OBJECTIVES: We evaluated the usefulness of intradermal smear microscopy (IDS) in the detection of asymptomatic malaria parasitaemia in pregnancy. Peripheral venous blood (PVB) served as control. The preference for the collection technique of dermal blood was also assessed. PATIENTS AND METHODS: One hundred and fifty (150) asymptomatic women were recruited. They had both intradermal smear and peripheral venous blood smear were made for all patients. Measures of test validity included sensitivity, specificity and accuracy rate. Test of statistical significance was with Yates correlation at 95% confidence limit. RESULTS: The prevalence of asymptomatic malaria parasitaemia was higher using intradermal smear (35.3% vs 33.3%) though this was not statistically significant. Intradermal smear had a sensitivity of 40% and specificity of 67%. The positive predictive value was 37.8% with accuracy rate of 58%. 41% of participants preferred the technique of collection of intradermal blood. CONCLUSION: Intradermal smear appears to have no usefulness in the detection of asymptomatic malaria parasitaemia in pregnancy. However, we recommend more studies on its value in pregnancy, especially amongst symptomatic pregnant women.

BACKGROUND: Bacteraemia is a relatively common event in HIV-infected patients, especially in late infection. Studies in Africa have shown that more than 23% of AIDS patients have bacteraemia but there is paucity of data from Nigeria. METHODS: Blood samples from 67 consecutive patients with AIDS attending the Lagos University Teaching Hospital between April and August 2000 were cultured. Temperature, ESR, Full blood count, and where possible CD4 counts were obtained. Socio-demographic details were also recorded. Thirty apparently healthy people were randomly selected from a low-risk population to act as non-AIDS controls. The Oxoid Signal Blood Culture System was used to investigate bacteraemia. Antibiotic sensitivity tests were carried out on all isolates. RESULTS: Twenty-two (33%) of the 67 AIDS patients were culture positive. Non-typhoidal Salmonella spp (45.5%), coagulase-negative staphylococci (22.7%) and Staphylococcus aureus (18.2%) were most commonly isolated. One isolate each of Klebsiella pneumoniae, Pseudomonas aeruginosa and Bacillus spp were identified. All bacteraemic patients had temperatures above 38 degrees C and white blood cell counts ranged between 2,700-13,500/mm(3). There was a high rate of antibiotic resistance particularly to chloramphenicol, tetracyclines, cotrimoxazole and beta-lactam antibiotics. However, most isolates were still susceptible to gentamicin and the fluoroquinolones. There was no significant difference in the socio-demographics of the bacteraemic AIDS and non-bacteraemic AIDS patients. CONCLUSION: Salmonella spp. were the most common aetiological agent of bacteraemia among AIDS patients seen at the Lagos University Teaching Hospital (LUTH), Nigeria. A high temperature was a pointer to the presence of bactaeraemia while total white blood cell counts were not useful. It is recommended that blood culture should be done for AIDS patients with elevated temperature irrespective of the total white blood cell count.

OBJECTIVE: This study assessed the knowledge and perception of house officers on halitosis in the University College Hospital, Ibadan. PATIENTS AND METHODS: Questionnaires including items relating to knowledge of halitosis, awareness and timing of bad breath, oral hygiene habits and opinions on other issues related to bad breath were administered to the subjects. RESULTS: Only seventeen (15.5%) of the 110 respondents knew that halitosis refers to malodour originating from the oral and nasal cavities while five (5%) were of the opinion that halitosis is only a cosmetic problem. Furthermore, thirty nine (35.5%) preferred not being told by a friend or colleague if their breath smells badly. CONCLUSION: The knowledge and perception of the newly qualified doctors to halitosis in this study is unsatisfactory. Therefore, concerted efforts should be made to improve them. This could be achieved by more emphasis on this subject during their undergraduate training.

AIMS AND OBJECTIVES: To find out the causes, time of presentation for ultrasound scan, pattern of eye injuries and orbital ultrasound findings in patients with orbito-ocular trauma. MATERIALS AND METHODS: Retrospective study of request cards, case notes and ultrasound reports of 67 patients who had trauma to the eye and were assessed with ultrasonography over a 3-year period (between 20th January 2000 and 19th January 2003) was done. The collected data included age, sex, presenting complaint, past medical history, duration of the injury before presentation to ultrasonographic study and ultrasound findings. RESULT: Sixty-seven patients were seen consisting of 54 males (83.58%) and 11 females (16.42%) with male to female ratio of 5:1. Age range was 4 to 91 years with mean age of 30.8 years. 44 patients (65. 67%) had blunt trauma while 23 patients (34.32%) had penetrating trauma. The causes of the ocular trauma include road traffic accidents 32 (47.76%), assaults 16 (23.88%), gunshot injuries 10 (14. 93%), sports injuries 5 (7.46%), and falls from heights 4 (5.92%) patients. 42 patients (53.73%), especially those with severe injuries presented late for ultrasonography. Those who made early presentation were cases of assault because of police involvement. Forty-five patients (67.16%) had structurally identifiable pathology in one or both eyes. Retinal detachment 18 (26.87%), vitreous haemorrhage 17 (25.37%), traumatic cataract 13 (19.40), ruptured globe 6 (8.96%) and posterior dislocation of the lens 6 (8.96) were the commonest abnormal sonographic findings. In 22 patients (32.84%) both eyes were normal. CONCLUSION: Ultrasound scan is a useful imaging modality for examination of the globe in patients with ocular trauma. Road traffic accident is the commonest cause of traumatic ocular injury affecting the globe. Retinal detachment and vitreous haemorrhage are the most frequent injuries to the globe diagnosed by ultrasound scan. Measures to reduce road traffic accidents will have far reaching positive effect in preventing blindness resulting from orbito-ocular trauma in Nigeria.

OBJECTIVE: To determine the awareness and practice of vasectomy among male health workers at University College Hospital, Ibadan and the influence of socio-demographic factors. METHOD: This is a descriptive cross-sectional study in which structured self-administered questionnaires were used to interview married male health workers at the University College Hospital, Ibadan between May and July 2006. RESULTS: Two hundred and fifty responses were analysed. The mean age was 36.7 (+/- 5.4) years. Two hundred and thirty nine (95.6%) respondents were married, 10 (4.0%) were separated while one (0.4%) was divorced. One hundred and fifty-one (60.4%) respondents were medical doctors while 34 (13.6%) were laboratory scientists. Fourteen (5.6%) respondents were pharmacists while 9 (3.6%) and 23 (9.2%) of the respondents were records officers and nurses respectively. Nineteen (7.6%) respondents belonged to other professions. Two hundred and twenty five respondents (90%) knew about vasectomy while twenty five respondents (10%) were not aware of it. One hundred and forty-five (58.0%) of the respondents were unwilling to accept sterilisation as a contraceptive procedure while 48 (19.2%) were willing to accept it and the remaining respondents 57 (22.8%) were uncertain. The cadre of medical profession and being previously aware of vasectomy were statistically significant with the willingness to accept vasectomy (chi(2) = 20.943, p= 0.021 and chi(2) = 10.666, p = 0.005 respectively). However none of the respondents had ever had vasectomy done. CONCLUSION: Some health workers are not aware of vasectomy or have some misconceptions about it. Family planning and contraception should be inculcated into the curricula of schools producing health workers such as laboratory scientists, radiographers etc. This will go a long way in improving their knowledge and attitude to vasectomy.

OBJECTIVE: To assess the knowledge and practice of food hygiene and safety among food handlers in fast food restaurants in Benin City, Edo State. METHODOLOGY: A descriptive cross-sectional study was carried out among 350 respondents who were selected by means of a systematic sampling method and interviewed using a semi-structured researcher-administered questionnaire. An observational checklist was thereafter used to inspect their personal hygiene status. RESULTS: The mean age of the food handlers was 26.4 +/- 6.1 years. Two hundred and twenty eight (65.1%) were females while 34.9% were males. A majority (98%) of the respondents had formal education. There was good knowledge and practice of food hygiene and safety among the respondents. Knowledge was significantly influenced by previous training in food hygiene and safety (p = 0.002). Food handlers who had worked for longer years in the fast food restaurants had better practice of food hygiene and safety (p = 0.036). The level of education of respondents did not significantly influenced their practice of food hygiene and safety (p = 0.084). Although, 299 (85.4%) food handlers were generally clean, skin lesions was seen in 4 (7.3%) of them. CONCLUSION: This study showed good knowledge and practice of food hygiene and safety by food handlers in the fast food restaurants in Benin City, but there is need for improvement through training and retraining of food handlers by the management of the restaurants and the local government authorities.

OBJECTIVE: The conventional treatment of Hirschsprung's disease involves colostomy creation, excision of aganglionic segment, pull through using normally ganglionated proximal bowel segment and colostomy closure. The ultrashort segment variety is treated with posterior anorectal myectomy which requires no prior colostomy creation. This study sought to evaluate the benefits and outcomes of the procedure in a tertiary hospital in Nigeria. PATIENTS AND METHODS: All children diagnosed with ultrashort segment Hirschsprung's disease between January 2003 and December 2007 at the University of Benin Teaching Hospital, Benin City, were prospectively studied. RESULTS: Of 64 children managed with Hirschsprung's disease in five years, 11 (17.2%) were diagnosed with ultrashort segment variety and had posterior anorectal myectomy without prior colostomy. They comprised 7 males and 4 females with male/female ratio 1.8:1 and were aged between 1 month and 9 years (mean 1.5 +/- 0.8 years). The procedure was well tolerated and gave satisfactory results in all the patients as no wound infection or any life threatening morbidity and mortality was recorded. Postoperative pain which responded to paracetamol in the majority of children was statistically significant in older compared to younger patients (P<0.0001). Oral feeds were commenced and tolerated earlier, length of hospitalisation was shorter and no incontinence was recorded unlike the conventional treatment. Also, postoperative nursing care was easier and the single procedure resulted in availability of theatre space for other paediatric operations. All the children did well on 9 months to 4 years follow-up. CONCLUSION: The procedure was found to be beneficial and effective for ultrashort segment Hirschsprung's disease, and should be employed in this subregion.

OBJECTIVES: The objectives of this study were to determine the prevalence and pattern of stimulant use and its association with 'brain fag syndrome' among secondary school students in Osogbo, Osun State. The study also aimed to determine the association of socio-demographic variables (of the students and their parents) with stimulant use. MATERIALS AND METHODS: A questionnaire consisting of sociodemographic variables, the stimulant use section of the WHO Student Drug Use Questionnaire and the Brain Fag Syndrome Scale (BFSS) was administered on randomly selected students of the two Local Government Areas of Osogbo. The prevalence rates of stimulant use were calculated and the association of stimulant use with Brain Fag Syndrome (BFS) and socio-demographic variables was determined. RESULTS: The 30-day prevalence rate of stimulant use was 20.3%. Users engaged more in the use of common and cheap stimulants (coffee and kola nut). Majority of users started at age 13 years or below. There was a very high relationship between stimulant use and the symptoms of the BFS (p<0.001). Stimulant use was associated with lower age group, poor school attendance, polygamous background, low education of mother, high education of father and the description of mother as being too permissive. CONCLUSION: The findings suggest the need to increase the awareness of the dangers of stimulant use among students. Control programmes are urgently needed to prevent student wastage.

Urethral diverticulum is a localised out pouching or fusiform dilatation of the urethra. It is an uncommon clinical entity affecting both males and females. Although, the diagnosis could be straightforward in the males, it may present as a diagnostic puzzle in the female because it often presents with non-specific symptomatology and diagnosis may not be easily made with common investigation techniques. Two cases of urethral diverticulum are presented to highlight the aetiopathogenesis of urethral diverticulum.

AIM/BACKGROUND: We report a rare case of pleomorphic adenoma arising from the lateral nasal wall. PATIENT AND METHOD: A 23 year old woman presented with a 9 month history of right sided nasal mass with progressive nasal obstruction. A CT-Scan of the paranasal sinuses was carried out and the mass was excised intranasally. RESULTS: A CT-Scan of the nose and paranasal sinuses showed a soft tissue mass in the right nasal vestibule measuring 2.33 x 3.04 cm in its widest dimension. There was associated expansion of the cavity with displacement of the nasal septum and thinning of the medial wall of the right maxillary antrum adjacent to it. The microscopic finding showed a lobular duct-like structure within a loose chondromyxoid stroma, which are histological characteristics of pleomorphic adenoma. CONCLUSIONS: Her post-operative clinic visits were uneventful, and she is currently disease-free; nine months after surgery. The diagnosis, clinical behaviour and treatment of pleomorphic adenoma of the lateral nasal wall are discussed from a review of the literature.