Background: To investigate the socio-economic differentials in health seeking and costs of malaria treatment in Southeast Nigeria Methods: A cross-sectional study design using questionnaires was conducted. The study areas are four malaria holo-endemic communities (towns) in Enugu State, Southeast Nigeria, namely Udi and Nachi in Udi Local government area (LGA) with Inyi and Oji-river (Oji) in Oji-River LGA. Udi and Oji were the local government headquarters, while Nachi and Inyi were not. Principal components analysis was used to generate a socio-economic status (SES) index, which was used to examine inequity. Results: Similar pattern of health seeking was found for both adult and childhood malaria with treatment mostly sought from patent medicine dealers. All SES were likely to incur similar level of costs to treat malaria implying that the poorest are spending a greater proportion of their income on the disease. The non-financial costs were considerable at about 1000 Naira per episode of malaria. The huge time cost would inevitably lead to a reduction in household production and could lead to adverse coping mechanisms especially by the poorer households. Conclusion: In order to decrease the inequity in costs of treatment and ensure the ready availability of appropriate treatment to the poorest households, the government should increase the availability of formal healthcare services for the provision of near and appropriate treatment of malaria. This strategy would decrease the financial costs (especially transportation) and maybe non-financial costs of seeking care for treatment of malaria and other illnesses.

Aim: This study was carried out to assess dental caries in 12 – 15 year old children in Enugu, a major city in South-eastern Nigeria. Methods: A multistage sampling technique was used to select 400 students from five secondary schools in Enugu. Questionnaires were administered by trained interviewers and participants were examined for dental caries using decayed, missing and filled teeth (DMFT) index according to the criteria laid down by the World Health Organization. The resultant data was analyzed using SPSS version 10. Results: One hundred and sixty-nine (169) males (42.2%) and 231 females (57.8%) were studied, 15.5% has had dental caries. Mean DMF score was 0.16 ± 1.25. Decayed teeth accounted for the largest component (85.5%), while only 3% of the caries were filled. Prevalence of caries was higher in females (18.6%) than in males (11.2%). Percentage DMFT was found to increase with age. No significant association between caries and mother's educational level was noted. Most children (84.5%) had never visited the dentist. Conclusion: Caries experience in Enugu is low. Untreated caries indicate the need for increase dental care and awareness through organized dental health education programmes in Enugu – Nigeria.

Aim: To evaluate the practice of therapeutic Paediatrics bronchoscopy in our environment; to review the anaesthetic practice in our centre, and compare them with universally accepted standards. Patients and Methods: This is a retrospective review of cases of foreign body aspiration in children treated at the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria, between 2002 and 2008. Foreign body aspiration was diagnosed clinically and radiologically. Data concerning demography, clinical characteristics, anaesthetics and complications were obtained from the hospital records. Result: A total of 45 patients were studied. They were between the ages of 6 months and 11 years, 29 males and 16 females. A total of 64 procedures were carried out, of which 38 (59.4%) were bronchoscopy. Bronchoscopy was done with Stortz ventilating bronchoscope under general anaesthesia. Repeated doses of suxamethonium were used as muscle relaxant in 92.1% of cases. Conclussion: Rigid bronchoscopy for aspirated foreign body is a safe, effective and often life saving procedure in the hands of experienced anaesthetist and bronchoscopist. A close rapour between the two teams is necessary for a desired outcome.

Introduction: Patent medicines vendors (PMV) are ubiquitous in developing nations like Nigeria. They have been engaged to improve public health indices for health conditions like malaria. Tuberculosis case detection has remained sub-optimal in Nigeria. Little is known of the PMV interaction with tuberculosis control in Enugu state, south east Nigeria. The study explores tuberculosis knowledge, perception and practices among urban and rural based patent medicine vendors. Method: A comparative cross-sectional descriptive study with multi-stage sampling technique. Following stratification, Enugu north (urban) and Nkanu West (rural) LGAs were selected. All registered patent medicine vendors (urban 90, rural 70) were identified for the study. Eighty three (83) urban and 66 rural PMV participated. Data was collected with a semi-structured interviewer administered questionnaire and analyzed using SPSS version eleven and Microsoft excel. Results: General knowledge was good in the urban area (53.2%) and poor in the rural (35.3%) a percentage difference of 17.9% (P<0.05). More of the urban PMV have the better perception of the need to refer customers with a chronic cough (Urban 81.9%, rural 62.1%, P<0.05) however, more rural PMV (18.2%) actually referred customers (not to DOTS centers) than the urban (4.8%) (P<0.05). The PMV include tuberculosis drugs among drugs sold for cough (urban 30.1%, rural 15.2%, P<0.05), despite poor knowledge of correct duration of tuberculosis drug treatment (urban 41.0%, rural 13.6%, P<0.05). The desired practices of asking customers for duration of cough (urban 97.6%, rural 95.5%, P>0.05) and advising them on ways to avoid spreading cough (urban 73.5%, rural 83.3%, P>0.05) were common among the PMV. Conclusion: Urban PMV in Enugu state are more knowledgeable about tuberculosis than rural PMV, but their practices in relation to the disease are at par with harmful aspects. They need to be trained to improve their capacity for quality interaction with tuberculosis suspects.

Objective: To determine the antero-posterior skeletal jaw relationship, in 12 -15 year old Nigerian school children in Benin city. Materials and Methods: Lateral cephalometric radiographs of 100 subjects aged 12-15 years with no history of orthodontic treatment were taken for this study. The radiographs were manually traced and analysed to generate values for SNA, SNB and ANB. Result: The mean age of the population studied was 12.16years. There were 40 males (40%) and 60 females (60%). No significant difference was noted in the mean value for males and females (p<0.05). The mean SNA was 88.78° ± 3.99°, SNB 85.26° ± 3.82°, ANB 3.47° ± 2.31° .The ANB values ranged from 1.50° to 4.750°. Conclusion: No significant difference was noted in the values for males and females. The skeletal pattern is defined by the ANB value.

Objective: To describe the computerized tomographic findings in children with head trauma who presented at the University of Benin Teaching Hospital, Benin City, Nigeria. Methods: It is a retrospective review of patients aged 0 – 15 years with suspected intracranial injury (ICI) following head trauma, who presented for CT scan at the University of Benin Teaching Hospital, Benin City, Nigeria from October 2006 to September 2010. SPSS version 16 software was used for data analysis. Results: The CT films and reports of 88 patients which comprised 47 boys and 41 girls were reviewed. The mean age of the children was 6.9 ± 4.6 years. The most common mode of injury was road traffic accident (69.3%) followed by falls (22.7%). The specific abnormalities seen in these patients were fractures in 35 (76.1%), intracranial bleeds in 26 (56.5%), cerebral oedema in 3 (6.5%) while aerocele was seen in only one (0.2%) patient. The fractures were linear in 16 (45.7%), depressed in 10 (28.6%) and comminuted in 9 (25.7%) patients. Intracerebral bleeds were by far the most common intracranial bleeding occurring in 18 (69.2%) patients. Intracranial bleeding was associated with linear fractures in 47.0% of the patients and depressed fractures in 12.5%. Conclusion: Computed tomography is a valuable tool in the management of pediatric patients with head trauma in the acute setting. Caution must however be exercised in children because of their sensitive nature to the hazards of ionizing radiation.

Objective: Leaf extracts of Saccharum officinarum have numerous medicinal properties and have been used by humans in the treatment of many ailments. There is paucity of information towards the effect of leaf extract of Saccharum officinarum on hematological parameters. Thus we decided to investigate on the effect of crude methanolic leaf extract of Saccharum sofficinarum on some hematological parameters in Albino Wistar rats. Materials and methods: Twenty (20) male Albino Wistar rats weighing 100 – 200g, aged 2 – 3 months, obtained from the Animal House of the College of Medicine, University of Nigeria Enugu Campus were acclimatized for two weeks and fed with commercially available rat feed and have access to the feed and water ad-libitum. The rats were divided into five groups labeled A to E. Groups A to D were orally administered with graded doses of the crude extract (200, 400, 800 and 1600mg/kg body weight) once daily for 28 days in lower concentration compared to an oral LD50 of >5000mg/kg. Group E served as control without receiving the extract. On Day 29, 2.5ml of blood sample were collected from each rat through the median canthus into Tripotassium- ethylene diamine tetra acetic acid (K₃- EDTA) containers for haemoglobin estimation, haematocrit, total leucocyte count, platelet count and blood film. Results: The results revealed significantly increased total leucocyte count in all the groups (A=5.6±0.2, B=6.0±0.7, C=6.1±0.4, D=8.0±0.4 × 10⁹/L) when compared with control E=4.6±0.3 × 109/L (p<0.05). The blood film revealed dose dependent neutrophilia in all the groups when compared with the control. Other parameters did not differ significantly when compared with the control (p>0.05). Conclusion: This result pattern suggests that the crude methanolic leaf extract of Saccharum officinarum may posses' properties that stimulate neutrophil leucopoiesis.

Background: As a response to the negative impact of implementation of user fees for health care services, an exemption scheme from payment was developed in many low-income countries including Nigeria with the aim of increasing access to health care services for poor individuals and households. This paper revisits the issue of exemption in Nigeria, the recent interest in implementing such schemes, the challenges that should be kept in view if exemptions have to be implemented, and finally, makes recommendations for improving implementation practices for exemptions. Methods: We searched two electronic databases - Ovid PUBMED/MEDLINE, and Global Health for relevant articles. This was done by restricting search to papers discussing exemption in West African countries. In addition, we examined gray literature related to the issue of exemption implementation in Nigeria. Data from identified eligible studies were then abstracted into a table and organized based on thematic areas, which have been used to discuss the findings. Findings: Exemption policies are receiving increased political and social attention especially with the evolving democratic atmosphere in Nigeria. However, the implementation of exemption policies is faced with numerous challenges which lead to a failure of attainment of objectives of such a social policies. These implementation challenges could be political, financial, technical or organizational. The said challenges make exemption policies ineffective, demanding a change in policy implementation practices. Conclusion: Though exemption policies exist, they are ineffective as several factors pose challenges, which impede implementation of such a desirable policy. We note that exemption systems should give way to more sustainable prepayment financial risk protection systems in the long-run.

Background: Many disorders in man have been described as genetic or hereditary in nature and have defied absolute medical treatment and cure. Genomic studies have given profound insights into the genetic organization of many organisms including man. The information gathered and the new technologies developed in the course of the HGP will provide intense understanding of the genetic basis of human disease. Objective: The review aims at the collection/assembly of information on the Human Genome Project, highlighting the dividends, challenges and controversies. Methods: The search method was by review of literature. Information was gathered from the internet (Google search engines) in the form of journal articles, abstracts, reports, science newsletters, science magazines, encyclopedia/wikipedia and other relevant write-ups. Additional information was also obtained from text books available in the Medical Libraries of University of Nigeria Enugu Campus and Nnamdi Azikiwe University Nnewi Campus. Results: The HGP established the sequence and map of the 3 billion base pairs that make up the human DNA.It also identified all the 30,000 genes in the 23 pairs of human chromosomes. The genomic information thus generated is stored in databases. While there are a lot of dividends, the project raised a number of challenges and controversies. Conclusion: Though the HGP has generated a lot of challenges and controversies, it is believed that with appropriate legislations in place, the totality of the human race stands to benefit from the dividends and promises of the HGP. The completion of the HGP and the issues associated with it will be an essential part of modern medicine and biology for years to come.

Introduction: Chronic myeloid leukaemia (CML) patients with hyperleukocytosis may demonstrate signs or symptoms of leukostasis including priapism. Methods: We report two patients with CML who presented with priapism. Results/Observations: Both cases reported achieved full detumescence after commencing chemotherapy for CML. These cases illustrate the importance of full haematological investigations in patients presenting with priapism in accident and emergency as well as urological emergency clinics.

Introduction: Autoimmune haemolytic anaemia is an important cause of acute or chronic anaemia. Its association with lymphoproliferative disorders such as non-Hodgkin lymphoma, and Hodgkin disease is well documented in the literature. Subjects and Methods: We report a 14 year-old male adolescent who presented with protracted recurrent fever, as well as clinical and laboratory findings suggestive of autoimmune haemolytic anaemia. Results: Patient however responded poorly to standard therapeutic interventions including steroids. Postmortem histology revealed Hodgkin disease (lymphocyte-depletion type) as the fundamental diseasea diagnosis not strongly considered before the patient 's death. Recommendations: We recommend a high index of suspicion for Hodgkin disease in any patient who presents with chronic haemolytic anaemia not responding satisfactorily to treatment even in the absence of peripheral lymphadenopathy.