Objectives: The objective of this study was to compare the efficacy and safety of 5% phenol in almond oil with 50% dextrose water as sclerosants in the treatment of first- to third-degree haemorrhoids. Patients and Methods: This was a prospective, comparative study conducted on eighty patients with first-, second- and third-degree haemorrhoids who consented to treatment by injection sclerotherapy with either 5% phenol in almond oil or 50% dextrose water. They were randomised equally into two groups. Results: A total of eighty patients including 58 males and 22 females whose age ranged from 19 to 61 years were included in the study. Bleeding was the chief symptom which was present in 78 (97.5%) patients, and there was complete resolution of this in 92.3% and 89.7% in the 5% phenol in almond oil and 50% dextrose water groups, respectively, at 6 months (P = 0.905). Similar degrees of resolution were noted for anal protrusion (89.1% and 85.3% in the 5% phenol in almond oil and 50% dextrose water group, respectively, P = 0.899). The overall complication rate was 3.6% with anal mucosa ulceration being the only complication, occurring in three patients who had 5% phenol in almond oil. Peri-procedure pain, patients satisfaction and acceptability were not significantly different in both groups (P = 0.912, 0.928 and 0.926 respectively). Conclusion: Five percent phenol in almond oil and 50% dextrose water are equally effective sclerosants in the treatment of haemorrhoids with very low complication rates.

Aims and Objectives: The aim of this study was to evaluate the efficacy of intravenous tramadol in control of shivering in obstetric patients under spinal anaesthesia and to determine the minimal dose of tramadol that is effective. Patients and Methods: This was a prospective, randomised, double-blind, cross-sectional study of 144 pregnant women at term who had an indication for caesarean section. The patients were randomly allocated into three groups at the occurrence of shivering. Group T0.5 received 0.5 mg/kg of tramadol (n = 47), Group T0.25 received 0.25 mg/kg tramadol (n = 47) and Group TNS received 0.05 ml/kg of normal saline (n = 46). Statistical analysis was performed using Statistical Package for Social Sciences version 17. Results: There were no significant differences between the groups with regard to age, weight and duration of surgery. There was a statistically significant difference in the time of cessation of shivering after the treatment for various groups (P = 0.000). A total of 80.1% responded to the treatment in Group T0.5, while for Group T0.25 and TNS, a total of 44.7% and 4.3%, respectively, responded. There were statistically significant differences in the recurrence rates of shivering among the groups (P = 0.000). Conclusion: Tramadol is effective in control of shivering during spinal anaesthesia in obstetric patients. Tramadol 0.5 mg/kg controlled shivering better than 0.25 mg/kg. Therefore, 0.5 mg/kg of tramadol can be used to manage shivering following caesarean section under spinal anaesthesia.

Background: Sexual maturation is an important milestone which starts between 8 and 14 years in girls. However, varying ages of onset of sexual maturation have been reported in different environments, with more recent studies showing earlier ages of onset in girls. There is therefore need to describe the sexual maturation of girls in each environment. Subjects and Methods: A cross-sectional study of 6–18-year-old school girls in Abakaliki. One thousand one hundred and fifty-five girls were selected through multi-staged sampling. They were interviewed, and sexual maturation was assessed using breast and pubic hair development. Results: Pubic hair development occurred earliest at a mean age of 9.87 ± 2.19 years. Breast development followed at a mean age of 10.53 ± 2.38 years. The mean age for menarche was 12.82 ± 1.29 years, which chronologically occurred between sexual maturity rating stages 3 and 4. Overweight/obesity was found to be correlated with an earlier age of onset of sexual maturation (P < 0.05). Participants belonging to the upper socioeconomic class also had earlier age of onset of sexual maturation (P < 0.05). Compared with earlier studies, positive secular trend for earlier maturation was found using pubic hair development, breast development and menarche as markers of onset of maturation. Conclusions/Recommendations: Against the background of the present findings of a continuing secular trend of earlier sexual maturation in Igbo girls, there is a need to provide relevant information to parents/guardians and to reduce puberty-related anxiety. This will go a long way in improving quality of parental support for adolescents during this crucial period.

Purpose: The study aimed at determining the associations between ocular biometry and anthropometric measurements in a Nigerian adult population. Subjects and Methods: Participants were healthy members of staff and students of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. The height and weight were measured, and the body mass index (BMI) was calculated. Ocular axial length (AL), anterior chamber depth (ACD), keratometric readings (K) and corneal radius of curvature were measured with the IOL Master. Data were analysed with SPSS version 16 (IBM Corporation), and associations between ocular biometric variables and anthropometric measurements were explored. Results: Three hundred and fifty healthy participants aged 18–60 years (mean age: 34.8 ± 11.2 years) were enrolled. Height was significantly positively correlated with AL (r = 0.37, P< 0.01) and ACD (r = 0.17, P = 0.01) and negatively correlated with K (r = −0.28, P< 0.01). A significant positive correlation was found between weight and AL (r = 0.13, P = 0.02) while the BMI was only negatively correlated with ACD (r = −0.11, P = 0.04). In multivariate analysis, the relationship between height and AL (R² = 0.58, P< 0.01) as well as ACD (R²= 0.11, P< 0.01) persisted. The relationship between weight and AL and that between BMI and ACD were totally abolished after controlling for age and height. Conclusion: The body height is independently associated with ocular AL and ACD while the body weight and BMI are not independently associated with any of the ocular biometric indices studied.

Background: Presbyopia is an age-related loss of lens accommodation resulting in difficulty in performing near task with attendant effect on the quality of life. Objective: The objective of the study was to determine the prevalence of presbyopia and presbyopic spectacle correction coverage among public school teachers in Ifo township, with a view to providing a baseline information that could be useful for advocacy and planning appropriate intervention. Study Design: The study was a descriptive, cross-sectional study. Materials and Methods: Six hundred public school teachers aged 30 years and above were examined in 25 clusters using a multistage random sampling technique with probability proportional to size. Questionnaire was used to obtain information on demographic data, sources of spectacle and barriers to spectacle use. All participants underwent a standardised protocol including visual acuity assessment (distance and near acuity), anterior and posterior segment examinations and refraction. Results: Six hundred teachers were examined with an age range of 30–61 years. The mean age was 44.7 ± 7.5 years and the male to female ratio was 1:2.2. The prevalence of presbyopia was 81.3% and 38.5% of the presbyopic teachers did not have presbyopic correction. However, the average age of onset of presbyopia was earlier in females 33 years compared to 36 years observed in males, although not statistically significant (P = 0.88). The presbyopic correction coverage was 61.5%. One hundred and eighty-six (62%) presbyopic teachers obtained their spectacle from opticians, and the main barriers to the use of near vision spectacle were lack of awareness (23.7%) and cost (13.7%). Conclusion: This study demonstrated a high prevalence of presbyopia among public school teachers in Ifo town, South-West Nigeria, but less presbyopic spectacle correction coverage.

Background: The prevalence of goitrous swelling has reduced in Nigeria since the introduction of salt iodisation programme. Thyroid disorders are the second most common endocrine disorder after diabetes mellitus worldwide. They present to general outpatient, medical and surgical clinics accompanied by great anxiety and poor health-related quality of life. Objectives: The study aimed to determine and describe the spectrum of thyroid disorders seen at Olabisi Onabanjo University Teaching Hospital over a 10-year period. Materials and Methods: This was a retrospective analysis of records of patients who presented to the hospital with thyroid swellings over a 10-year period (June 2004 to June 2014). Clinicopathological and demographic data obtained from hospital records in 175 patients diagnosed by clinical examination, thyroid ultrasound, hormone profile and histological confirmation in cases that had surgery were analysed for this study. Results: The records of 175 patients were obtained comprising 151 (86.3%) females and 24 (13.7%) males (female to male ratio of 6.3:1) with age range from 18 to 76 years and mean age of 42.3 years, standard deviation 13.5. With clinical diagnosis, distribution of thyroid diseases was simple goitre 103 (58.9%), toxic goitre 64 (36.6%), hypothyroidism 3 (1.7%), malignant goitre 4 (2.3%) and thyroiditis 1 (0.6%). The age group of 30–49 years had the highest prevalence of the thyroid diseases 100 (57.2%) while the extremes of age, below 20 and over 70 years had the least (5.1 and 2.9%, respectively). Conclusion: The prevalent form of thyroid diseases seen at Olabisi Onabanjo University Teaching Hospital was simple goitre and most common in females. Studies on autoimmunity and other goitrogens are required to further elucidate the cause of this high prevalence.

Background: Discharge against medical advice (DAMA) portends serious ethico-legal consequences for healthcare givers. Several studies have described its prevalence and pattern but hardly any to evaluate adherence to standards by medical staff while administering DAMA in developing countries. Objectives: The objective of this study is to evaluate adherence of medical staff to standard protocols during the administration of DAMA in a public secondary hospital in Ondo State. Methodology: In a descriptive, retrospective study we examined case files and DAMA forms of in-patients who obtained DAMA between April 2014 and September 2015 for design, signatories and completeness. Data were analysed by means of SPSS version 17. Results: A total of 235 patients (male:female, 1.03:1) who obtained DAMA out of 7465 in-patients were studied. Their mean age was 40.5 ± 19.3 years (range, 17–110 years). The overall hospital DAMA prevalence was 3.2%. DAMA forms were inadequately designed, deficient and not protective against litigation. Improper processing of DAMA was high (66.7%). The only signatories in the DAMA forms were the nurses (8.5%) and patients' relatives (100%). There was no physician entry in the forms. Conclusions: Adherence to standard DAMA protocol by medical staff was poor. Update courses on ethico-legal matters, adopting a discharge planning team, upgrading of DAMA forms and stressing global best practices will reduce or eliminate risk of litigations.

Aims and Objectives: The aim and objective of the study was to determine the incidence, bacterial isolates and the antibiogram sensitivity of the isolates in neonates with septicaemia. Patients and Methods: The neonates with clinical diagnosis of neonatal septicaemia (NNS) were consecutively enrolled into our special care baby unit. The patients were investigated including blood cultures, cerebrospinal fluid cultures and urine among others. Data were analysed with Statistical Package for Social Sciences software version 16.0 (SPSS Inc., Chicago, IL, USA). Results: Forty-six neonates (42.0%) had a positive blood culture, while 64 (58.0%) were blood culture-negative. Eighteen (39.1%) of those septicaemic neonates with positive blood culture were inborn, while 28 (60.9%) were outborn. The incidence of NNS was 5.9/1000 live births. The male-to-female ratio among septicaemic neonates was 1.9:1. The common risk factors for NNS were prolonged rupture of membrane, prematurity and low socioeconomic status of parents among others. Common clinical features were fever, poor feeding, excessive crying, tachypnoea and hepatomegaly. Staphylococcus aureus 16 (69.6%) and Streptococcus pyogenes 5 (21.8%) were the predominant Gram-positive organisms isolated whereas Escherichia coli 9 (39.1%) and Klebsiella pneumoniae 7 (30.4%) were the predominant Gram-negative organisms isolated. S. aureus was sensitive to cephalosporins and quinolones, but resistant to penicillins. E. coli and K. pneumoniae showed a high resistance (16.7% and 25.6%, respectively) to commonly used aminoglycoside such as gentamycin. Conclusion: The burden of NNS was high with high mortality in the study centre. The sensitivity pattern had remarkably changed; however, a combination of cephalosporins such as cefuroxime and gentamycin is still a good option.

Aim: To assess the oral health knowledge, awareness and associated exercised practices of pre-school children's mothers in Greater Noida, India. Subjects and Methods: The sampling frame for this study was chosen via convenient sampling. It comprised 598 mothers of children aged between 2 and 5 years, attending the paediatrics division of a government and four private hospitals in Greater Noida. A pre-tested questionnaire was distributed to the participants which comprised questions on the participant's sociodemographic characteristics and 23 statements regarding their knowledge, attitude and practices towards their child's oral health. Data were analysed using SPSS 21.0. P < 0.05 was considered statistically significant. Results: The study showed that merely 24.9% of the participating mothers had good knowledge and 29.1% and 12.5% exhibited poor attitude and practices, respectively, towards their child's oral health. Knowledge about the role of fluorides, causes and prevention of dental caries, gum disease, malocclusion, appropriate timing of commencing of toothbrushing and importance of frequent dental visit was found to be inadequate among the participants. The knowledge varied significantly with respect to age (P = 0.04), education (P = 0.00) and working status (P = 0.006) of the mothers. Conclusion: The study participants exhibited poor knowledge and attitude towards their child's oral heath which was leading to the adoption of poor oral health practices by these mothers. Thus, to improve the oral health of children, appropriate practices and measures should be promoted among their parents/guardians.