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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Squamous cell carcinomas (SCCs) are among the most common malignancies in adults but are exceptionally rare in children. However, children with certain disease condition, for example, xeroderma pigmentosum (XP), a rare autosomal recessive inherited disease, is highly susceptible to the development of cancers including SCC. Reports on the use of ionizing radiation in the treatment of XP-related malignancy are very scanty in the literature. We hereby report our experience on the use of photon beam to treat a 7-year-old pupil with XP presenting with SCC of the anterior tongue and scalp.

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This is a case of a 22-year-old woman who has had a second-trimester abortion and two preterm deliveries incidentally diagnosed of sub-septate uterus on hysterosalpingography (HSG). The case is presented to emphasize on the value of HSG in the management of recurrent pregnancy loss due to suspected Mullerian duct anomaly (MDA). The degree of intercornual angle distinguishes between the types of MDAs and angles of <75° that have a high diagnostic accuracy for the septate uterus variety.

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Isolated primary penopubic epispadias is a rare anomaly with a reported incidence of one in 11,700 males. It is unusual for patients with this anomaly to present for the first time in adulthood due to the fact that the clinical presentation is striking at birth. The hallmark of surgical repair is the reconstruction of a functionally and cosmetically appealing genitalia as well as proper citing of the neomeatus. Several surgical procedures for complete epispadias have been described in the literature, but the modified Cantwell-Ransley technique and the Mitchell-Bagli repair (complete penile disassembly) are the most widely used. We report a case of a 25-year-old man who presented to our facility for the first time for surgical treatment. The patient underwent the modified Cantwell-Ransley procedure based on surgeon's preference and expertise. The delay in presentation was a thing of concern to us as it is well-known that boys born with epispadias suffer poor self-image as they grow older and become aware of their genitalia. Following a successful modified Cantwell-Ransley procedure our patient's self-esteem, confidence, and sexual appeal greatly improved. We, therefore, conclude that surgical procedures such as the Cantwell-Ransley repair are appropriate even in cases presenting late in adulthood.

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Introduction: The practice of ophthalmology and psychiatry meet over several aspects of patient management such as diagnosis, treatment, and follow-up. In addition, many of the drugs used in psychiatry may have some ocular side effects. This study assessed the profile of ocular disorder among patients attending the clinic at Federal Neuro Psychiatric Hospital Kaduna. Nigeria. Materials and Methods: This was a descriptive cross-sectional study carried out between May and August 2013 using interviewer administered questionnaire and eye screening protocol. The data were analyzed using SPSS version 20.0. Results: The male: female ratio was 1:1.1, age range of 18-69 years with mean age of 34.7 ± 5.9 years. Normal vision was recorded in 197 (77.2%), moderate visual impairment in 52 (20.4%), and severe visual impairment in 5 (2.0%). One (0.4%) was blind. Ocular disorders were seen in 139 (54.6%) and are as follows: Refractive errors/presbyopia 76 (29.8%); cataract 22 (8.6%); glaucoma 15 (5.9%); allergic conjunctivitis 15 (5.9%); optic neuritis 3 (1.2%), squint, and eye movement disorders 2 (0.8%) each; neurofibromatosis, color deficiency, ptosis, and macular scar 1 (0.4%) each. Average duration of treatment with psychotropics was 3 years. Conclusion: Majority had good vision. The predominant ocular disorders were refractive errors/presbyopia, cataract, glaucoma, and allergic conjunctivitis. Psychotropic drugs could be responsible for some.

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Introduction: By 1988, when the Global Polio Eradication Initiative began, there was an estimated 350,000 cases of poliomyelitis were occurring annually worldwide. By 2015, due to global vaccination efforts, indigenous transmission of wild poliovirus had been eliminated from all countries, except Afghanistan and Pakistan. A cornerstone of the polio eradication strategy is achieved by ensuring high levels of routine immunization coverage with 3 doses of oral polio vaccine (OPV) in children <1 year. Routine OPV coverage was assessed including some of the factors affecting coverage including region, place of residence, and mother's level of education. Methods: Secondary dataset analysis of the Nigeria Demographic and Health Survey carried out in Nigeria in 1990, 1999, 2003, and 2008 with available datasets was conducted. Results: Lowest coverage rates of 9%, 11%, 11% for 1999, 2003, and 2008, respectively, were recorded for the Northwest of Nigeria. OPV 0 coverage was twice that in urban areas compared to rural areas in 1999 and 2003 (42% vs. 19.91% in 1999 and 35.35% vs. 18.35% in 2003). OPV 0 coverage in children of mothers with no education was 12% in 1999, 2003, and 2008 compared to children of mothers with a tertiary education that were 56% in 1999, 50% in 2003, and 81% in 2008. Conclusion: OPV coverage was generally lower in the Northern region and in rural areas. Children of mothers with lower levels of education were less likely to receive OPV. Campaigns to improve routine immunization coverage should be targeted to the Northern regions, rural areas, and mothers with low educational levels.

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Introduction: Inadequate provision of family planning and contraceptive services contributes immensely to the worldwide burden of maternal and child morbidity and mortality. Objectives: To assess the uptake of family planning services and its determinants among women of reproductive age group in Edo North Senatorial District, Edo State. Methodology: A descriptive cross-sectional study was carried out. Respondents were selected using multi-stage sampling technique. Questionnaires and observational checklists were used for data collection. Data were analyzed using SPSS version 17. Results: A total of 340 respondents and 15 primary health care facilities were assessed in this study. Sixty percent of the respondents had at least secondary education. The choices of contraceptives were as oral contraceptive pills (OCP) (77.0%), condoms (75.8%), and injectables (56.2%). The predictors of uptake of contraceptives were as marital status (odds ratio [OR] =0.283, 95% confidence interval [CI]: 0.108, 0.746), monthly income (OR = 0.628, 95% CI: 0.491, 0.802), and respondents residence (OR = 0.504, 95% CI: 0.296, 0.859). Conclusion: Uptake of family planning services was higher than both the national and Edo State average values. The determinants of uptake of these services were, marital status, monthly income, and respondents' residence. The state and local government should increase the availability of family planning services in all the communities and create awareness among the single and unmarried women for improved uptake.

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Background: Internet is a relatively new medium of disseminating health information. Studies on Internet usage for health information among patients have mainly been done in developed countries, and very few studies have been carried out in developing world. Objectives: These were to determine the percentage of patients attending specialist clinics that use Internet for health information, describe types of information sought and if patients share the information with their physicians. Materials and Methods: This was a cross-sectional descriptive study. Stratified sampling with equal allocation was done from four specialist clinics and respondents were then selected by simple random sampling. Results: One hundred and ninety-four respondents participated in the study. The mean age of respondents was 31.24 ± 1.0 years. Majority were computer-literate 135 (69.60%) and had tertiary education 108 (55.70%). Sources of access to Internet and search engines used were phone set 167 (86.10%) and Google 147 (75.90%). Types of information sought on the Internet were on disease condition 55 (39.86%) and drug treatment 22 (15.94%); majority of respondents found the information useful 125 (64%) and shared it with their physicians. Educational status and not the age of respondents was significantly associated with computer literacy and Internet use (x² = 46.03, df = 5, P = 0.001). Conclusion: The study revealed that respondents are knowledgeable on the use of Internet, how to search for information and a high proportion of the patients use it. With increasing access to mobile phones, Internet users will continue to rise overtime and so will demand for seeking medical information. Practical Implications: Health care professionals must acknowledge the use of Internet by their patients in search for knowledge, be ready to discuss such information and provide reliable guide to useful health websites.

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Normal visual functioning is related to cognitive, motor, and emotional development since typical children learn to use visual communication, to move, to talk, and to develop many activities they observe others using. Early detection of atypical visual functioning, particularly in the 1 ^st year of life can help avoid potentially life-threatening conditions and delays in development which may follow. This article discusses five visual developmental milestones during the 1 ^st year of life in a typical healthy infant. It also advocates using these milestones in a multidisciplinary approach to early intervention, which includes training of pediatricians and other stakeholders in contact with infants at every level. In addition to this, the development of a cadre of ophthalmic counselors to improve compliance and follow-up may be a cost-effective strategy for pediatric vision care in the developing countries today.

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