Introduction: Integrated management of childhood illnesses (IMCI) is a holistic approach to reducing under-5 morbidity and mortality, and improving growth and development of children. This study compared key household and community practices in IMCI implementing and non-implementing communities in two local government areas (LGAs) of Kano State, Nigeria. Materials and Methods: A cross-sectional study was employed with multistage cluster sampling selection of caregivers of children 0-59 months of age and their index children (n = 400). The study was conducted from February 2009 through January 2010. Data analysis was performed using EpiInfo ^TM v6.0 and Minitab ^TM software. Results: The adoption of IMCI key household and community practices was generally better in IMCI-implementing communities than in non-IMCI communities. Exclusive breastfeeding (EBF) rate among children under 6 months was higher in IMCI communities than in non-IMCI communities (P = 0.05). Non-IMCI communities also had a greater proportion of low weight-for-age children (42.5%) than IMCI communities. Mothers from IMCI communities (30.5%) were more likely to have antenatal care (ANC) during the first trimester than those from non-IMCI communities (P < 0.05). There was no difference between the study communities with regard to use of insecticide-treated nets (ITN) during pregnancy (P = 0.09), and having skilled attendance during last childbirth (P = 0.23). Conclusion: Mothers in communities implementing IMCI are more likely to adopt EBF and to attend ANC services than their counterparts in communities not implementing IMCI. Expanding IMCI activities to other LGAs in northwest Nigeria will have a positive impact on reducing morbidity from common childhood diseases.

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Background and Aim : Protein energy malnutrition (PEM) is the most common nutritional disorder affecting children in developing countries including Niger Republic and continues to be a major health burden in these countries. There is paucity of data on the pattern of laboratory parameters among malnourished children in Niger Republic. The aim of the present study was to evaluate the pattern of some laboratory parameters among under-five malnourished children in Magaria District, Zinder, Niger Republic. Materials and Methods : A total of 220 malnourished children and 220 age- and sex-matched well-fed apparently healthy (controls) children were recruited for the study. Albumin, glucose, calcium, phosphorus and hemoglobin were estimated in the subjects and the data were analysed using Sigma-Stat 2.0 for Windows (San Rafael, CA). Results : Serum albumin, calcium, phosphorus and hemoglobin were significantly lower (P < 0.001) in PEM children compared to the controls. The serum levels of albumin and hemoglobin were also found to be significantly lower (P < 0.03) in children with edematous PEM than in children with non-edematous PEM. Conclusion : PEM children had reduced serum levels of the measured laboratory parameters when compared to apparently healthy well-fed children with resultant hypoalbuminaemia and anaemia, with more marked reduction in edematous than in non-edematous PEM children. This suggests that routine measurement of these laboratory parameters and their subsequent supplementation in PEM children could improve the management of this group of patients.

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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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Context: Teaching of medical students in Ahmadu Bello University (ABU) has been by conventional lecture methods. However, in other parts of the world, there has been a shift toward the use of PowerPoint and other computer-aided instructions (CAI). The conventional lecture method is said to encourage rote learning, whereas CAI is considered to improve students' performance as information is presented in the form of "reality." This study was conducted to determine the effect of PowerPoint presentation of lectures on the academic performance of students at ABU Zaria. Aims: The aim of this study is to determine the effect of PowerPoint presentation of lectures on the academic performance of 400 level medical students of ABU Zaria. Materials and Methods: It was a quasi-experimental technique, divided students into control (67) and experimental (67) groups. Pre- and post-test were conducted on the complications of blood transfusion. The experimental group was taught with PowerPoint using pictures, diagrams and algorithms, while the control group was taught with white board and marker. The mean pre- and post-test scores were compared using the t-test of significance (P < 0.05). Statistical Analysis Used: Student's t-test. Results: The mean pre- and post-test scores of the control (conventional) and experimental (CAI) groups were 54.3 versus 53.6 (P > 0.05) and 74.0 versus 80.5 (P < 0.05), respectively. Conclusion: PowerPoint presentation significantly improves the academic performance of medical students more than conventional lecture method. It is recommended that medical tutors should be encouraged to use PowerPoint in delivering lectures to students.

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Background: In developing countries, especially in Africa, most people with blinding eye conditions are not aware of their state and present with advanced disease. Objective: The main objective of the study was to determine common eye conditions and reasons for not seeking eye-care services among a teaching hospital staff. Materials and Methods: On World Sight Day 2012 staff of Benue State University Teaching Hospital (BSUTH) were invited to the eye clinic for the examination of their eyes. A questionnaire was filled for each and eyes examined and findings were analyzed. Results: There were 76 (48.1%) males and 82 (51.9%) females. The median age was 36.5 (range 19 to 65) years. The perceived cause of visual impairment (VI) and blindness was not significantly related to the level of education (P = 0.239). Reasons for not seeking eye-care services even when they had eye problems included finances 22 (13.9%), distance from eye-care center 4 (2.5%), lack of awareness 2 (1.3%), job situation 1 (0.6%) and fear 3 (1.9%). Of the 158 participants 30 (19%) had a close relative who had visual impairment (VI) or was blind. Most of the participants 151 (95.6%) had normal bilateral presenting visual acuity, 2 (1.3%) mild visual impairment and 5 (3.2%) moderate VI.The commonest ocular disorder was refractive error 39 (48.8%), followed by allergic conjunctivitis 14 (17.5%).Glaucoma 5 (6.3%) was the second potentially blinding ocular disorder, with 4 presenting with advanced disease. Cataract was seen in 4 (5.0%) and posterior segment disease in 2 (2.5%) participants. Conclusion: This study has shown that there is a lot of ignorance concerning causes of blindness and visual impairment among this group. There is therefore a need for awareness creation and eye health education and screening programs to detect ocular disorders.

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Klebsiella pneumonia (KPLA) liver abscess is a cause of morbidity and mortality in especially diabetic patients. Early case reports have been from the Southeast Asia, also been found in other parts of the world. Diagnosis is usually by culture of hepatic aspirate and/or blood culture and treatment by drainage of abscess and administration of appropriate antibiotics. This is a case of KPLA in a 52-year old man treated and responded to antibiotics. KPLA is an entity that should be sought for especially in poorly controlled diabetic patients when they present with clinical features of liver abscess. Blood culture must always be done especially when aspiration or drainage proves difficult. Use of appropriate antibiotics alone may be successful in treating them if surgical drainage is unsuccessful.

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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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Background: Kashmiri population is ethnically distinct, culturally unique and has distinct lifestyle and dietary habits. There is a high prevalence of obesity in Kashmiri populations and also studies have shown high prevalence of diabetes mellitus in this population. Aim: We designed this study to evaluate important metabolic parameters contributing to the prevalence of metabolic syndrome (MS). Materials and Methods: A prospective study involving 500 participants was designed. An informed consent was obtained from all the subjects before selection and permission was granted by Hospital Ethical Committee beforehand. The subjects were selected from the attendants who accompanied patients in in-patient and out-patient Departments of Sher-i-Kashmir Institute of Medical Sciences, Srinagar Kashmir. A random sampling procedure was adopted for the study. Age, sex, weight, height, waist circumference, hip circumference as well as blood pressure were measured in all study participants. Furthermore, measured were blood glucose and lipids in all participants. Subjects were screened for the components of MS according to criteria given by Adult Treatment Panel-111. Statistical Analysis: Data were analyzed using SPSS Version 11.5. Student's t-test was used to analyze categorical variable, while Chi-square tests was used for categorical variable and Mann-Whitney U-test to define association. The level of significance in each case was considered as P < 0.05. Results: The mean age of both men and women was 37 years. The prevalence of MS in this population is 8.6%, among males the prevalence is 7.4%, while among females it is 9.9% (P = 0.323). The prevalence of hypertension was 24.9% for males and 12.3% for females. The prevalence of hyperglycemia was 9.3% for males and 7.8% for females. About 9.7% males and 25.9% females had low high density lipoprotein-cholesterol (HDL-C). 17.1% males and 13.2% females had elevated triglyceride levels. The prevalence of obesity in males was 1.9% and in females it was 8.6%. Hypertension was the most common factor affecting the estimates of MS in men, whereas central obesity and low HDL-C were the common contributing factors in women. Conclusion: In this population, the components of the MS are more common among females than males. This could be related to the high prevalence of obesity and diabetes among them.

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A case of cholangiocarcinoma (CC) of the distal common bile duct in a 59-year-old woman in whom an ultrasound and CT diagnosis of mass in the head of pancreas was made but, surgery and histology revealed the correct diagnosis of CC. This case highlighted the dilemma of imaging in the diagnosis and management of cholangiocarcinoma. The clinical presentation, radiological diagnosis, and literature review have also been discussed.

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