Aim: To study twinning among a selected group of Igbo women. Method: A retrospective study was carried out as regards 100 Igbo twin prone women attending the author's self-referral outpatient clinic situated in Enugu. Results: 91 women bore twins once, 6 delivered them twice, and the three remainders got them thrice. On distinguishing between the first, second, penultimate and last positions in the order of birth, the last situation preponderated. Worse fates awaited twins born in times past, some being killed avowedly. The parity varied from 4 to 12 with a mean of 8. The catchment population was mostly from Enugu town and Enugu State as a whole. Conclusions: Self-referral is an important aspect of the utilization of health services. Distance is a limiting factor, but satisfaction with the service rendered can ameliorate matters. Although there is familiarity about twinning, much remains unknown. Perhaps, establishing a National Twin Registry will become a very valuable research resource.

Tubal pregnancy is relatively common. A rare variety of it is twinning in which two fetuses occupy the same tube. Another unusual form of twinning is when ectopic tubal pregnancy itself is combined with normal intrauterine pregnancy proper. Quite extraordinary is the present report of two cases occurring in Enugu within a fortnight during which each tube exhibited its own fetus. Microscopy showed that the chorionic villi in each patient manifested either normal appearances or necrotic changes unilaterally, thereby indicating earlier conception in one tube. This appearance supports among other things the hypothesis that tubal conception may self-terminate and leave behind an occlusive lesion.

A case of a large dermoid cyst in the floor of the mouth of a 22-year old Nigerian man is presented. Before presenting to us, the patient had visited several herbal homes and made many traditional rituals. Clinical examination revealed the presence of a large painless fluctuant mass in the floor of the mouth with corresponding protrusion of the submental region depicting a double chin in appearance. Simple needle aspiration of the lesion yielded no aspirate. A provisional diagnosis of dermoid cyst was made. The patient was admitted and enbloc enucleation of the lesion carried out under local anesthesia. The diagnosis was confirmed histologically. Clinical progress was uneventful and postoperative assessment after six months showed no recurrence. The patient management is hereby presented.

Aim: To investigate oral health knowledge and behaviour amongst nursing students in a Nigerian tertiary hospital. Materials and methods: The study was conducted at University of Nigeria Teaching Hospital on respondents aged 17 to 40 years, using self administered structured questionnaire. Result: From oral health knowledge variables, only level of study, knowledge of calculus and orthodontics and role of fluoride in caries aetiology were significant. However, no oral health behaviour variable was significantly associated with oral health knowledge. About 11.0% of the respondents had visited the dentist within the last 12 months as against 68% that had never. About 53% brushed once daily, 43% brushed more than once a day and 2.7% brushed occasionally. Conclusion: The respondents had good oral health knowledge, but further improvements, especially on oral health behaviour should be stepped up.

Aim: To determine if there is a difference in the blood pressures, weights and heights of children living in urban and rural areas in Southeast Nigeria and to determine if their weights or heights affected their blood pressure. Methods: Pupils from six randomly selected primary schools in Enugu urban (4) and two rural communities (one from each community) had their weights, heights and blood pressures measured. Using the SPSS software their mean values were found and were subjected to z-test at a level of significance of 0.05 while the correlation coefficient, r, between weight and height on the one hand and systolic blood pressure and diastolic blood pressure on the other for all the ages were determined. Results: A total of 2516 (1218 males & 1298 females) children living in urban area and 817 (401 males & 416 females) in rural area aged 6 to 14 years were studied. The mean systolic blood pressures were only significantly higher in the boys living in the urban area than those in the rural areas at ages 7 to 9 and 14 years. The mean diastolic blood pressures were significantly higher in the children living in the urban than in the rural areas at ages 6 to 10 years in the boys and 7 to 10 years in the girls. The children living in the urban areas had weights and heights that were significantly more than those of the children living in the rural areas for all ages studied. Conclusion: The blood pressures were higher in the second halve of the first decade of life in children living in urban areas than as found in those in rural areas but this difference disappeared by the early phase of the second decade of life as studied. These blood pressures of the rural children at this period did not correlate with the weights.

Aim: To compare the effect of de-worming alone and de-worming plus iron supplementation on the haemoglobin (Hb) of primary school children. Materials and methods: An intervention study involving 502 primary school children aged 5-15 years was carried out between May to August 2003. The study group comprised 253 children who were de-wormed using Levamisole hydrochloride as single dose and also given ferrous sulphate twice a week for 3 months. The control group was 249 children who were only de-wormed using Levamisole hydrochloride. Pre- and post-intervention Hb estimation of each child were obtained and results of study and control groups compared. Hb of less than 12g/dl was taken as anaemia. Results: There were no significant differences in the sex (P=0.65) and age (P=0.18) distributions of study and control groups. Pre-intervention, there was no significant difference in the level of anaemia among the school children (P = 0.54). Post-intervention, the level of anaemia dropped more significantly in study than control group (P=0.00). Conclusion: Though de-worming will improve the Hb level better result will be achieved by including twice a week iron supplementation especially as a short term preventive/curative measure for mild to moderate anaemia in school children.

Background: Diabetes Mellitus is leading endocrine disorder of global interest. It is of multifactorial aetiology. Methods: Coagulation status of newly diagnosed and untreated diabetic patients from the Diabetes Medical out-patient Department of University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria was studied. Seventy (70) newly diagnosed and untreated diabetic patients aged 20 - 60 years and 70 age and sex-matched non-diabetic controls were randomly selected after screening biochemically for diabetes mellitus, using standard glucometer. The 1997 World Health Organisation criteria for diagnosis of diabetes mellitus were used. Results: Prothrombin Time (PT), and Activated Partial Thromboplastin Time (APTT) were determined using Dacie and Lewis method. Body Mass Index (BMI) was also estimated. Only PT and BMI, showed statistically significant differences (PL 0.05) when the male mean diabetic values were compared with those of the female diabetic patients. Also, APTT, Fasting Blood Sugar (FBS) and BMI revealed statistically significant differences (P<0.05) when diabetic males mean values were compared with those of the control group. Furthermore, mean values of PT, APTT, FBS and BMI demonstrated statistically significant differences (P<0.05) between the female diabetic patients and their corresponding control. Conclusion: This study revealed that diabetes mellitus has adverse effects on coagulation, hence screening of diabetic patients for PT and APTT are recommended.

Background: Charcot-Marie-Tooth disease is a heterogeneous group of inherited peripheral neuropathy. It has various genetic and phenotypic characteristics and can be a significant cause of morbidity with severe disabling consequences. Often the diagnosis may be missed. It is not commonly encountered in Nigerian medical clinics and there is no documented prevalence rate for the country. Method: A case report of a 31-year-old man presenting to the medical outpatient clinic of the University of Nigeria Teaching Hospital Enugu with features of Charcot -Marie - Tooth disease is presented. Relevant literature is also reviewed. Result: A thirty three year old Nigerian male presented to the medical clinic with a thirteen-year history of progressive paraesthesiae in the feet, which later involved the hands. This was accompanied seven years later by gradual onset weakness of the muscles especially the distal group in both upper and lower limbs which led to paralysis. No sphincter involvement. Family history was not contributory. He had typical features of HMSN type I and was a possible proband. Conclusion: Though not common, the inherited peripheral neuropathies are a cause of significant morbidity. When recognized there are potential issues of genetic counseling that arise for which Nigerians are yet to come to terms with.

Alzheimer's disease(AD) is the most common of the chronic neuro-degenerative disorders affecting the elderly especially in the industrialized nations. It is accompanied by progressive functional deterioration, loss of independence, and numerous cognitive symptoms and behavioral problems. The number of patients with AD is expected to increase in the coming decades due to advances in health care extending the human life span. Different nomenclatures have been used to describe AD, such as, frontotemporal dementia, and Lewy body dementia. It is the moso common form of dementia accounting for two thirds of all dementia cases. The disease puts a tremendous practical, emotional and financial burden on individuals and governments.