer involving a well differentiated colonic adenocarcinoma and corresponding mesenteric Hodgkin lymphoma. The sentinel lymph node shows metastatic adenocarcinoma however, lymph nodes further away within the mesentery revealed mixed cellularity Hodgkin lymphoma. We want to emphasise that collision adenocarcinoma and Hodgkin lymphoma especially of the mesenteric lymph nodes is a very rare event.

EHALAIYE B, NDONYA-SALEH D, YOHANNA J, KWAGHE BV

Background:A 20 year old para 2, presented at our gynaecological clinic with a 4 year history of “something protruding from her vagina”. She was referred to us with a diagnosis of utero-vaginal prolapse. Examination revealed a 6x6 cm, cystic, anterior vaginal wall mass, which was confirmed to be a vaginal cyst on ultrasound. Surgical excision of the cyst was done and histopathology confirmed it was of mullerian origin. Vaginal mullerian cysts are usually small and asymptomatic, but may rarely enlarge as reported in this case. They are therefore important in the differential diagnosis of utero-vaginal prolapse or cystocele.

IBRAHIM AG, ALIYU S, LAWAN AM, SALIM UM.

Background:Male circumcision is a common surgical procedure that involve excision of the prepuce, which is practiced all over the world for religious and cultural reasons. Medically it has the advantages of preventing phimosis, paraphimosis, balanitis, and decreases the risk of cancer of the penis. Common complications of circumcision are hemorrhage, sepsis, and inadvertent trauma. Excessive unusual bleeding may follow circumcision in hemophilia and other bleeding disorders. We report a case of such bleeding that necessitated transfusion of blood and fresh frozen plasma.