Context: Stroke is a devastating complication of sickle cell anemia (SCA) and is fatal in about 5% of patients, with chronic sequelae in survivors. The occurrence of stroke is predictable and preventable. However, up to 50% of children in some low-income settings are deprived of optimal care. Aims: The study aimed to document the presentations of stroke in sickle cell patients, and the interventions utilized. Settings and Design: A descriptive, retrospective review was conducted. Materials and Methods: Case records were manually retrieved of patients managed for sickle cell stroke from April 2011 to March 2016. Statistical Analysis Used: Descriptive and analytic statistics were utilized. Results: A total of 21 patients were analyzed, comprising 38.1% males, with a male-to-female ratio of 1:1.6. The mean age at the time of diagnosis of SCA was known to parents was 1.9 ± 1.7 years, and the chronological age of patients, at the time of first registration in the unit for sickle cell related care was 3.9 ± 2.6 years. Ten children (47.6%) were presenting for the first time on the account of the stroke, while the rest had been on follow-up visits in the unit, prior to stroke occurrence. Age at the occurrence of sickle cell stroke was 5.8 ± 2.7 years. Only 2 (9.5%) had a transcranial Doppler (TCD) examination prior to experiencing the stroke. The symptoms of the stroke were observed 8.3 ± 19.2 days before medical care was sought. The interval between onset of stroke and medical intervention was 11.5 ± 21.3 days. Only 2 (9.5%) had intervention within 24 h of the onset of symptoms, and only 4 (19%) patients had complete recovery of stroke symptoms. Conclusion: Although many of the participants were known to have SCA at an earlier time by parents, they were not presented for specialist care until stroke had developed. In addition, TCD was not accessible or available to majority of the patients, and there was also delay in seeking and providing medical intervention for majority of patients after stroke occurrence.

Background: Blood lipid profiles are known to be under the influence of genetic and environmental factors, with considerable age variation. While lipid levels are generally lower in childhood and may predict future risk for atherosclerosis, normal ranges in cord blood have not been fully evaluated in developing countries. Objective: To evaluate the cord blood lipid profiles for full-term newborn infants. Materials and Methods: A descriptive cross-sectional study was performed at Ahmadu Bello University Teaching Hospital, Zaria, involving 71 term newborn infants. At delivery, cord blood was collected and serum separated by centrifugation. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured using Selectra XL AutoAnalyser (HUMAN Gesellschaft für Biochemica und Diagnostica mbH, Wiesbaden, Germany), while the atherogenic index of plasma (AIP) was calculated from the lipid fractions. Using a standardised pro forma, obstetric and demographic data, and cord blood lipid levels were collected. Data were analysed using the Statistical Package for Social Sciences version 20.0 software (SPSS Inc., Chicago, Illinois, USA), and results were presented in tables and charts. A P value of <0.05 was considered as significant. Results: There were 38 males and 33 females. The mean TC, TG, HDL-C and LDL-C were 1.87 ± 0.10, 0.57 ± 0.05, 0.70 ± 0.04 and 1.02 ± 0.07 mmol/L, respectively. The mean TG concentration is lower while the LDL-C is higher than the standard reference values. The AIP was −0.09. Neither gender nor anthropometric differences were observed. Conclusion: This study has defined the cord blood lipid profile and reference ranges for full-term newborn infants, with no sex or anthropometric differences. Further studies are recommended to determine values for pre- and post-term infants.

Background: Human immunodeficiency virus (HIV) infection is a major public health problem in sub-Saharan Africa. In addition to immunological complications of the disease, hematological abnormalities have been documented as strong independent predictors of morbidity and mortality in HIV-infected individuals. Objectives: To determine the effect of antiretroviral therapy (ART) on hematological and immunological parameters in HIV-positive patients. Materials and Methods: This was a retrospective cross-sectional analytic study involving 90 HIV-positive treatment naïve patients aged 18 years and above attending a tertiary hospital over a 6-month period. Frequencies, proportions, and paired t test were performed using SPSS version 20.0 and the level of significance was set at ≤0.05. Results: The mean (±SD) age of the study participants was 35.6 ± 9.65 years with females comprising of 56 (62%). The mean (±SD) values of the hematological parameters (at baseline and 6 months after initiation of ART) were: hemoglobin concentration [10.9 ± 1.95 vs 11.8 ± 1.83 g/dL, 95% Confidence Interval (CI); −1.1938, −0.5218, P value <0.001], white blood cell count (5.95 ± 2.84 vs 5.32 ± 1.75 × 10⁹/L, 95% CI; 0.0691, 1.1843, P value <0.001), mean corpuscular volume (83.04 ± 6.90 vs 85.33 ± 7.44 fL, 95% CI; −3.9424, −0.6290, P value <0.001), mean corpuscular hemoglobin (MCH) (26.3 ± 2.93 vs 27.5 ± 3.44 pg, 95% CI; −1.7713, −0.5030, P value <0.001), MCH concentration (31.4 ± 1.86 vs 31.9 ± 1.71 g/dL, 95% CI; −0.9369, −0.1088, P value <0.001), lymphocyte count (37.0 ± 12.9 vs 38.7 ± 11.78%, 95% CI; −4.7148, 1.1170, P value <0.001), neutrophil count (46.6 ± 13.8 vs 46.4 ± 12.0%, 95% CI; −3.3644, 3.6444, P value <0.123), and CD4 count (222.3 ± 230.10 vs 284.2 ± 196.72 cells/μL, 95% CI; −96.2642, −27.5802, P value <0.001). Conclusion: Anemia, neutropenia, and immunosuppression were the predominant findings in this study at recruitment. However, an improvement of these parameters was observed 6 months after commencement of ART among the HIV-positive treatment naïve patients. This showed that ART has improved both the hematological and immunological parameters in HIV-positive treatment-naïve patients.

Introduction: Hypertension affects approximately one billion people worldwide. Three hundred and forty million of these in economically developed and 340 million in economically-developing countries. The World Heart Federation reports that in the developed world, about 330 million people have hypertension, and about 640 million in the developing world. Estimates indicate that up to three quarters of the world’s hypertensive population will be in economically developing countries by the year 2025. Non-adherence to antihypertensive drugs is one of the most important causes of uncontrolled blood pressure. Materials and Methods: Between August 2013 and June 2014, we enrolled 424 hypertensive patients in a cross-sectional study using systematic sampling technique. The Morisky Green test for non-adherence was used to assess non-adherence to drugs. Information was collected regarding socio-demographic, drug related and healthcare service delivery factors to patient non-adherence using an interviewer administered questionnaire. Univariate, bivariate and multivariate analysis was conducted using Epi info software. Results: The level of non-adherence was 69.1%. Factors that were independently associated with non-adherence were; being a Junior Civil Servant (OR 2.9: 95%CI 1.1–7.7), exhaustion of drugs before the next clinic appointment (OR 5.9: 95%CI 2.8–12.5), buying drugs in private pharmacies and open market (OR 1.9: 95%CI 1.03–3.3) and total time spent counselling of less than five minutes (OR 1.8: 95%CI 1.02–3.2). Conclusion: The level of non-adherence in this study was found to be high. Creating special support groups for Junior Civil Servants, ensuring patients come back to the hospital to refill their drugs, improving counselling techniques and making prescribed antihypertensive drugs constantly available in the hospital, could improve the level of non-adherence to antihypertensive drugs among patients attending Federal Staff Hospitals and Clinics.

Background: Neonatal mortality remains high and currently accounts for about 54 and 29% of infant and under-five mortality rates, respectively, in Nigeria. Newborn deaths usually result from varying causes, some of which are neonatal emergencies. The study was conducted to document neonatal emergencies and their relative contributions to newborn death. Patients: and Methods A retrospective review of emergency cases admitted into the Special Care Baby Unit (SCBU) of Ahmadu Bello University Teaching Hospital, Zaria in Northwestern Nigeria over an 18-month period (January 2013–June 2014) detailing information on age, sex, place of delivery, birth weight and outcome. Results: About 70% (700/997) of the admissions were the emergency cases of which severe neonatal jaundice, sepsis and perinatal asphyxia accounted for 96%. A mortality of 9.8% was recorded with the case fatality rates of 5, 11, 18.8 and 25% for severe neonatal jaundice, neonatal sepsis, perinatal asphyxia and neonatal tetanus, respectively. Overall, neonatal emergencies accounted for 68% of neonatal mortality in the SCBU. Outborns were 1.4 times more likely to die from these emergencies compared to inborns. Conclusion: Neonatal emergencies constitute a major proportion of admissions and deaths in Zaria. Efforts should be directed at the prevention of the three major emergencies (neonatal jaundice, sepsis, perinatal asphyxia) identified and provision of available, accessible and affordable neonatal healthcare services.