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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Street begging is a social challenge that is more rampant in Northern Nigeria than elsewhere in the country. Some poor individuals resort to street begging to sustain their families. Street begging is found more among people living with physical challenges, particularly the blind persons. We reviewed the literature on the causes of blindness and challenges to accessing curative and rehabilitation support services. This is with a view to draw the attention of policy formulators on the appropriate rehabilitation of the visually disabled persons in order to tackle the menace of street begging in Northern Nigeria. A review of the literature was done electronically as well as manually. For electronic search, various scientific journals and web-based search engines were used. The search terms were blind street beggars, visual disability among beggars, avoidable blindness, blindness in northern Nigeria, socioeconomic impact of blindness, psychosocial impact of blindness, challenges of rehabilitation in Nigeria, visual disability in Northern Nigeria, destitution in Nigeria. Cross references of relevant articles were also retrieved. Majority had blindness from avoidable causes (over 75%) and had difficulty in accessing curative and rehabilitation support services. In the light of the avoidable nature of the majority of the causes of blindness among blind beggars in Northern Nigeria, coupled with the existing inadequate modalities for rehabilitating incurably blind, it is recommended that, a comprehensive eye care program on preventive, curative and rehabilitative services with a strong public health education campaign on the avoidable causes of blindness and discouraging street begging should be put in place by relevant stakeholders.

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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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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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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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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: Chemical burns sustained following assault, represent a considerable medical and financial challenge for the society. These patients have poorer outcomes, are difficult to manage, and represent an economic drain on an already-strained health care system. This article explores the peculiar presentation and management of chemical burns of the head and neck in Zaria, North West Nigeria. Materials and Methods: The study was performed between April 2004 and June 2013. A retrospective medical records review was undertaken to select patients who had burn injuries to the head and neck from chemicals in the setting of an assault. Recorded information included details of the patient demographics, clinical presentation and treatment. Records with incomplete data were excluded. Results: The motive for the assault in three victims was revenge for perceived injustices at school and work, and in the setting of a relationship that had gone sour in one patient. The assailant was known to the victims in two of the chemical assault. The upper eyelids, nose and the scalp were most commonly injured. Two patients sustained chemical burns to the eyes with complete loss of vision, (no light perception) and three developed mentosternal contractures. Twenty six reconstructive procedures were carried out and these patients underwent an average of three operations each during admission in the hospital. The average hospital stay was 5 months with a range of 1-14 months. Conclusion: There was a preponderance of male patients and most of the perpetrators were men. Motive was reduced to three categories robbery, matters related to love or the lack of it and revenge. Majority of the patients in this study had burns <30% of the total body surface area, however more than half of the patients required three or more surgical procedures. A multidimensional approach will be required to prevent chemical assault through heightening awareness, legislation and enforcement.

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A male child presented at 2 years of age with intractable infantile spasms. He had various dysmorphic features, global developmental delay and inability to feed. The electroencephalogram and MRI was suggestive of lissencephaly. We confirmed the diagnosis by FISH test. Thus, FISH test can be used in diagnosing rare genetic disorders.

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