Introduction: Perinatal asphyxia is a global neonatal problem which significantly contributes to both morbidity and mortality. It is the fifth largest cause of under-five mortality. This study was aimed to determine the prevalence, risk factors and outcome of perinatal asphyxia in newborns seen in the Special Care Baby Unit. Materials and Methods: A retrospective study of newborns managed for perinatal asphyxia over a 1-year period. All inborn babies with Apgar scores <6 at 5 min and out born babies with no Apgar score but with features of asphyxia were studied. Case files of the patients were retrieved and relevant information was obtained. Results: Of the 223 neonates admitted during the study period, 67 (30.1%) newborns had perinatal asphyxia from our record; but only 47 (70.1%) case files with complete data were retrieved, giving a prevalence of 21.1%. Twenty five (53.2%) of the mothers were primiparous, 31 (66.0%) had no antenatal care and 25 (53.2%) presented with prolonged obstructed labor. Twenty-eight (59.6%) of the newborns were females; 41 (87.2%) were term, 27 (57.4%) of normal birth weight, 42 (89.4%) delivered in the hospital and mostly through an emergency caesarean section. Thirty (63.9%) of the newborns were discharged; while 12 newborns died, giving a case fatality rate of 25.5%. Conclusion: Perinatal asphyxia is a significant cause of morbidity and mortality in Gusau. Health education of pregnant mothers on antenatal care for early detection of high-risk pregnancy is highly recommended in order to reduce the high incidence of this preventable condition.

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Clinical microbiology laboratory plays several important roles in the management of bacterial infections. Isolation, identification of pathogenic microorganisms in cultures and subsequent antimicrobial susceptibility testing always assists in selecting appropriate antimicrobial agent and prevention of unnecessary complications. The most important and primary test to perform directly on some special samples such as cerebrospinal fluid and positive cultures is Gram staining which serves as the most rapid and simplest test to characterize microorganisms. It is therefore highly likely that the information provided by the Gram staining will help to assess the adequacy of preliminary diagnosis and antimicrobial therapy selected after collecting culture specimens and before final identification of the microorganism. In recent reports, the impact of Gram staining results on patient mortality has been documented. On the other hand, there remains the possibility that Gram staining results do not match with the final identification of microorganisms. This would carry a risk leading to inadequate antimicrobial therapy and potentially affecting patients' clinical course and mortality. The aim of this mini review is to analyze and discuss the clinical significance and limitations of reporting Gram staining results for sample meant for bacteriological investigations.

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Diabetes is a major cause of morbidity and mortality both in developing and developed countries. The incidence is rising rapidly with sub-Saharan Africa experiencing the largest percentage increase between 2013 and 2035. Nigeria has the largest number of people with the disease, yet information on the diabetes mellitus for policy and programming is fragmentary. Therefore, the purpose of this study to systematically identify population-based studies on diabetes in Nigeria and to determine the prevalence and sex differential. A literature search of the PubMed database was conducted of published research between 1990 and 2013 using the medical subject headings "diabetes mellitus" and "Nigeria." The search was done at the end of 2013 which returned 741 hits. A manual search for additional studies was performed using references cited in the original articles. Some authors were contacted whose full-text publications were not available on the PubMed database or freely on the internet. Twenty population-based studies that had been conducted on the prevalence of diabetes in Nigeria between 1990 and December 2013 that satisfied the inclusion criteria were identified. The prevalence of diabetes ranged from 0.8% to 11% involving both urban and rural populations, with varying sampling schemes, one study reported a traditional population with very low prevalence of diabetes and highly specific populations as well. The review revealed a generally low prevalence (<10%) of diabetes in Nigeria. It also found that there is dearth of literature on diabetes. There is the need to undertake a nationally-representative survey to assess the burden of diabetes in general population.

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Background: Neural tube defects (NTDs) are congenital malformations of the cranium, spine, and nervous system. About 350,000 infants are born with NTDs yearly worldwide. This study aimed to determine the prevalence and spectrum of NTDs in live-born neonates in the Kano Metropolis of North-western Nigeria. Materials and Methods: This is a prospective study of all live-born neonates in three selected hospitals in the Kano metropolis between April 2013 and December 2013. A descriptive study design was employed. Neonates delivered at gestational ages 28 weeks or more were examined within 48 h of birth for external congenital anomalies. Detailed family history and clinical data were recorded for each child. Data were analyzed using SPSS version 15.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: Of the 1456 neonates recruited into the study, there were 757 (52%) boys and 699 (48%) girls. Of these, 4 neonates (2 boys and 2 girls) had NTDs (male:female ratio = 1:1), giving a birth prevalence of NTDs (2 spina bifida cystic, 1 anencephaly, and 1 encephalocele) of 2.75/1000 live births. The mean gestational age for the neonates with NTDs was 38 weeks (standard deviation [SD] 2.16 weeks) while their mean birth weight was 2.93 kg (SD 0.51 kg). Only 5.03% of the mothers in this study began the use of folic acid-containing multivitamin supplement at least 1-month before or in the 1 ^st month of the index pregnancy. Conclusion: Given the high prevalence of NTDs in this study, public health measures aimed at the prevention of this anomaly should be encouraged.

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Introduction: Once human immunodeficiency virus (HIV)-positive women become aware of their status, many demonstrate a reduced desire for pregnancy, particularly because most of them know that there are risks involved in delivering an HIV-positive child. Others, on the other hand, want to have children despite their HIV-positive status. These women have reproductive needs that should be respected and attended to. This study assessed the knowledge of contraception and contraceptive choices among HIV-positive women of reproductive age (15-49 years) attending antiretroviral clinics in Zaria. Materials and Methods: A cross-sectional descriptive study was carried out on 340 HIV-seropositive women of reproductive age group in January 2015 using a simple random sampling technique. Data were collected via structured interviewer administered questionnaire. Data collected were analyzed using SPSS version 21.0 and results were presented in tables and charts. Statistical significance was at P = 0.005. Results: The modal age group of the respondents was 20-29 years (44.7%) with mean age of 24.5 ± 8.4 years, 45% were Hausa, 59.4% Muslim, and 57.4% married. The majority (32%) had secondary education and of different occupation. About 87% had knowledge of HIV transmission from infected mother to child and 73.8% had heard of contraception. Prevalence of past contraceptive usage among these women was 56.1%, of which male condom was the most commonly used contraceptive (60.4%), either alone or dual contraception. This was followed by injectables (52%) and oral pills (35%). However, the current contraceptive use among the respondents was 36.3%. There was statistical relationship between age and educational level of the respondents and contraceptive use. Conclusion: The study has demonstrated that majority of these HIV-positive women had good knowledge about contraception but they do not apply this knowledge they have toward using an appropriate family planning method. Hence, there is a need for proper counseling and education of these women and their spouses by the health workers as they attend the antiretroviral clinic to erase fear and misconceptions of modern contraception. Male involvement will also go a long way in promoting contraceptive utilization.

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Background: Sickle cell disease (SCD) is relatively prevalent in Nigeria and it is associated with obstetric complications, especially in unsupervised pregnancies. This study was to determine the prevalence of SCD among pregnant women seen in an antenatal clinic in a tertiary health center in South-South Nigeria. Materials and Methods: This was a 10-year retrospective study of all registered pregnant women seen at the antenatal clinic of Braithwaite Memorial Specialist Hospital (BMSH) (2004-2013). Sociodemographic data and hemoglobin (Hb) electrophoresis were obtained using questionnaires and alkaline cellulose acetate electrophoretic machines (Helena), respectively. Data were analyzed using Epi-info version 7.02 by the WHO, Geneva, Switzerland, and CDC, USA. Results: A total of 35,976 pregnant women were seen at the antenatal clinic of BMSH within the study period, out of which 28,815 (80.09%) were Hb AA, 7,109 (19.77%) were Hb AS, and 52 (0.14%) were SS. The average gestational age of booking was 22.1 weeks. More women with tertiary education registered earlier than those with secondary education. Anemia in pregnancy (Hb <11 g/dl) was found in 94.2% of the pregnant women with Hb SS, while 5.8% was above 11 g/dl (P = 0.001). Conclusion: There is a high prevalence of SCD among pregnant women in this region. Late antenatal booking, anemia, and poor education are the predictive markers of poor pregnancy outcome in this region.

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Background: Watermelon (Citrullus lanatus) is a roundish or ovoid fruit rich in antioxidant supplements that prevent oxidative stress in hepatic tissues due to generation of reactive oxygen species following exposure to alcohol. The present study aimed to investigate the protective effects of watermelon seed on ethanol-induced oxidative damage in liver of Wister rats. Methods: Twenty-five adult Wister rats of both sexes were randomly divided into five groups of five rats each. Rats in group I were administered distilled water for 8 days. Group II were administered distilled water for 7 days followed by 20 mL/kg body weight of 40% ethanol per body weight on day 8. Groups III and IV were administered 200 and 400 mg/kg, respectively, of the extract for 7 days followed by 20 mL/kg of 40% ethanol on day 8. Group V received 100 mg/kg body weight of silymarin for 7 days followed by 20 mg/kg of 40% ethanol on day 8. Animals were sacrificed on day 8. Liver was excised and then processed for histopathological examination. Biochemical assay for the following hepatic marker enzymes was carried out: alanine amino-transferase (ALT), aspartate amino-transferase (AST), alkaline phosphates (ALP), and protein concentration. Results: The results showed that watermelon treatment leads to increase in body weight. Furthermore, pretreatment with watermelon seed extract lead to significant decrease (P < 0.05) in plasma AST, ALT, ALP, and protein concentration, compared to ethanol treatment group. Conclusion: Watermelon seed extract demonstrates hepatoprotective effect in ethanol-induced oxidation in the liver of Wister rats, which might be linked to various antioxidant phytochemical content present in the extract.

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Background: Hair loss in African women appears to be on the increase and has been associated with some hair-care practices. Objectives: The aim of this study was to determine the prevalence, pattern, and possible hair-care factors associated with alopecia in females in some educational institutions in Ibadan, Nigeria. Methodology: The respondents were interviewed using a pretested questionnaire containing information about their bio-data, hair-care practices, and history of hair loss if any. Subjects were examined for the presence and pattern of hair loss. Results: The prevalence of alopecia was 46.7%, with the traction alopecia being the most common (97.5%). The age range of those with alopecia was mainly 20-29 years. Hair loss was more common in subjects who had chemically treated their hair (P < 0.001). Conclusion: Alopecia is common among female students in secondary and tertiary institutions in Ibadan. Traction alopecia was the most common pattern of hair loss in this study supporting claims of hair-care practices as important etiological factors.

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Background: Malaria remains a disease of public health concern in tropical countries. Diagnosis in such countries largely depends on clinical assessment, microscopy (as the gold standard) and recently by rapid diagnostic tests (RDTs). This study was conducted to document common presenting symptoms of malaria, compare microscopy and RDT in the diagnosis of malaria in children in Gusau, Nigeria. Materials and Methods: A cross-sectional, study of children under-five years with presumptive diagnosis of malaria that was managed at the pediatric outpatient department and emergency pediatric unit of Yariman Bakura Specialist Hospital, Gusau. All consecutive children that met the inclusion criteria were recruited over a 4 weeks period. Malaria thick film microscopy and RDTs were carried out on all children. Results: Of the 118 children enrolled, 61 (51.69%) were males while 57 (48.31%) were females. Fever and vomiting were the most common presenting complaints. Microscopy was positive in 55 (46.61%) while RDT was positive in 10 (8.47%) of the children. Only 5 (4.24%) were positive for both microscopy and RDT. Fifty-eight (49.15%) children had negative microscopy and RDT results. There was no significance when positivity of both tests were compared (χ² = 0.050, P = 0.822). RDT had a sensitivity of 9.09%, a specificity of 92.06%, positive predictive value of 50.00%, and a negative predictive value of 53.70%. Conclusion: Our study observed higher positivity rate for microscopy than RDT. We recommend microscopy to be carried out on all patients suspected of having malaria where possible, even in the presence of negative RDT.

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Background: Despite the safety, affordability and widespread use of ultrasound; there is a paucity of literature on ultrasonographic assessment of the portal vein (PV) diameter in adult patients in our local environment. Aims and Objective: The aim of this study was to determine the mean and range of PV diameter in chronic liver disease (CLD) patients in our local environment. Materials and Methods: This cross-sectional prospective study was carried out at the University of Maiduguri Teaching Hospital between January and June, 2013. Two hundred and fifty adult male and female CLD patients and equal number of age and sex matched controls aged 18 years and above had abdominal ultrasonography for measurement of their main, right and left PV diameter in both inspiration and expiration. Transverse and longitudinal measurements were obtained, and the averages of the two measurements were used to determine their final diameter. Results: There were 187 (74.8%) male and 63 (25.2%) female CLD patients aged between 19 and 77 years (mean ± standard deviation [SD], 43.78 ± 12.97 years). The mean diameter of the main PV (±SD) in CLD was 18.68 ± 2.59 mm which is higher than that of the control (10.87 ± 0.81 mm). The mean diameter of the right and left PVs in CLD were 9.04 ± 1.26 mm and 8.58 ± 1.23 mm respectively, which were higher than the respective values of 4.35 ± 0.52 mm and 4.12 ± 0.52 mm in the control. The PV diameter correlated with age and respiratory phases in both CLD and the control group (P < 0.05). There was statistically significant difference in PV diameter between males and females (P < 0.05) with values higher in females. Conclusion: The mean value and range of PV diameter in CLD patients in this environment were statistically and significantly higher than controls. The diameter correlated with age and showed significant difference between the two sexes and respiratory phases.

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Background: There are many causes of the portal vein (PV) disease and these include portal hypertension (PHT), PV thrombosis, PV gas and PV stenosis/obstruction. PHT is a common clinical presentation of portal venous disease with multiple causes and several sequelae. There is a need for an imaging parameter that will aid early diagnosis of PHT since portal pressure monitoring devices are not available in most tertiary hospitals in Nigeria. Aims and Objectives: To determine the normal values of PV parameters using triplex ultrasound (US) among adults in Zaria, Nigeria. Settings and Design: This prospective study was conducted over a period of 6 months between November 2011 and May 2012 at the Radiology Department of Ahmadu Bello University Teaching Hospital, Zaria. Materials and Methods: Following an overnight fast, US scan was performed on 186 eligible participants. The diameter, cross-sectional area (CSA) and flow velocity of the PV were obtained. Results: The PV parameters obtained were as follows (mean ± standard deviation): PV diameter, 1.09 ± 0.22 cm (range: 0.87-1.31); CSA, 1.10 ± 0.203 cm ² (range: 0.89-1.30) and mean flow velocity, 15.44 ± 2.63 cm/s (range: 12.80-18.10). All the measurements in males were significantly higher than those in females (P < 0.001). Conclusion: The normal values of PV parameters have been established in adult subjects in Zaria. These values will serve as a reference to detect abnormalities of dimensions and flow velocities in the PV, thus enabling quantitative evaluation of patients with suspected PV disease.

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Aims: Identification of predisposing factor(s) for acute stroke death is of utmost importance to clinicians as this will assist in instituting specific therapy and management. This study was set out to determine factor(s) that predict mortality within 30 days of stroke ictus among adult Nigerians. Materials and Methods: A prospective hospital-based study. It involved consecutive adult stroke patients (≥18 years) admitted into the medical wards of the University of Ilorin Teaching Hospital Ilorin, North central Nigeria, between June 2011 and May 2013. Results: The mean age of 302 patients studied was 60.47 ± 13.60 years with more male (53.4%) and no significant difference in mean age between stroke survivors (60.8 ± 13.4 years) and the deceased (59.6 ± 14.0 years). The random blood sugar in survivors and case fatality were 9.4 ± 5.7 mMol/l and 9.3 ± 4.7 mMol/l, respectively. Mean cholesterol level was 6.1 ± 1.3 mMol and 7.1 ± 2.4 mMol in stroke survivors and deceased, respectively. Serum creatinine was higher among case fatality (107.1 ± 49.7 μmol/l) than survivors (101.7 ± 67.2 μmol/l). Brain Computer Tomography was available for 166 (55%) patients with pathologic stroke sub-types of cerebral infarction −71.1%, intracerebral hemorrhage −25.5%, and subarachnoid hemorrhage −3.0%. The median (interquartile range) National Institutes of Health Stroke Scale (NIHSS) score for all was 12 (8-15), survivors 11 (7-14), and 16 (10-23.5) for the deceased (P < 0.01). Sixty-four patients died within the study period giving a case fatality rate of 21.2%. Risk factors for stroke deaths were low Glasgow coma score (<8), high NIHSS score, and presence of complication. The independent predictors of 30 days mortality were admitting stroke severity using NIHSS score (≥15) (P < 0.001) and the presence of at least a complication (P < 0.001). Conclusion: More than one-fifth of these stroke patients died within the first 30 days of the ictus. Prevention, early recognition, and prompt treatment of complications of stroke could help reduce mortality.

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Background: Iodine deficiency is a major public health problem worldwide, especially in pregnant women and young children. It is the most common cause of preventable mental retardation all over the world. Few among the devastating outcomes of iodine deficiency in pregnancy are increased perinatal mortality, abortions, stillbirths, neonatal hypothyroidism, goiter, and congenital anomalies. Objective: To assess the nutritional iodine status of pregnant women in Zaria. Methods: Four hundred subjects were recruited for this study consisting of three hundred apparently healthy pregnant women and one hundred apparently healthy nonpregnant age-matched controls. Random urine samples were collected and analyzed for iodine by modified Sandell-Kolthoff reaction. Data were analyzed using Epi-Info 3.5.3 to obtain the mean ages and median urinary iodine concentration (UIC) for pregnant women, controls and then for each trimester of pregnancy. P ≤ 0.05 was considered statistically significant. Results: Mean ages ± standard deviation for pregnant women and controls were 25.41 ± 5.98 and 26.70 ± 5.83 years, respectively (P > 0.05). Median UIC for pregnant women and controls were 193 μg/L and 205 μg/L, respectively. Trimester-specific UICs were 250 μg/L, 154 μg/L, and 150 μg/L for the first, second, and third trimesters, respectively. The percentage of women with iodine deficiency increased with advancing gestational age. Conclusion: Pregnant women in Zaria were iodine sufficient. There was a progressive decline in median UIC from the first through the third trimester.

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Introduction: Highly active antiretroviral therapy (HAART) has become more accessible to human immunodeficiency virus (HIV)/AIDS patients in resource-poor countries, especially sub-Saharan Africa. However, its use is often complicated by the occurrence of drug-related toxicities and interactions limiting this benefit in a substantial proportion of individuals. Hepatotoxicity being one of the adverse effects of HAART has led to the interruption of therapy from sub-clinical and clinical hepatitis and sometimes led to death. This study, therefore, sets out to determine the prevalence and risk factors for hepatotoxicity among HIV/AIDS patients on HAART in our environment. Materials and Methods: This was a cross-sectional comparative study carried out at Aminu Kano Teaching Hospital, Kano, North-Western Nigeria. HIV positive patients aged 18 years and above who consented to take part in the study were recruited. The study subjects were made up of patients on HAART for at least 6 months who were compared with age-and sex-matched HAART naοve subjects. Data were collected using a pretested interviewer administered questionnaire. Sociodemographic information, clinical characteristics, possible risk factors, CD4 cell count, HAART regimen, etc., were extracted from the case notes of the subjects. Venous blood samples were collected for necessary investigations and analyzed at the hospital central laboratory. Results: Four hundred and forty subjects consisting of 220 HAART-experienced (group 1) as cases; while the other 220 (group 2) HAART-naοve served as controls. The prevalence of hepatotoxicity for the HAART-experienced group was 36.4%, with severe hepatotoxicity occurring in 3.2%. There was no statistically significant difference in the prevalence of hepatotoxicity between in the two groups (P = 0.738). Over 90% of liver enzyme elevations were asymptomatic. Independent risk factors for hepatotoxicity were concurrent use of antituberculosis drugs and HAART and low CD4 count. Conclusion: There is a need for pre-emptive regular monitoring of liver function tests in patients on HAART since cases of hepatotoxicity found in this study were predominantly asymptomatic. Careful selection of less hepatotoxic HAART regimens in patients with identifiable risk factors is an important strategy in preventing the hepatotoxicity.

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Introduction: Microalbuminuria (MA) an early marker of glomerular dysfunction is also associated with increased risk of cardiovascular disease (CVD) in the general population, and is frequently seen among patients with human immunodeficiency virus (HIV) infection. Measurement of MA is not routinely done in many HIV/acquired immunodeficiency syndrome (AIDS) patients in our environment, especially those on antiretroviral therapy (ART). This study was to determine the prevalence of MA among HIV/AIDS patients in Zaria. Subjects and Methods: Screening for MA was carried out in this cross-sectional study involving 101 HIV/AIDS patients on ART. Patients with hypertension, diabetes, renal disease, pregnancy, and with features suggestive of malignancy were excluded from the study. Urinary albumin and creatinine, serum creatinine, glucose, cholesterol, and CD4 count were assayed. The data obtained were analyzed using the statistical software package for the social sciences version 16.0 (SPSS 16.0). Result: The mean values for urine albumin, urine creatinine, and albumin creatinine ratio (ACR) were 9.35 mg/L ± 1.32 mg/L, 6.50 mmol/L ± 0.35 mmol/L and 1.77 mg/mmol ± 0.34 mg/mmol, respectively. Twenty-one (20.8%) patients were found to have MA (ACR 3-30 mg/mmol) with remaining 80 (79.2%) having normoalbuminuria (ACR <3 mg/mmol). Among patients with MA, 6 (5.9%) had estimated creatinine clearance of <60 ml/min. There was a statistically significant association (P < 0.001) between ACR and age in microalbuminuric patients. Conclusion: Prevalence of MA is high among HIV/AIDS patients on ART in Zaria. Routine measurement of microalbumin in urine is suggested for early identification of renal disease and CVD and possibly reduces morbidity and mortality among patients with HIV/AIDS infection.

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Context: Anacardium occidentale (cashew) leaf is used medicinally to treat various kinds of diseases such as diabetes, fever, bronchitis, and cetera, in different parts of the world, including Nigeria. Liver diseases are a worldwide problem. Medicinal plants are being increasingly utilized to treat a wide variety of diseases, liver disorder inclusive. Aim: This study investigated the hepatoprotective activity of pre-treatment with methanolic leaf extract of A. occidentale (MLAO) against carbon-tetrachloride (CCl ₄ )-induced hepatotoxicity in Wistar rats. Materials and Methods: A total of 20 Wistar rats were divided into five groups I-V of four rats each. Group I was the control, while groups II-V were treatment groups. Groups V and IV were administered MLAO (500 mg/kg and 1000 mg/kg, oral, respectively); III administered silymarin (100 mg/kg, oral) as the reference drug and group II administered CCl ₄ only. Treatment lasted a week. Twelve hours after the last treatment, hepatotoxicity was induced in the treatment group animals by administering a single dose of CCl ₄ (1 ml; 1:1 solution:oil, oral). Hepatoprotective effect was studied by histological and serum marker enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and alkaline phosphatase [ALP]) analysis. MLAO showed significant (P < 0.05) hepatoprotective effect by lowering the levels serum liver enzymes: AST, ALT, and ALP, which were in turn confirmed by histopathological examinations of liver sections and are comparable with the reference drug. Statistical Analysis Used: One-way analysis of variance. Results: Histological and biochemical examinations of the liver showed CCl ₄ -induced hepatotoxicity. Pretreatment with MLAO, especially at dose 500 mg/kg, revealed hepatoprotective effect against chemically induced acute liver toxicity by preserving the histoarchitecture of the liver and significantly (P < 0.05) reducing of the serum marker enzymes. Conclusion: MLAO possesses significant hepatoprotective activity.

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Background: There is a paucity of information on the relationship of renal ultrasound echogenicity and serum creatinine levels to CD4 cell counts in patients with human immunodeficiency virus-associated nephropathy (HIVAN) in our local environment. This necessitated the conduct of this study. Aims and objectives: To establish a relationship between renal ultrasound echogenicity and serum creatinine levels and CD4 cell counts in adult patients with HIVAN. Settings and Design: A cross-sectional study of 100 consecutively confirmed HIV-seropositive patients aged between 19 and 65 years (mean ± standard deviation: 35 ± 10.79) comprising 32 males and 68 females with clinical and laboratory features of HIVAN was conducted at the infectious disease clinic of the University of Maiduguri Teaching Hospital, between April 2011 and September 2012. Materials and Methods: The subjects underwent renal ultrasound scan, and the degree of parenchymal echogenicity was recorded. Serum creatinine levels and CD4 lymphocyte counts were also obtained for all the patients. Statistical Analysis: The data obtained were recorded on Data sheet and analyzed using SPSS for windows version 16. Results: Of the 100 cases studied (i.e., 200 kidneys), ultrasound showed abnormal echogenicity in 192 kidneys (96%) with a grade I echogenicity in 4 patients (4%), grade II echogenicity in 36 patients (36%) and grade III echogenicity in 56 patients (56%). Four patients (4%) had a normal renal echogenicity. Majority of the patients had grade III renal echogenicity. The lower the CD4 count, the higher the degree of the renal echogenicity. Although, the higher the serum creatinine levels, the higher the degree of the renal echogenicity. Conclusion: The degree of the renal echogenicity was found to be inversely proportional to the CD4 cell counts. Prognosis also worsens with higher serum creatinine and lower CD4 cell counts.

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Context: The cerebellum is vulnerable to damage from a variety of sources such as degenerative diseases, infectious processes and toxins, like antimalarial drugs. Various parts of Phoenix dactylifera (date palm) are used in traditional medicine to treat various disorders such as memory disturbances, loss of consciousness, nervous disorders, etc., in different parts of the world. Aim: The neuroprotective effect of aqueous fruit extract of P. dactylifera (AFPD) was assessed against artesunate (AS) (antimalarial drug) - induced cerebellar damage in Wistar rats. Materials and Methods: Twenty Wistar rats (male and female) were divided into five groups (A-E) of four rats each. Group A was the control whereas Groups B-E were treatment groups. Cerebellar toxicity was experimentally induced in Wistar rats by administering AS. Group B was administered AS (300 mg/kg, oral). Groups C, D, and E were administered AFPD (500 mg/kg, 1000 mg/kg and 1500 mg/kg, oral, respectively) followed by AS (300 mg/kg, oral) for a period of 7 days. Neuroprotective activity was studied by histopathological examination of brain sections applying routine (Haematoxylin and Eosin) and histochemical (Cresly Fast Violet) staining techniques. Statistical Analysis Used: One-way analysis of variance. Results: Histopathological examination of brain sections revealed neuronal degeneration of cerebellar cells, such as, vacuolations and degeneration of Purkinje cells, and alteration in the general histoarchitecture of cerebellum was observed in AS-intoxicated group. The administration of AFPD remarkably inhibited AS-induced neuronal damage in Wistar rats with maximum neuroprotective effect at 500 mg/kg and 1500 mg/kg doses when compared with tissue sections of AS-intoxicated group. Conclusion: Result suggests that the effectiveness of AFPD in neuroprotection is probably due to its constituent antioxidant properties.

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Background: Thyroid physiology changes significantly during pregnancy. Consequently, thyroid disorders are prevalent in women of child-bearing age and commonly present in pregnancy and puerperium. Untreated thyroid dysfunction in pregnancy has adverse effects on fetal and maternal well-being, including miscarriage, placental abruption, preterm delivery and preeclampsia. Aim: The aim of this study was to determine the prevalence of thyroid dysfunction among patients with gestational hypertension in Nigeria. Materials and Methods: Plasma concentrations of thyroid stimulating hormone, free thyroxine, and free tri-iodothyronine (fT ₃ ) were measured in 165 pregnant women (aged 18-40 years) with gestational hypertension and 126 age-matched normotensive pregnant women, who served as controls. All laboratory analyses were conducted on Elecsys 2010 immunology analyzer, using a highly sensitive and specific chemiluminescence immunoassay method. Results: The prevalence of thyroid dysfunction was 23.6% and 10.3% in women with gestational hypertension and the normotensive pregnant women respectively. The most common thyroid dysfunction among the study participants was subclinical hypothyroidism accounting for 41.0% and 46.2% of all cases of thyroid abnormalities among the gestational hypertensive women and their normotensive counterparts, respectively. Conclusion: In view of the relatively high prevalence of thyroid dysfunction found in this study, it is suggested that all pregnant women (especially those with gestational hypertension) should be routinely screened for thyroid function abnormalities.

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Context: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are growing public health concerns and are responsible for most cases of chronic liver disease worldwide. Aims: This study evaluated the prevalence and associated sociocultural factors in HBV and HCV infections among pregnant women in our hospital. Settings and Design: Cross-sectional hospital-based study. Materials and Methods: Two thousand four hundred and sixty-two pregnant women were recruited for the study with a mean age of 26.4 ± 5.6 years. Screening for hepatitis B surface antigen was done using latex rapid agglutination slide tests and samples that were reactive were further confirmed using enzyme linked immunosorbent assay (ELISA, Bio-Rad, France). Anti-HCV antibody was evaluated using a third generation ELISA (DRG International Inc., USA). Statistical Analysis Used: Statistical analysis was performed using the Statistical Package for the Social Sciences version 20 software (SPSS Inc., Chicago, Illinois, USA). Results: Seroprevalence of HBV and HCV infections in this study was 14.6 and 2.0%, respectively. Percentages of pregnant women who were positive for HBV increased progressively with age. Seroprevalence of HBV was significantly higher among participants with below secondary (20%) than those with secondary and tertiary education (13.1%), P = 0.001. Significant positive correlation was observed between HBV and scarifications (P = 0.001), and negative correlation was observed between educational level and HBV (P = 0.001). Significant positive correlation was seen between previous blood transfusion and HCV (P = 0.002). Conclusion: There is a high prevalence of HBV and HCV infections among the participants. HBV and HCV infections are associated with age, scarifications, blood transfusion, low level of education, and multiple sexual partners among the participants. There is a need for infants of HBV-positive mothers to receive hepatitis B immune globulin in addition to hepatitis B vaccine within 12 h of birth.

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Introduction: Hypospadias and its surgical correction is a challenging urologic discipline. Various surgical procedures for correction of this anomaly have evolved, in order to reduce complication rate and improve cosmetic outcome. The aim of this study is to review the complication rate and cosmetic outcome in patients who had hypospadias surgery at Ahmadu Bello University Teaching Hospital, Zaria. Patients and Methods: The case records and clinical appearance of 54 patients with hypospadias who had surgery between June1998 and June 2008 were reviewed. The effect of different variables on the overall complication rates were evaluated, including: the degree of chordee; the urethral meatal site after correction of any penile curvature; the age of the patient at surgery; the source of the neourethra; and tubularization of the flap. Result: The mean age of the patients was 1.97 (0.5-12) years. Most patients had their repair at 2 years of age. Twenty-six had distal hypospadias while twenty-eight were mid penile or proximal hypospadias. Distal hypospadias have a better outcome than proximal hypospadias. Onlay flaps have lower stricture and fistula compared with tubularized flaps. Repairs are done recently at earlier age with equal or better outcome. Conclusion: Skin flap procedures have had sufficiently extensive use to support the feasibility of a one-stage repair of different types of hypospadias. Snodgrass is gaining popularity in recent times, and more procedures are likely to evolve in order to improve cosmetic outcome.

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Background: The true incidence rate of appendicitis in Nigeria and the magnitude of appendicular fecaliths as a specific causal factor in appendicitis are unknown. Materials and Methods: A retrospective clinicopathologic study was conducted using the medical database of the Ahmadu Bello University teaching hospital, Zaria, northern Nigeria for the decade from 2001 to 2010. The National Population Census in Nigeria 2006 was used to estimate the standardized annual incidence of appendicitis in the locality. Pathologically confirmed specimens of appendicitis were analyzed against demographic data of the patient. Results: During the decade, there were a total of 382 cases with intraoperative diagnosis of appendicitis of which the diagnosis was confirmed pathologically in 373 cases. With a local population whose disease or specimens would most probably end up in this hospital pathology department estimated at 1,423,469 the standardized incidence rate of appendicitis was 2.6 per 100,000 per annum. In 354 (93%) out of the 382 specimens, fecaliths were identified and thought to be causally related to the disease in the individual case. Conclusion: Appendicitis is very uncommon in northern Nigeria and when it occurs, it is almost always caused by fecaliths.

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Context: Breast tumors are common worldwide, and various reports suggest an increasing incidence in Nigeria, which necessitates an urgent need to differentiate benign from malignant tumors. Aims: To classify, grade and to determine the changing pattern, frequency, age and sex distribution of breast tumors seen in a tertiary hospital. Materials and Methods: This was a 10-year retrospective study of all breast tumors diagnosed at the Pathology Department of a Teaching Hospital from 1 January 2001 to 31 December 2010. Results: A total of 1,566 breast tumors were diagnosed during the study period, of which 1035 (66.1%) were benign, and 531 (33.9%) were malignant. Fibroadenoma was the commonest benign breast tumor followed by fibrocystic change, and they accounted for 47.1% and 25.4% of benign breast tumors respectively. Out of the 531 malignant cases reviewed; 496 (93.4%) were females, and 35 (6.6%) were males with a female to male:ratio of 14.2:1.0. The age range of malignant cases was between 21 and 79 years with a mean age of 42.0 years. Invasive ductal carcinoma was the predominant histological type with 316 cases (59.5%). This was followed by medullary carcinoma with 61 (11.5%) cases, invasive lobular carcinoma and invasive papillary carcinoma each with 37 (6.9%) cases. Three hundred and ninety-eight cases satisfied the criteria for grading, out of which 237 (59.5%) cases were classified in Grade 1, 133 (33.4%) cases in Grade 2 and 28 (7.1%) cases in Grade 2. Conclusions: Breast tumors are quite common which are mostly benign and are seen in both sexes with a striking female preponderance. The findings are generally similar to most previous studies from Nigeria, Africa and western world with minimal variations.

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Background: Diabetes mellitus (DM) is a risk factor for tuberculosis (TB) and may modify its presenting features. Atypical radiologic images of pulmonary TB are common in DM. Many studies have compared the radiological manifestations of TB between patients with and without DM. Aim of the Study: To study the impact of poor glycemic control on radiographic manifestations of the newly diagnosed smear-positive pulmonary TB patients with type 2 DM. Materials and Methods: In a tertiary care hospital, 70 patients newly diagnosed with smear-positive pulmonary TB and with coexisting type 2 DM were enrolled. Glycemic control was assessed by glycosylated hemoglobin (HbA1 _C ). A pretreatment chest radiograph was read independently by two qualified pulmonologists blinded to patients' diabetic status. Films with any discordant reading were read by a third reader. Radiological lesions on chest radiograph were classified into minimal, moderately advanced and far advanced as per American Thoracic Society criteria. Results: Of 70 patients, 47 (67.1%) had their HbA1c level ΃7%. Patients with poor glycemic control (HbA1c ΃7%) were more likely to have lower lung field involvement (29.8% vs. 13.04%; P < 0.01), far advanced lesions (40% vs. 4%; P < 0.001) and cavitary disease on chest radiograph (76.6% vs. 43.4% P < 0.05). Conclusion: Poor glycemic control significantly influences radiographic manifestations of pulmonary TB in patients with DM. Uncontrolled diabetics seem to have multiple and large cavities. Also isolated lower lung field involvement is more common in uncontrolled diabetics than in optimal control patients. High index of suspicion is, therefore, required in uncontrolled diabetics when radiological patterns are atypical.

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Background: Decrease or increase in eyeball volume (EV) may indicate ocular pathology. Unfortunately the reference values utilized for EV in Nigeria has been that of Caucasians. There is paucity of literature on EV measurements in Nigeria and none (to the best of our knowledge) on magnetic resonance imaging (MRI) EV biometry in Nigeria. Aim: To establish the normal EV in healthy population in Zaria using a reliable MR imaging. Patients and Methods: The EV volumes of 100 consecutive 'normal' patients who had MRI scan done (using Siemens MR imaging permanent magnet, 0.2T) were calculated. The dimensions were obtained at mid-ocular axial slices with maximum anterior-posterior dimension and maximum size of the eye lens. Results: The mean EV of the right eye was 6.75 ± 1.01 cm ³ while that of the left was 6.74 ± 0.95 cm ³ . The mean EV in the males' right eye was 6.86 ± 0.98cm ³ while that of the left eye was 6.97 ± 0.99 cm ³ . Whereas, the mean ± right VE in the females was 6.61 ± 1.03 cm ³ while that of the left eye was 6.52 ± 0.86. VE correlated with the patients' age with P < 0.001 for both sides. Conclusion: The EV of males is larger than that of females but not statistically significant. EV was observed to increase with age, but it declined after age 40 years. The study also established EV in a sample of normal population in Zaria with the hope that it will serve as reference values in that local environment.

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