Aims and Objectives: To determine the difference in outcome between a 1- day and 5- day antibiotic regimen in the prevention of infective complications following transrectal prostate biopsy. Patients and Methods: This prospective comparative study was done in the urology unit of University of Benin Teaching Hospital over a period of 14 months. Eighty seven patients were randomly assigned to 2 groups prior to the procedure. The patients in group I (N=42) received oral ciprofloxacin (500mg, 12 hourly) and oral metronidazole (400mg, 8 hourly) for 1 day while those in group II (N=45) received same antibiotic combination for 5 days. Urine samples for culture were taken an hour before the procedure and then 5 days after in all patients. Temperature monitoring with an easy-to-use thermometer was done thrice daily by the patients. Post biopsy fever and positive urine cultures were indicative of infection. Results : The mean age of the patients was 68.5± 8.1 years. Infective complications occurred in 8(19%) in group I and 7(15.6%) in group II. Fever was noted in 5 patients in group I and 4 patients in group II (p=0.73) while positive urine culture was noted in 4 patients in each group (p=1.00). Complications were minor and transient except in a case of septicaemia in group II that required hospitalisation. Escherischia coli was the most common organism isolated from positive urine cultures. Conclusion: A 1-day antibiotic regimen of oral ciprofloxacin and metronidazole is as effective as a 5-day regimenin the prevention of infective complications following transrectalprostate biopsy.

Aims and Objectives: To determine the level of compliance with driver's license laws among commercial bus drivers in Lagos, Nigeria. Subjects, Materials and Methods: Two intercity motor parks were selected by simple random sampling and all consenting minibus drivers participated in the study. Key Informant Interviews (KIIs) were also conducted with selected officials in the driver training and licensing authorities. Results: Compliance with the minimum age for driving was high (93.6%), so also was having driving test prior to driver's license procurement (83.3%). Formal driver training and VA testing were very low, (26.1% and 32.9% respectively) Overall, only 9.3% of them were found to have fulfilled all the pre-license obligations before obtaining their first driver's license. The odds of a driver with a secondary education having formal driver training is 3.33 times higher than those with no education (OR 3.33, 95% CI 1.01-11.35). Drivers who were 60 years or older were 3.62 times more likely to be compliant than those who were between 20-29 years (OR 3.62, 95% CI 0.56-29.19). For the 98.3% of them who possessed valid licenses, 52.3% of them obtained them illegally. All the key officials saw RTIs as a serious public health problem but faced several challenges in the course of their work. Conclusion:Overall compliance with pre-license regulations was very poor. There is need for a review and strict enforcement of driver's license laws to improve compliance. Also vital are fostering inter-sectoral collaboration and improvement in the operations of all establishments involved in driver training and license procurement in Nigeria.

Aims and Objectives: To determine the plasma concentration of fibrinolytic protein (D-dimer) and Fibrinopeptide A(FPA) in sickle cell anaemia (SCA) patients in steady state and vaso-occlusive crisis(VOC) for the purpose of determining their clinical value in assessing/or predicting the onset of VOC Subjects and Methods: A total of 25 (14 Males: 11Females) HbSS subjects in VOC , 24 (13M:11F) HbSS subjects in steady state between the ages of 10-40 years old and 30 (17M:13F) healthy HbAA volunteers, of the same age and sex with the subjects were recruited for the study. Haematological parameters{Haemoglobin (Hb), Haematocrit(HCT), White blood cell count(WBC) and Platelets(Plt)}, prothrombin time(PT), activated partial thromboplastin time(APTT), plasma concentrations of D-dimer and FPA were determined. Results: Haemoglobin concentration of 6.22±1.75 g/dl and HCT of 18.45±6.43% for SCA subjects in VOC; Hb of 7.42±1.36 g/dl and HCT of 22.83±4.68% in steady state were significantly decreased(p<0.01) compared with Hb(13.0±1.04 g/dl and HCT( 41.09±3.50%) for HbAA controls. However, plasma FPA of 680.99 ± 411.37 ng/ml, WBC of 19.44±14.88 x109/L, Plt of 292.72±148.57 x109/L, APTT of 52.24±5.34sec. for SCA subjects in VOC and Plasma FPA of 449.67 ± 310.01 ng/ml, WBC of 11.84±7.67 x109/L, Plt of 292.72±148.57 x109/L, APTT of 47.76±4.80secs in steady state were significantly increased when compared with FPA(163.52 ± 86.26ng/ml), WBC(5.15±1.24 x109/L), Plt(173.44±59.90 x109/), APTT( 37.75±1.41secs) for HbAA controls. Conclusion:Fibrinolysis is not significantly increased in SCA either in the steady state or during VOC. Fibrinopeptide A assay appears to be of value in the assessment of VOC in sickle cell anaemia.

Materials and methods- Archival formalin fixed paraffin embedded gastric Adenocarcinoma tumour tissue from the Department of Pathology, University College Hospital, Ibadan were studied for HER 2 protein status using immunohistochemistry. Results- HER 2 protein receptor status was determined in 36 cases using immunohistochemistry. The male: female ratio was 1.4:1. The age range of the patients was 30 to 86 years, with peak age-groups being in the 6th and 7th decade of life. Mean age of the patients was 57.6 years while the median age was 56years. Four cases were positive for the HER 2 receptor protein representing about 11% of the cases. Two cases had staining score of 2+ while another 2 cases had score of 3+. The four positive cases were intestinal variants of gastric adenocarcinomas based on Laurens classification. Three were well differentiated tumours and one was moderately differentiated. Conclusion-HER 2 protein overexpression by immunohistochemistry can be demonstrated in black Africans with gastric carcinoma. More detailed and multicentre studies will be needed to draw firm conclusions in this regard.

Aims and Objectives: The study assessed the knowledge level of doctors, their preparedness to respond to pandemic influenza and the preventive practices employed by them. Materials and Methods: A descriptive cross-sectional survey of doctors from a tertiary-referral teaching hospital in Benin City, Nigeria was conducted between August and October, 2011. Interviewer administered structured questionnaires were distributed to 240 doctors in different departments in the University of Benin Teaching Hospital. Results: In the study, 15.4% of participants had poor knowledge, 60.4% of respondents had fair knowledge and 24.2% of respondents had a good knowledge about pandemic human influenza. An analysis of attitudes showed that 46.2% of doctors have poor attitudes to work and only 10% had good attitude to work in the event of a pandemic human influenza emergency. Conclusion:Doctors had basic knowledge about how the virus is transmitted, symptoms and mode of spread of the human influenza infection, and about the preventive measures that should be taken. Most respondents had a poor attitude to work and did not consider themselves competent enough for role specific responsibilities during a pandemic. Up-to-date information and in-service training of health personnel will strengthen national preparedness and will delay international spread of novel influenza viruses.

Objective: This study was undertaken to determine the prevalence and severity of dental caries among a cross section of a sample from different locations in Chad as part of a general assessment of their oral health status. Methods: A cross-sectional descriptive survey of a nationwide sample included volunteers, 10 years or older, for a total of 1,011 participants. The survey consisted of a brief interview followed by a 1-2 minute oral examination of each subject. Results: The mean age of the participants was 29.61 ±12.59 years and the total mean value for Decayed/Missing/Filled Teeth (DMFT)=1.96 ±1.78. Females had a higher mean DMFT (2.72 ±1.88); decayed (2.82 ±1.07); missing teeth (1.81±1.14) than males (1.61 ±1.60): decayed (2.11 ±1.09); missing (1.45 ±0.89, respectively; all p<0.001). The older group (>30 years) had higher DMFT (2.79±1.93) than the younger group (d"30 years; p<0.001). Urban area showed lower DMFT (1.81 ±1.68) than rural areas (2.31 ±1.95). Conclusion: In this study, the prevalence of dental caries is very low which is similar to the most of the African Saharan and sub-Saharan countries. However, there is need to establish caries control programs to prevent tooth decay in the future and help people maintain lifelong dental health.

Aims and Objectives: This study was designed to evaluate dental conditions, factors contributing to these conditions, and treatment needs among a population from different places in Chad, as part of a general assessment of their oral health. Patients and Methods: A cross-sectional nationwide survey was conducted with 1,011 participants. The survey consisted of a brief health interview (conducted by dental students and public health specialists) followed by a 1-2 minutes oral examination (conducted by dental students and dentists). Results: Sixty four per cent of the subjects had experienced dental pain, 66.7% had decayed teeth, and 56.6% had gum diseases. Dental pain was found to be distributed according to age, gender and locations (p<0.001). Only 25% of the participants had ever visited a dentist. Males were show to engage in more tobacco use than females (19.2% vs. 0.3%), while females were more likely to have visited a dentist than males (30.8% vs. 22.8%). Brushing of teeth occurred more often in urban than in rural locations (p<0.001), while date, sugar cane and cola nut intake were statistically significant in the older generation compared to the younger subjects (p<0.001). Conclusion:There was a significant need for dental treatment and care in the sample population. In addition, the availability of sugar, combined with poor knowledge, utilisation of preventive and restorative oral health care services have been contributed to have several dental conditions.

Aims and Objectives The aim was to determine CT measured ocular biometry in Mid-Western Nigeria which may be employed on other Nigerians and Black Africans. Patients and Methods The ocular images of 200 patients that had normal cranial CT scans without ocular abnormality or complaints were retrospectively retrieved and analysed. The CT scans were done at the University of Benin Teaching Hospital. The axial length and width were obtained at the maximum mid-axial images and analysed using SPSS version 17 for measures of central tendency and correlations between variables (level of significance set at 0.05). Results The mean axial length was 21.4mm (right) and 21.6mm (left) while the width was 21.6mm (for right and left). The ocular biometry was larger in the left eye than the right, and also in males than females. The axial length and width increased with advancing age. ConclusionCT ocular biometry can be performed on previous cranial CT scans done for other reasons. The dimensions in this study may be used as a local normogram.

Aims and objectives: To describe the prevalence and pattern of eye disorders existing among commercial motorcycle riders (CMRs) in Ile-Ife, Osun State. Materials, Subjects and Methods: A total of 1626 registered CMRs operated in 40 registered motorcycle assembly units in Ile-Ife. Using a multi- staged random sampling technique, a total of 322 riders were randomly selected from 10 units. Equal number of 322 was selected from the sample space as control. Structured questionnaires were administered and ocular examination carried out. Results: A total of 312 (96.9%) CMRs had normal vision (better than 6/18) in the better eye. The observed prevalence of subnormal visual acuity (<6/18-3/60) was 3.1% (10 CMRs) while prevalence of monocular vision was 2.8% (9 riders). Cataract and glaucoma were the major causes of visual impairment and blindness. The common ocular conditions seen were presbyopia (11.8%), allergic conjunctivitis (11.5%), glaucoma suspect (8.1%), pterygium (4.7%), pingueculum (4.0%), uncorrected refractive error (3.7%) and cataract (2.8%). It was also observed that the longer the years of riding experience of these riders, the higher the occurrence of pterygium with a significant statistical impact of p value of 0.009. Presbyopia was also the commonest disorder amongst the control group (11.2%). Conclusion:Presbyopia was the most common finding from the study while the commonest anterior segment disorder was pterygium which was an occupation- related ocular disorder. Causes of blindness seen were avoidable.

Aims and objectives: This study was designed to document the Transvaginal Scan (TVS) findings in women presenting with infertility and menstrual irregularities at the University of Calabar Teaching Hospital. Materials and methods: Subjects were women of reproductive age presenting at the University of Calabar Teaching Hospital with menstrual irregularities and infertility over a two year period, February 2011-January 2013. As part of their management, transvaginal scans were done and findings included a substantial number with polycystic ovarian cysts. Therefore the ovaries were further analysed with controls. Results: Out of seventy-one women with age distribution of 22 to 46years, twenty- four(33.8%) presented with infertility, the rest presented with either menstrual irregularity alone or in combination with infertility. Polycystic ovaries (PCO), chronic pelvic inflammatory disease and fibroids were the main pathologies seen. PCO was by far the commonest. Ovarian volumes and follicular numbers were significantly higher in women with PCO than in controls, whereas their average follicular sizes were lower. Conclusion:PCO is the major finding in women with menstrual irregularity and infertility in the Calabar area. This hitherto poorly recorded pathology should be actively investigated in women representing with these symptoms by the use of TVS.

Aims and Objectives: This is a case of posterior reversible encephalopathy syndrome (PRES) associated with postpartum eclampsia in a primiparous Nigerian. Case presentation: A 20-year-old primiparous woman presented to the emergency unit of the department of obstetrics and gynaecology of our hospital with symptoms and signs consistent with postpartum eclampsia. While being managed for this, she developed weakness of the left limbs with associated altered sensorium. Significant findings on physical examination were hypertension, left-sided hemiparesis and cortical blindness. She had a computed tomographic (CT) scan of the brain which showed features consistent with posterior reversible encephalopathy syndrome. She was given full supportive care with control of her blood pressure and she made a significant improvement. She was discharged home about 3 weeks after admission with improvement in clinical condition and is currently being followed up in our neurology clinic. Conclusion: PRES complicating eclampsia is a clinicoradiological diagnosis. In most cases neurological symptoms improve with good supportive care and adequate treatment of the underlying condition as was the case in this patient. However permanent neurological sequelae can result from delayed diagnosis and treatment; therefore a high index of suspicion, early diagnosis and treatment are essential.

Advanced carcinoma of the prostate presenting initially with supraclavicular lymphadenopathy is uncommon. These are 2 cases of advanced prostate cancer that presented initially with persistent painless left supraclavicular mass. Both patients had elevated prostate specific antigen (PSA) level. This as well as histological finding of metastatic adenocarcinoma following biopsy of the neck masses necessitated referral to the urologists. Urological review revealed enlarged hard nodular prostate and transrectal prostate biopsy findings in keeping with high grade adenocarcinoma in both cases. The patients had initial clinical and biochemical response to androgen deprivation therapy with resolution of neck masses within 4-8 weeks of treatment. The authors advocate that men presenting with persistent supraclavicular masses should have a digital rectal examination (DRE) and a PSA test as part of their initial assessment