Aims and objectives: The objective of this study was to determine the seasonal variation in hospitalisation for respiratory disease in a tertiary care centre in the tropical rain forest zone of South Western Nigeria. Patients and methods: A retrospective analysis was performed to the determine the seasonal variation of respiratory diseases hospitalised in Federal Medical Centre in Ido-Ekiti, Nigeria from November , 2006 to October 2009. Data were extracted from the medical records of hospitalized patients who had acute exacerbation of chronic obstructive pulmonary disease (COPD), asthma, pneumonia and pulmonary tuberculosis (PTB). Results: Two hundred and thirty three patients aged ≥15 years hospitalised for respiratory diseases were analysed, 68(29.2%) had PTB, 66(28.3%) had pneumonia, and 61(26.2%) had asthma while 38(16.3%) people had COPD. The mean age of the patients was 47.8 ΁ 19.6 years. Monthly mean of hospitalisation for pneumonia (8.00 vs.3.86; p=<0.001) and acute exacerbation of chronic obstructive pulmonary disease (4.60 vs.2.50; p=0.004) were significantly higher in dry season, while that of asthma (5.29 vs.4.80; p=0.338) and pulmonary tuberculosis (5.71 vs.5.60; p=0.898) were higher in the rainy (wet) season, although seasonality of asthma and PTB was less pronounced and not significant. Conclusion: The hospitalisation of asthma and pulmonary tuberculosis were higher during the rainy (wet) season while pneumonia and acute exacerbation of COPD were higher during the dry season. The outcome of this study may help to identify seasonal disease-modifying factors associated with hospitalisation of respiratory diseases. Furthermore, identifications of these variations are important for efficient allocation of health-care resources based on seasonal hospitalisation trend.

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Aims and objectives : Diseases of medical origin leading to coma account for 3 -15% of emergency hospital admissions in developed countries. There is dearth of data on causes of medical coma in adults in Nigeria in particular and Africa in general. This study is to determine the causes of coma in adult patients admitted at the medical emergency unit and wards of the University College Hospital (UCH) Ibadan. Patients and methods : A prospective study of two hundred consecutive adult unconscious patients seen at the medical emergency unit of UCH, Ibadan, from August 2004 to March 2005, was undertaken using a structured clinical history and physical examination protocol, and results of relevant diagnostic investigations, including post-mortem. Results : Medical causes of coma constituted 10% of all emergencies and 3% of total hospital admissions respectively during the 8- month period. Sixty six percent were males. The age group 20-59 years were affected most (76.5%). Four commonest causes were: Acute stroke (33%), diabetic emergencies (12.5%), uraemic encephalopathy and meningitides (11% each). Four least causes were cerebral malaria (1.0%), hypertensive encephalopathy, alcohol and gamalline poisoning (0.5% each). Four common predisposing factors which also had significant male predominance were systemic hypertension (38.5%), diabetes mellitus (14%), alcohol and substance abuse (12.5%), and HIV/AIDS (11.5%). Conclusions : Hypertensive stroke and diabetic coma constituted the commonest medical causes of coma. Thus preventive measures such as public health enlightenment campaigns for lifestyle modifications, routine blood pressure and glucose examinations are necessary to avert their disastrous consequences.

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Objectives: To report the outcome in the yield of two techniques of prostate biopsy. Patients and methods: The study was a retrospective review of the experience with digitally guided trans-rectal Tru-cut needle biopsy of the prostate using manually- driven and the Biopty gun-driven methods. The record of patients who had undergone prostate biopsy was retrospectively reviewed from January 2000 to December 2007. Data extracted included the age, the year of biopsy and/or the method of biopsy, the status of the operator and the histology report of tissue obtained. Data was analysed with the aid of SPSS (Version 11.0) software, the Chi - square test was calculated for the variables and statistical significant P value at P < 0.05. Results: A total of 292 prostate biopsies were undertaken during the review period. One hundred and ninety were gun-driven (65.1%) while 34.9% were manually-driven. A total of 55.5% of the specimens were benign prostate hyperplasia while 28.4% were adenocarcinoma of the prostate on histological examination. Thirty-six per cent of the tissues obtained from manually-driven biopsy were not representative as compared with only 4% of tissue from gun-driven biopsies. There was a significant correlation between the method of biopsy and the likelihood of tissue representativeness for histological appraisal (P<0.0001). Conclusion: There was a significant difference in the tissue yield between manually- driven and the gun-driven Tru-cut needle biopsy of the prostate.. Biopty-driven Tru- cut needle sampling of the prostate is the recommended procedure in this environment.

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Aims and objective: This study was aimed at evaluating the prevalence of Hallux Valgus (HV) and related foot problems among the youth population in Lagos, Nigeria. Subjects and methods: A structured questionnaire was administered to 1, 200 subjects from 10 secondary schools and undergraduate students of the College of Medicine University of Lagos, Lagos, Nigeria. The participants were requested to provide information on demographic data, severity of HV, and the functional limitation imposed on the participants by HV. Nine hundred and seventy (970) of the 979 returned questionnaires were analyzed using descriptive statistics. Results: The prevalence of HV in this study was 15.4% of which 43.6% and 56.4% were male and female respectively. 36 (3.7%) out of total number of participants had bilateral HV (both feet), 57 (5.9%) and 56 (5.8%) had HV on left and right foot only respectively. Eighty four (25.2%) of the 333 (34.3%) subjects that complained of pain at the first metatarsophalangeal joint had HV. Inability to stand for long periods due to pain at the first metatarsophalangeal joint was reported by 90 (9.3%) participants, while 136 (14.0%) reported inability to walk long distances. Conclusion: Prevalence of HV among youths in Lagos, Nigeria is low. HV is more common among females and its prevalence increases with age. More attention should be focused on foot pain and deformities. Preventive measures and education on the HV deformity is advocated.

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Aims and objectives: To assess liver function in Nigerian cancer patients undergoing cytotoxic chemotherapy, with a view to contributing to the existing literature and possibly making recommendations for better management of the affected patients in Nigerian hospitals. Patients and methods: Serum levels of total bilirubin (TB), alanine amino transferase (ALT), aspartate amino transferase (AST), alkaline phosphatase (ALP), total protein (TP), albumin (ALB) and De Ritis ratio (AST/ALT) were determined in 50 cancer patients both before and after chemotherapy and 50 age- and sex-matched control individuals. The data obtained were analysed using Microsoft Office Excel 2003. Two-tailed student's t- test for matched samples and Pearson's linear correlation statistical methods were employed for the analyses. Results: The levels of serum ALT, AST, ALP and TB, ALB, TP and AST/ALT were significantly higher in cancer patients than in controls both before and after chemotherapy, with more pronounced elevations after chemotherapy. There were positive and significant correlations between cycles of chemotherapy and the serum liver function tests. Conclusion: The findings from the present study conclude that there is slight difference when compared to controls in liver function test profile in cancer patients even before commencement of chemotherapy with a worsening of the profile of patients after chemotherapy. This difference in liver function also increases with the cycles of chemotherapy.

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Aims and objectives: : This study is aimed at assessing the practices of breast cancer screening and risk perception of women of reproductive age group in a tertiary institution in Osun state. Subjects and methods: It was a descriptive cross sectional study carried out at the Federal polytechnic, Ede. A total of 393 eligible respondents recruited using a stratified random sampling technique, were interviewed using semi-structured questionnaire after obtaining a verbal consent from them. Results : About two thirds (67.9%) of those who had heard of breast cancer knew that there were screening methods available. Of these 91.6% knew breast self examination, 93.2% knew clinical breast examination and only a third 32.8% knew mammography as a screening method. About half of respondents who were aware of breast cancer practice breast self examination. Only 28 (7.6%) of the respondents had ever visited any clinic for breast cancer screening, and 85.7% (24) of the visit was for clinical breast examination while mammography was rarely done (14.3%). Eighty one per cent of those who were aware of breast cancer believed that screening had a role to play. Conclusion : The study shows that though awareness of breast cancer among respondents was good, the practice of breast cancer screening was poor among the respondents and even worse with screening with mammography. A major recommendation is that initiatives to reduce morbidity and mortality due to breast cancer among young females in the southwest Nigeria should include education on risk factors, early signs and methods of screening for breast cancer.

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Aims and objective: The aim of this study was to determine the rate of spirometry utilisation among hospitalised patients with clinical findings of chronic obstructive pulmonary disease (COPD) in a tertiary hospital in Nigeria. Patients and Methods: A case record review of hospitalised patients with clinical findings of COPD from January 2002 to June 2009 from the record of the cardiopulmonary unit of the University of Ilorin Teaching Hospital Ilorin, Nigeria was carried out. Age and sex, hospital stay, admitting physician, and outcome of admission were obtained. Results: A total of 228 patients were hospitalised with clinical findings of COPD, 185 (81.1%) were males and 43(18.9 %) were females. The rate of utilisation of spirometry in hospitalised patients (228) with clinical findings of COPD was 8.3%. More than half of those that had spirometry were aged ≥65 years. Majority (16; 84.2%) of those that underwent spirometry were under the care of the pulmonologist (p<0.001). Age, sex, total days of hospitalisation of patients were not significantly associated with utilisation of spirometry. Conclusions The utilisation of spirometry among hospitalised patients with clinical findings of COPD in this study was very low when compared to the developed countries. Our study has highlighted the experience of a low income country and the need to increase the awareness of the role of spirometry in the evaluation of COPD among doctors.

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Objectives: The study aimed at identifying the risk factors for neonatal septicaemia in Zaria. Patients and methods: Consecutive newborns admitted into the Special Care Baby Unit of Ahmadu Bello University Teaching Hospital, Zaria with the presumptive diagnosis of neonatal septicaemia between 25th May, 2004 and 31st May, 2005 were studied. History of events in the antenatal and neonatal periods was obtained and physical examination was done. Blood, urine, cerebrospinal fluid and swabs of body discharges were taken for culture and sensitivity studies. The data were analysed using Epi Info version 6 software. Associations were tested using Chi square, with Yates correction, or Fisher's exact tests where appropriate, while statistical significance was set at p < 0.05. Results: A total of 211 neonates, consisting of 69 in-born and 142 out-born infants were studied. There were 122 (57.8%) males and 89 (42.2%) females; giving a male: female ratio of 1.4:1. Seventy-five (35.5%) of the newborns had bacteriologically proven septicaemia consisting of 54 (38.0%) of the outborn and 21 (30.4%) of the inborn babies (p = 0.3535); 42 males and 33 females (p = 0.8011). The male: female ratio of newborns with culture-proven septicaemia was 1.2:1. The predisposing factors that were associated with culture-proven septicaemia were lack of antenatal care (p = 0.0234), prolonged rupture of membranes (p = 0.0085), prolonged labour (p = 0.0032), preterm delivery (p = 0.0125) and perinatal asphyxia (p = 0.0078). Conclusion: The risk factors in neonates with septicaemia in this study emphasise the need for timely improvement in the implementation of existing public health strategies.

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Aims and objectives: This study was done to find out factors that contribute to development of Non-union of long bone fractures in this environment and the outcome of operative intervention. This is a prospective hospital based study. Patients and methods: All patients with Non-union of long bone fracture that presented in the hospital since January 1997 were recruited into the study. The data included causative factors, treatment given before presenting in the hospital, type of surgical procedure and result of treatment. The study was completed in December, 2005. Results: 78 patients presented with 87 Non-union of long bones. A male, female ratio of 1.6:1 was encountered while 69.2 per cent of the patients were below the age 55years. Road Traffic Accident accounted for 68 fractures (78.2 per cent) while duration of injury before presentation varies from 6 months to 22 months. Atrophic non-union occurred in 60 cases (69.0 per cent) and hypertrophic non-union in 21 cases. Non-union of the femur occurred in 33 cases (37.9 per cent) humerus in 24 cases (27.6 per cent), tibia in 16 cases (18.4 per cent), radius and ulna in 14 cases (16.1 per cent). The initial treatments of the fresh fracture in the 78 patients with non- union were by the traditional bonesetters in 51 patients (65.4 per cent) while the remaining fractures were treated by plaster of paris in hospital. Open reduction and internal fixation using plate and screws with bone grafting was the most common procedure for treating the non-union in most cases. Union was achieved in the entire patients following surgical intervention. Conclusion: Important factor that appears to contribute to non-union of long bone in this environment is soft tissue interposition between the fracture ends of the bone, which is found in all fractures with more than one diameter displacement. Another factor is interference with periosteal blood supply from disruption of soft tissue envelope as a result of high energy injuries which is also responsible for the displacements that were observed in these fractures. The treatment by traditional bone setters which entails daily massage of the fracture creating a macro movement at the fracture site is also an important contributing factor.

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Aims and objectives : To determine if there is any change in the common causes of gross haematuria among adults Nigerians and to determine what proportion of these aetiologies is due to urological malignancies. Patients and Methods : Consecutive adults with presenting with gross haematuria seen in our centre were studied prospectively between February 2006 and January 2007. All patients had detailed clinical and diagnostic evaluation including urine cytology, flexible/rigid urethrocystoscopy, ultrasonography and intravenous urography to determine the causes of their haematuria. Other special investigations including CT scan and tissue biopsies were only used in selected patients as indicated. Results: The cause of haematuria was determined in 74 patients (93.7%) while haematuria was of undetermined origin in 5 patients (6.3%). Fifteen different specific diagnoses were made as the causes of haematuria in this study. The three commonest individual causes of haematuria were benign prostatic hyperplasia (30.4%), bladder carcinoma (12.6 %) and carcinoma of the prostate (10.1%). Urological malignancies were diagnosed in 29.1 % of the patients. The Urological malignancies detected were bladder cancers (12.6 %), prostate cancers (10.1%), renal Cell Carcinoma (5.1%) and urethral Carcinoma (1.3%). The incidence of the cancers increased with age; 82.6% of the patients with malignancies were aged 50years and above while only 17.4% were below 50 years of age (P= 0.045). Urological malignancies were also more common in men (73.9 %) than in women (26.1 %) (P < 0.05). Conclusion: We conclude that there is changing trend in the aetiologies of gross haematuria among adult Nigerian patients with urological malignancies being now more prevalent than previously reported in our environment.

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Aims and objectives: This study is to determine effect of chemotherapy on plasma lipids and lipoproteins in haematological malignancies. Patients and Methods : All consecutive patients with haematological malignancies attending University of Benin Teaching Hospital, Benin City, Nigeria between July 2007 and December 2008 were studied. Clinico-pathological types of haematological cancers, demographic features, serum lipid and lipoprotein levels of the patients were analysed, pre and post treatment with chemotherapy. Results: A total of 28 haematological cancers were studied. Chronic leukemias 10 (35.7%) and lymphomas 7(25.0%),acute leukaemia 6(21.4%), multiple myeloma 4(14.3%), and aplastic anaemia 1(3.6%). The pre therapy median values for TC, TG, LDL-C and HDL-C were 103, 115, 40 and 36mg/dl respectively while the median values for post therapy for TC, TG, LDL-C and HDL-C were 110, 126, 60 and 43 mg/dl respectively. The pre therapy ratio of TC : HDL-C in the patients was 2.4 while the post therapy ratio of TC : HDL-C was 2.7. Conclusion: Hypocholesterolaemia and hypolipoproteinaemia were seen in our patients when compared with the population reference values and there were no significant changes in lipid and lipoprotein levels between pre and post therapy values.

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Background : Osteoarthritis (OA), a chronic degenerative disease of synovial joints is characterised by pain and stiffness. Aim of treatment is pain relief. Complementary and alternative medicine (CAM) refers to practices which are not an integral part of orthodox medicine. Aims and objectives : To determine the pattern of usage of CAM among OA patients in Nigeria. Patients and methods : Consecutive patients with OA attending orthopaedic clinic of Havana Specialist Hospital, Lagos, Nigeria were interviewed over a 6- month period of 1st May to 31st October 2007 on usage of CAM. Structured and open-ended questions were used. Demographic data, duration of OA and treatment as well as compliance to orthodox medications were documented. Results : One hundred and sixty four patients were studied.120 (73.25%) were females and 44(26.89%) were males. Respondents age range between 35-74 years. 66(40.2%) patients used CAM. 35(53.0%) had done so before presenting to the hospital. The most commonly used CAM were herbal products used by 50(75.8%) of CAM users. Among herbal product users, 74.0% used non- specific local products, 30.0% used ginger, 36.0% used garlic and 28.0% used Aloe Vera. Among CAM users, 35(53.0%) used local embrocation and massage, 10(15.2%) used spiritual methods. There was no significant difference in demographics, clinical characteristics and pain control among CAM users and non-users. Conclusion : Many OA patients receiving orthodox therapy also use CAM. Medical doctors need to keep a wary eye on CAM usage among patients and enquire about this health-seeking behaviour in order to educate them on possible drug interactions, adverse effects and long term complications.

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