Aims and objectives: - To determine the prevalence of ADHD, epilepsy co-morbidity and social and clinical correlates in Nigerian children. Patients and methods: - A cross-sectional study of 113 children with epilepsy was carried out and assessed for ADHD prevalence using the home version of the ADHD Rating Scale IV. The presence of certain variables occurring in association with the co-morbidity was also determined. Results: - Sixteen (14.2%) children had ADHD, epilepsy co-morbidity. The inattentive subtype of ADHD was the most common (68.8%). The factors that were significantly associated with the co-morbidity were poor academic performance ( p=0.01), living in rural areas ( p=0.00), history of status epilepticus ( p=0.00) and the presence of other associated neurological pathologies ( p=0.00). Conclusion: - Children with the co-morbidity are more likely to be those that are underachieving academically, with history of status epilepticus, family history of epilepsy, and abnormal EEG. Children with the co-morbidity should be actively sought after and managed accordingly.

Aims and Objectives: To assess caregivers' knowledge of their child's illness following hospital admission and to determine whether healthcare workers (physicians and nurses) render health information during their daily routine works. Patients and methods: This cross-sectional descriptive study was carried out from July to October 2012 in University of Benin Teaching Hospital, Benin City, Nigeria among 108 caregiver and child (ages 0 - 5 years) pairs admitted in the paediatric wards of the hospital for common childhood illnesses. A semi-structured interviewer-administered questionnaire was used to obtain data from the caregivers. Each child's case note was then reviewed to extract data on child's disease diagnosis and to check and categorize whether the attending physician(s) documented the content of health information provided to the caregivers. Analysis of data was done using Statistical Package for Social Sciences version 16. Results: The children were 48 males and 60 females with mean age [SD] 19.6 [15.4] months. The caregivers mean age [SD] was 32.1[7.1] years (range 15 - 60 years). Majority (38.0%) of the caregivers had at least secondary or tertiary education. Two-thirds of the caregivers correctly mentioned names of diseases of their children; and 25/108(23.1%) received health information from the healthcare providers. Caregivers with primary or no formal education significantly did not know the correct names of the child's disease when compared with caregivers with either secondary or tertiary education (OR = 2.8, p = 0.03). There was no documentation of the content of health information rendered by the healthcare providers during their routine work. Conclusions: Physicians should provide health information to all caregivers especially those with lower level of education. All cadres of health workers should be encouraged to give health information to health seekers utilising their facility.

Aims and Objectives: This communication is an attempt to present the experience and a preliminary report of results over a one-year period. Patients and Methods: From December 2011 to December 2012, a prospective determination of the HLA types of 20 individuals referred to the Tissue Typing Laboratory of the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife was done. These consisted of prospective transplant recipients, their donors, and a migrant pair for kinship determination. DNA was extracted from the client's peripheral blood sample, using the QIAmp Blood DNA Mini kit, (Qiagen). PCR was done using Olerup; low-resolution PCR-SSP typing kit. The PCR product was resolved in 2% agarose gel, and the bands visualised under UV light. The HLA types were determined using provided tables and/or Helmberg software. Data were presented using descriptive statistics whileHLA antigen frequency (AF) was expressed in percentage and gene frequency (GF) was determined using square root method (1-(1-AF)1/2). Results: A total of 20 individuals (13males and 7females) consisting of seven renal transplant recipients and seven prospective donors; a stem cell recipient and three donors and a migrant pair for kinship determination were typed. Age ranged from 4-65 years. 44 HLA alleles were detected, while HLA-A, B, C, DRB1 and DQB1 were 7, 10, 11, 8, 8 alleles respectively. The alleles were heterogeneous in distribution while 6 antigens (HLA-A*02, B*30, C*15, DRB1*03, DRB1*08 and DQB1*06) were having frequencies e"25%. Conclusion: This report confirms that DNA-based HLA typing is feasible locally, andit was observed that renal transplantation procedure is the most frequent indication. The HLA antigens observed to have very high frequencies (e"25% frequency) in this population were HLA-A*02, B*30, C*15, DRB1*03, DRB1*08 and DQB1*06. There is a strong need to develop a broad-based HLA data bank for Nigeria to further strengthening her transplantation programmes.

Aims and Objectives : To describe the pattern of lipid profile of members of staff of a tertiary education institution in South-West Nigeria with a view to assessing risk of cardiovascular disease among them. Materials and Methods : One hundred and ninety three (193) members of staff of the Institution were involved in the study. Questionnaires were administered to obtain information on demographic characteristics and medical history of respondents. Weight, height and blood pressure of participants were measured and the Body Mass Index (BMI) calculated. Fasting plasma lipid profile parameters -Total cholesterol (TC), High Density Lipoprotein cholesterol (HDL-C) , Low Density Lipoprotein cholesterol (LDL-C) and Triglycerides (TG)) were also determined in all the participants using standard assay methods. Results: Mean TC, HDL-C, LDL-C and TG were 4.04 mmol/L, 1.63 mmol/L, 1.98 mmol/L and 0.92 mmol/L respectively . Mean BMI was 25.98 kg/m2. Twenty-eight (14.5%) participants had mean cholesterol values e" 5.2 mM/L, 19 men had HDL values <1.0 mM/L and 28 women had HDL values < 1.3 mM/L (making a total of 24.3% of the study population). Twenty (10.4%) had LDL cholesterol e"3.3 mM/L, while 14 (7.3 %) had triglyceride valuese" 1.7 mM/L. One hundred and thirty one (67.8%) participants had values of all lipid parameters within reference range while 62 (32.8%) had abnormality in 1 or more of the parameters. Sixty two participants (32.1%) were overweight while 45 (23.3%) were obese. Statistically significant differences were found when TG and BMI levels of male participants were compared with those of their female counterparts. Abnormalities in lipid profile parameters were found mostly in participants who were 40 years and above. Age of participants correlated positively with total cholesterol and LDL cholesterol levels while LDL - C levels correlated negatively with HDL levels. Conclusion: A significant proportion of the population had abnormality in one or more Lipid profile parameters, the most common being low HDL cholesterol levels. A considerable number of participants were also either overweight or obese. Most of the abnormalities in lipid profile were found in participants e" 40 years. The study underscores a need to sensitise members of the community to regular lipid profile check up .

Aims and Objectives : The study was conducted to determine the role of lamivudine in the treatment of Nigerian patients with chronic HBV infection (CHB). Materials and Methods : Twenty one Nigerian patients with laboratory, histologic and clinical features of CHB were studied over a period of 30 months for response to a six-month therapy with lamivudine using liver biopsy as gold standard for assessment of response to therapy. Results : The mean age of the patients was 32.6±9.3 years and the receipt of injection from chemists (76%) was the most common risk factor for HBV infection among the subjects. About 67% of the patients were asymptomatic while 90.5% had normal liver span. Patients with low serum albumin, raised serum alkaline phosphatase, bilirubin and globulin prior to lamivudine therapy had restoration to normal values after 24 weeks of therapy. There was prolongation of prothrombin time (five patients) and hypokalaemia (one patient) after lamivudine therapy but there were no changes in the HBsAg, anti-HIV and anti-HCV status of all the patients. Although, post therapy liver biopsy was declined by 8 patients and contraindicated in 5 patients, there was 48% reduction in Knodell score of histologic findings in the liver biopsy specimens of 8 patients who had pre- and post-lamivudine therapy liver biopsies. Conclusion: The findings from this study suggested that six-month therapy with lamivudine is beneficial in treating Nigerian patients with CHB using biochemical markers and liver histology in assessing response to treatment.

Aims and objectives : This study characterises malignant lesions of lymph nodes seen in patients in the University of Port Harcourt Teaching Hospital, which is the reference cancer center in the Niger Delta region. Materials and methods : Five-year retrospective study which reviewed haematoxylin and eosin stained slides of malignant lymph node lesions seen between January 2006 and December 2010. Request forms were reviewed for patients' age, sex, diagnosis and site. Nodes accompanying malignant lesions were noted and compared histologically with the lesions of the primary tissue for consistency of morphologic features. Results : Malignant lesions were recorded in 49.8% of 237 lymph node biopsies. There were 54 males and 64 females. The age range was 2 to 72 years and the mean was 46.5 years. Peak age range was 60-69 years. Metastatic lesions constituted 59.3% while primary lymphoid malignancies constituted 40.7%. Majority of the metastases were from the breast Seventy-one per cent of NHL were of high grade, while 29% was of intermediate grade. Nine (56.3%) of the HL were of the nodular sclerosing type while 25% were of lymphocyte depleted and 12.5% were of lymphocyte rich types. The axillary lymph node was the commonest node involved in metastases followed by cervical lymph node. Conclusion:Metastatic lesions constitute the bulk of malignant lymph node lesions presenting in the Niger Delta region of Nigeria. The commonest primary lesions are from the breast in females. Implementing cancer-screening programmes and public enlightenment will reduce cancer prevalence in the region.

Aims and objectives: To provide a comprehensive report on the various causes of natural death in our centre and consider its implication for prevention. Materials and methods: A descriptive cross sectional study of post mortem reports, autopsy registers and duplicate copies of death certificates of all cases of SND on which autopsy was performed on in UBTH, Benin City, between 1990 and 2009. Results: Of the 4481 medicolegal deaths autopsied during the period, 2734 (61.0%) cases were SND, involving 1614 males and 1120 females with a M:F ratio of 1.4:1. The modal age group was 25-44 years which accounted for 30.2% of the cases. Cardiovascular system diseases occurred most and accounted for 30.2% of all cases, with complications of hypertension accounting for 79.5% of all cardiovascular system diseases. Other causes of SND include; gastrointestinal/hepatic diseases, 15.1%; respiratory system diseases, 13.8%; genitourinary system diseases, 10.1%; immune/ infectious diseases, 9.9% and endocrine/metabolic diseases, 7.7%. Less common causes are central nervous system diseases, haemato-lymphoid system diseases, breast diseases retroperitoneal diseases and musculoskeletal system disease each accounting for 6.6%, 5.4%, 0.7%, 0.4%, and 0.1% respectively. Conclusion: Cardiovascular system diseases, with complications of hypertension are the leading cause of SND in our environment. Public enlightenment on the need for routine medical health checks will help to reduce the incidence of SND.

Aims and objective: To determine the functional outcome and infection rate in patients who were surgically treated for non-missile traumatic depressed skull fractures. Patients and methods: It is a prospective cross-sectional descriptive study carried out on computerised tomography scanned depressed skull fractures surgically treated in Lagos University Teaching Hospital, Lagos from October 2008 to September 2009. Data were collected using structured proforma in accident and emergency, theatre, wards, and in outpatient clinic. Data collected included age, gender, occupation, type of depressed fracture, aetiology, clinicaland radiological findings, type of surgery done, complications, and outcome of treatment. Data was analysed using EPI info 2002 software. Results:A total of 17 patients were studied. There were 12males and 5females. Fifteen (88.2%) of the patients were0- 40years. The aetiology was road traffic accident in 82.4% of cases. Fourteen (82.4%) of the patients had open depressed skull fractures, while 17.6% had closed depressed skull fractures. Five (29.4%) of the patients had wound infection. Two (22.2%) of thepatients operated within 48hours had wound infection, while 37.5% of those operated after 48hours had wound infection. There was no infection among patients who had primary bone fragments replaced. Fifteen (88.2%) of the patients had good functional outcome. Conclusion: The functional outcome in this study is good but the infection rate is high. Primary bone fragments should be replaced whenever possible as it prevents the need for cranioplasty and there is no relative risk of increased infection rate.

Aims and Objectives: To determine the treatment outcome of rhegmatogenous retinal detachment at the Guinness Eye Centre Onitsha, Nigeria. Materials and Methods: Case files of patients who had surgery for rhegmatogenous retinal detachment at the Guinness Eye Center Onitsha between June 1997 and May 2012 were reviewed. Information obtained included age, sex, presenting and post-operative visual acuity, anatomical reattachment, post- operative complications and causes of treatment failure. Results: Fifty four patients, 33 males and 21 females, age range: 48-79 years, median-56 years, had surgery. Three patients had giant retinal tears; 10 patients alsohad proliferative vitreo-retinopathy(PVR).Symptoms duration was 7 days to 18 months; median - 7 months; the post-surgery follow-up was 9 months to 6 years; median -2 years.While 47(87%) patients had pre-operative visual acuity <3/60 in the affected eye, post-operatively 48(88.9%) patients achieved acuity e" 3/60, with 14(25.9%) attaining uncorrected visual acuity of 6/9 - 6/18. The retina remained attached 6 months after surgery in 45(83.3%) patients.The post- operative complications included re-detachment, 12(22.2%) patients, cataract,5(9.3%), exposed explant, 2(3.7%), suture granuloma, diplopia and retinal haemorrhage, 1(1.9%) patient each.The surgical failure in the 12 patients were were due to PVR (9 patients) and missed retinal holes (3 patients). Conclusions: Despite poor infrastructure and late presentation by patients, the anatomical and visual results of surgical treatment of rhegmatogenous retinal detachment using cryo-retinopexy and scleral buckling technique are encouraging. Better results would be expected if patients presented early and facilities for vitrectomy provided for tackling complex detachments.

Aims and Objectives: Highly active antiretroviral therapy (HAART) has been shown to reduce AIDS- defining illnesses, including neuropathies. However, it has been postulated that an increase in age -, HIV- and HAART- related neurological complications will occur as HIV-infected persons live longer. This study investigated the frequency and outcome of neuropathies in relation to CD4+ cell count and HAART status of hospitalised HIV/AIDS patients in Shika. Patients and Methods: Consecutive adult (e"15 years) non pregnant HIV- infected patients treated at Ahmadu Bello University Teaching Hospital Shika-Zaria from January 2006 to May 2013 with neuropathies were studied. Non HIV-infected patients with neurological disorders and HIV-infected patients without neuropathies were excluded. Results:Of 5240 HIV/AIDS patients seen , 11% (566) presented with neuropathy at median CD4+ cell counts of 200 cells / μl, with yearly reduction of the frequency of patients with neuropathy from 3.9% in 2006 to 0.06% in 2013. Male: female ratio was 2:1 and respective mean years were 41.9±10.1: 45.3±17.4 (p< 0.00). 253 (45%) were on HAART at presentation. 40 patients died and the mortality was associated with recurrent seizures, CD4+ cell counts d" 100 / μl, male sex, HAART-naivety and presence of co-morbidity and complications. Conclusions: The progressive reduction in the yearly frequency of neuropathy among HIV/AIDS patients suggests a beneficial effect of HAART on neuropathies. However, late presentation, low CD4+ cell counts and failure of patients to start HAART early were responsible for AIDS-related mortality thus highlighting the importance of early HIV screening and treatment.

Aims and objectives: This study was carried out to determine the prevalence of anaemia at booking clinic, describe the antenatal booking pattern, and categorize the degree of anaemia with certain demographic features. Subjects and methods : This is a descriptive cross-sectional study carried out over a six month period between 1st April and 30th September 2008. A questionnaire was used to obtain demographic information and venous blood samples were collected from 1,086 consecutive patients who consented to participate in the study. The blood samples were tested for haemoglobin levels, genotype and blood group. Results:Seven hundred and thirty two (67.4%) of the women anaemic at booking. Anaemia was more prevalent among multgravidae than primigravidae (p<0.05). Six hundred and sixty nine (61.6%) had mild anaemia while 40(4.4%) had moderate anaemia and 15 (1.4%) were severely anaemic, of which 8 (53.3%) were below 18 years of age. Varied degrees of anaemia were more common among women aged 24-28 years and in the 3rd trimester of pregnancy (80.7%) (p<0.05). One hundred and seventy (15.7%) of the enrolled booked for antenatal care in the 1st trimester, while 703(64.7%) booked in the 2nd trimester and 213 (19.6%) in the 3rd trimester of their pregnancies. Thirteen (1.2%) had sickle cell anaemia. Conclusion: Prevalence of anaemia at booking remains high in our society. Urgent need for public health education on early antenatal booking and improved literacy level of women is suggested to reduce the burden of anaemia in pregnancy.

Aims and objectives: To assess the proportion of patients with suspected adverse drug reactions (ADRs) to highly active antiretroviral therapy (HAART) who reported the reactions to their healthcare providers and the factors associated with the reporting. Patients and methods: The study was conducted in the US President's Emergency Plan For AIDS Relief (PEPFAR) clinic at the University of Benin Teaching Hospital (UBTH), Benin City. The study population consisted of adult HIV infection patients receiving HAART at the clinic, who had suspected ADRs (SADRs). Using a systematic random sampling technique, patients were selected and interviewed with the aid of a structured questionnaire. The outcome measure was whether or not a SADR was reported to a healthcare provider. Results: The study participants totalled 233, 171 (73.4%) of whom reported SADRs to their healthcare providers. Statistically significant difference was demonstrated with following higher-than-mean proportions of participants that reported SADRs: 100% (13/13) of respondents who experienced a SADR perceived to be life-threatening, (p=0.02; OR=0.00, 95%CI=0.00-0.87); 88.6% (31/35) of those who regarded their SADRs as severe (p=0.01; OR=4.02, 95%CI=1.28-16.63); and 95.2% (20/21) of those who had skin eruptions (p=0.02; OR=0.12, 95%CI=0.00-0.81). Conclusions:The finding that a high proportion of patients reported SADRs suggests that majority of patients contribute to pharmacovigilance and that they constitute opportunities for direct reporting of HAART-related ADRs to pharmacovilance centres. Facility-based pharmacovigilance desks should be set up and access should be created for patients to report SADRs directly. Healthcare providers should educate patients to report SADRs.

Aims and Objectives: The objective of this study was to determine the rate ofdisclosureto sexualpartnersand consequent safer sexual practices among people living with HIV (PLHIV). Materials andMethods : Thiswas a cross-sectional study. A semi-structured interviewer administered questionnaire was used to collect demographic data of age, gender, marital status as well as HIV status disclosureand consistentcondom use. This information was collected from consenting consecutiveantiretroviral- therapynaïve PLHIV accessing care at the Lagos State University Teaching Hospital (LASUTH), southwest Nigeria. Collected data were analysedusing statistical package for social sciences (version 10.0, spss) and group comparisons were done with chi square tests. Results : A total of 443respondents were interviewed. The age of the respondents ranged from 18 to 75 years with a mean of 46.5±9. Majority268 (60.5%) of respondents were females while 175 (39.5%) were males. The disclosure rate to sexual partners was 43 (9.7%) among studiedPLHIV. Consistent condom use was highest (12.7%) among PLHIV who had disclosed to sexual partners while inconsistent use was highest (93.3%) among the undisclosed.p=0.26 Conclusion: This study reveals that there is a low sexual partnerdisclosure rate among studied PLHIV.Seropositive status disclosure to sexual partners was associated with consistent condom use.

Aims and objectives: This study was conducted to examine the contributions of professional health associations, non-governmental organisations, government ministries, and community-based organisations in implementing community-based interventions for the reduction of maternal mortality in Delta State Nigeria. It also seeks to demonstrate the challenge of coordinating activities of several stakeholders and quantifying the impact on reduction of maternal mortality. Materials and methods: Various publications, reports, public presentations and policy documents on activities of professional health associations, non- governmental organisations, government ministries, and community-based organisations in Delta State of Nigeria were collected and analysed by the authors. Results: Professional health associations, non-governmental organisations and community-based organisations in Delta State have contributed to the reduction of maternal mortality through advocacy, awareness creation, and sensitisation programmes on reproductive health using behaviour change communication materials. Participation in programmes organised by the Delta State Ministry of Health has also contributed to some positive outcomes. These include the successful implementation of Delta State Free Maternal Health Care Programme since November 2007 and increase in contraceptive utilisation. Conclusion:Professional health associations, non-governmental organisations, government ministries and community-based organisations have impacted positively in the quest for reduction of maternal mortality. The challenge is in coordination of interventions and tracking indicators to measure desired impact.

Lipomas of the Colon are uncommon. This is the report of a case of sub mucosal lipoma of the transverse colon in a 43 year old Nigerian woman. The clinical presentation was that of a sub acute intestinal obstruction. She had laparotomy and limited colonic resection with no post operative complications. The clinical diagnosis was confirmed by histopathology. The modes of presentation, differential diagnosis and treatment options of colonic lipomas are discussed. Lipomas of the large bowel should be considered in the setting of mechanical intestinal obstruction in this environment.

Aims and objectives This is to highlight the case of a multi-gravida who developed ureterovaginal urinary fistula following dilatation and curettage. It is necessary to document the possibility of this injury from the common procedure of D&C. Case report This is an unusual occurrence of ureterovaginal fistula resulting from D&C for an incomplete abortion in a patient who had urinary incontinence for 16 years and carried three pregnancies to terms while this lasted. Uretero-neocystostomy achieved cure in this patient. Conclusion Dilatation and curettage though a common procedure is subject to complications which may make life of the patient miserable especially in this sub region, therefore should be carried out by only trained and skilled hands.