Background: Diabetes Mellitus (DM) is an endocrine disease with profound vascular morbidity and mortality, and hypertension is known to play a prominent role in this regard. The aim of this study is to determine the prevalence of hypertension and to assess drug control of hypertension among DM patients seen in Enugu, Nigeria. Methods: The medical records of 420 adult patients with diagnosis of type 2 DM and hypertension, managed consecutively in the outpatient unit of University of Nigeria Teaching Hospital Enugu were studied. Results: Sixty percent of the diabetic patients had hypertension. Only 12% of these patients had their blood pressure controlled to ≤ 130mmHg and ≤ 80mmHg. About 12.3% of the patients who had hypertension were not on anti hypertensive drug treatment. Most of the patients were placed on 1 or 2 drugs. Angiotensin converting enzyme inhibitors were the most frequently prescribed drug. Conclusion: This study and similar ones from other parts of Nigeria indicate that the prevalence of hypertension among Nigerians with type 2 DM is high. Clinicians and patients should be reminded that even though blood glucose control is important, aggressive blood pressure control in diabetics is top priority in preventing adverse cardiovascular events which causes the highest mortality in the average population of type 2 diabetics. Appropriate antihypertensive regimen optimizes nonpharmacological therapies, reduces adverse effects on glucose control, minimizes the risk of medication-related side-effects, and provides much needed cardiac and renal protection.

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Introduction: Pediatrics is a vast field with many facets. The importance of having dedicated specialists trained in the treatment and care of pediatric patients has long been recognized. It is necessary to determine if the profession of radiography is making similar progress in improving on the pediatric radiography services offered in the country. Objective: The objective of this study was to establish if there was a perceived need for specialized pediatric radiographic education in Nigeria. Subjects and Methods: This was a descriptive cross-sectional survey, which accessed radiographers' take on the need for specialized education in pediatric imaging. A Google Form link was distributed through various Nigerian radiographers' WhatsApp groups, inviting interested radiographers to participate in stating their opinions on the need for specialized pediatric radiographic education in the country and other related questions. Data were analyzed using IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. Results were presented using tables and charts. Results: Seventy-six radiographers working in 25 states across the federation participated in the online survey. A total of 90.8% of the respondents stated there was a need for specialized radiographic education in pediatric imaging, and 64.5% felt that this education or training opportunities for radiographers was inadequate. Only 43.4% were comfortable performing pediatric imaging. Conclusion: Majority of the radiography departments in Nigeria do not have dedicated equipment or staff for pediatric radiography. Undergoing specialized pediatric imaging training will benefit radiographers who are keen on improving the radiography services offered to pediatric patients.

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Objective: The study investigated the level of awareness and extent of financial risk protection among the population in Enugu state, southeast Nigeria. Materials and Methods: A mixed-method approach involving cross-sectional quantitative and qualitative methods was adopted for data collection and analysis. The study was conducted in two purposively selected urban and rural local government settings in Enugu North and East senatorial zones, respectively. Results: The quantitative results show that most of the respondents (77.1%) were women and 80.2% were married. Slightly above a quarter of the respondents (25.6%) were self-employed, whereas 29.1% were main income earners. Out-of-pocket (OOP) dominates payment mechanisms (94.9%), whereas more than half (54.4%) of the respondents went to patent medicine dealers for treatment in the last one month. Logistic regression shows overall significance in use of prepayment mechanisms with χ² = 56.57 and P = 0.001. More so, finding indicates that 55.9% of respondents have heard of prepayment mechanisms mainly from television (30.4%) and radio program (20.2%), while 89.5% has not used any prepayment mechanism in the State. Conclusion: OOP still dominates payment mechanism in Enugu state. Although over half of the respondents (55.9%) have heard of prepayment mechanisms, approximately 90% has not used any prepayment mechanism in the State. This calls for policy that will ensure moving away from OOP payment to prepayment mechanism through health system strengthening and awareness creation for the populace.

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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.

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Background: The most common indication for lower limb amputations in Nigeria is not known. Almost all studies on amputations in Nigeria considered lower and upper extremities together and report varying leading indications. Major lower limb amputation imposes a significant health burden on the patient and deserves effort at its prevention. The aim of the present study was to determine the predominant indication and patterns of lower limb amputations from a Nigerian premier teaching hospital to enable appropriate preventive recommendations. Materials and Methods: The operative records of patients who underwent lower limb amputation surgeries in the premier University of Nigeria Teaching Hospital, east of Nigeria, between January 2013 and December 2017 were retrospectively analyzed for the indications, levels of amputations, and patient characteristics. Results: Ninety-three unilateral lower limb amputations were performed within the 5-year period. There were 52 (55.9%) males with an M:F ratio of 1.3:1. The mean age of the patients was 52.23 years. Trans-tibial amputation was more commonly performed (51.6%), followed by trans-femoral (45.2%). Diabetic foot (DF) gangrene constituted the dominant indication (57%) and accounted for 54.8% of all the major amputations. The next common indication was tumors (19.3%). Foot gangrene from diabetes and from nondiabetic peripheral arterial diseases (10.8%) accounted for 67.8% of the indications. Conclusions: Major lower limb amputations predominate from this study, with peripheral vascular diseases (PVDs), especially due to diabetes mellitus, being the leading cause. Appropriate public health advocacy on DF complications and establishment of comprehensive multidisciplinary foot-care services, capable of prevention, diagnosis, and treatment of early DF lesions, will help reduce the incidence of DF gangrene. This measure will, no doubt, lower the high rate of major lower limb amputations.

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Background: Surgical audit is a normal part of surgical practice. Earlier reports on the availability of oral and maxillofacial surgical services in Nigeria showed limited number of centres and shortage of specialists. Objective: To determine the pattern of oral and maxillofacial surgical diseases in order to establish the local demographic data base and subsequently structure service delivery on evidence-based disease profile. Materials and methods: A retrospective study using the admission registers and folders of cases treated in the oral and maxillofacial unit in the period of January 2005 to December 2010 in a Nigerian teaching hospital. Results: Within the period, 7948 patients were seen and17.0% needed oral and maxillofacial surgical treatment. Ratio of male to female subjects was 4:1, whereas the age of subjects ranged from one-83 years with mean age at 38.7±10.6 years. Both congenital (0.8%) and acquired (99.2%) cases were recorded. Subjects that had acquired conditions were categorized into traumatic (67.1%) and non-traumatic (32.1%). The commonest aetiological factor (79.1%) causing disease was road traffic accident. The common treatments were intermaxillary fixation (54.8%) and resection (7.5%), whereas the complications were limitation in mouth opening, 22.1% and facial deformity, 19.5%. Conclusion: The commonest indication for consultation was trauma, and since resources for care are scarce in Nigeria, the focus should be to reduce the disease burden by prevention.

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Aims and Objectives: The purpose of this study is to present an experiential audit of initial data accumulated in 3 years since inception in 2007 of mammographic and sono-mammographic work at the Radiology Department of the University of Nigeria Teaching Hospital, Enugu. Materials and Methods: In the three years under review 443 patient records were examined. Results: Majority of the women were in the mid-forties.Breast pain was the leading complaint (54.8%). This was followed by complaint of breast mass (34.5%). The predominant breast pattern encountered is the fibro-glandular type. Reduction in cost of imaging when combined with awareness campaign appeared encourage health-seeking behaviour. Beyond basic imaging, cases of suspicious nipple discharge unfortunately underwent no further radiologic work up like ductulography to establish definitive diagnosis. Conclusions: This paper concludes that the culture of breast imaging for diagnostic and screening purposes is evolving in South-East Nigeria where the breast imaging unit of the institution has played a pioneering role. Sensitization advocacy to the general public about breast diseases and the local availability of breast imaging services, followed by reduction of cost of access to such services impacts positively on service utilization. There is need to encourage earlier screening as most patients screened are close to the peak incidence of breast carcinoma in this environment.

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Background: Multiply transfused patients (MTPs) are often at risk of alloimmunization and other transfusion-associated complications. These complications could be ameliorated through extended blood typing prior to transfusion of blood and blood products. Objective: The aim of this study was to assess the knowledge and practice of safe blood transfusion in MTPs by physicians. Materials and Methods: This was a cross-sectional questionnaire-based study of physicians who attended a scientific conference of the West Africa College of Physicians in Asaba, Delta State. Result: Most of the respondents (68%) managed patients requiring multiple blood transfusions. Forty-seven respondents (68.1%) had a blood transfusion policy for MTPs in their respective centers, and 43 (68.1%) had no transfusion trigger hemoglobin level in their respective health facilities. Respondents who had a blood transfusion policy in their centers had a better knowledge of safe blood transfusion than those that did not, P = 0.008. None of the respondents reported carrying out antibody screening before and after multiply transfusing the patients. Although 100% performed initial screening for transfusion transmissible infections (TTIs), only 11.6% repeated screening for TTIs annually. Conclusion: Practice of safe blood transfusion in MTPs was found to be poor among physicians in Nigeria. Hospitals and training institutions should design ways to update knowledge of physicians on safe blood transfusion especially in MTPs and by so doing optimize safe blood transfusion practices, so as to improve the quality of life of patients.

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Background: Dyslipidemia is an established risk factor for cardiovascular disease (CVD). Different schools of thought hold different opinions regarding the use of statins in the perioperative period for cardiac surgery patients. There seems not to be a consensus yet on when to commence statin therapy for cardiac surgery patients not yet on treatment for dyslipidemia, but the beneficial effects of dyslipidemia management are not in doubt. Objectives: The objective was to characterize the pattern of dyslipidemia and atherogenic indices present in cardiac surgery patients. Materials and Methods: The study was a retrospective record review of patients who presented for open heart surgery between 2013 and 2017. Results of pre-operative lipid profile of patients were extracted and analyzed using SPSS version 22. Atherogenic risk was determined using three different risk ratios: atherogenic plasma index and Castelli’s risk indices-I and II. Results: The study included a total of 51 adult patients with the age range 18–75 years and male: female ratio of 1:1.4. Dyslipidemia observed in participants was majorly in the form of low high-density lipoprotein 24 (49.0%) and elevated low-density lipoprotein 11 (22.5%). Using atherogenic plasma index, more than one-quarter of participants 15 (30.6%) were found to be in the high- and medium-risk groups. Conclusion: Incidental findings of dyslipidemia made in this group of patients have its associated health implications. Hence, it buttresses the importance of assessing for and adequate management of the medical condition, particularly in a group of patients already burdened with CVD.

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Background: The clinical severity of sickle cell anemia (SCA) varies from one individual to another. Several factors, including genetic predisposition, environmental and social factors, are known to modify the clinical presentation and complications of SCA but not much is known about the influence of gender. Objective: This study aims at determining the gender differences in the pattern of SCA complications in Enugu, Nigeria. Materials and Methods: This is a retrospective analysis of clinical and laboratory data from the folders of patients with SCA at the University of Nigeria Teaching Hospital Enugu, Nigeria between February 2008 and February 2014. A total of 248 folders comprising 151 males and 97 females were retrieved. Data on the age, sex, hematological parameters, number of complications, and frequency of SCA crises were extracted and analyzed. Only the case files of adult patients with SCA were investigated. Results: The median age of the participants was 25 (IQR = 22–30) years. The male to female ratio was 1.5:1. A total of 182 out of 248 (73.4%) cases reviewed had one form of complication or the other. Sickle cell leg ulcer was the most common complication seen among the cases (50/182 [27.5%]), followed by avascular necrosis (AVN) (28/182 [15.4%]). The mean frequency of crises was not different between the male and female genders (15.00 ± 9.01 vs. 9.8 ± 6.97; P = 0.293). However, the male gender had more complications than the female gender (116/151 [73.9%] vs. 116/151 [73.9%]; odds ratio [OR] = 2.13; 95% confidence interval [CI] = 1.2–3.7; P = 0.007). Conclusion: The male gender is twice more likely to develop complications of SCA and, thus, are more likely to have more morbidity from this condition.

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Background: Artequin (AQ) and other Artemisinin-based therapies have replaced chloroquine (CQ) as the preferred treatment for uncomplicated Plasmodium falciparum malaria, due to the resistance of the parasite to CQ. This study was designed to investigate the comparative effects of CQ and AQ on some haematological parameters in Wistar rats. Materials and Methods: Thirty-six (36) female Wistar rats were randomly assigned into two batches. Each batch had three groups of six rats each, and they were placed on normal rat chow: AQ (1.6mg/100g bwt) and/or CQ (0.875mg/100g bwt) orally and once daily for three and seven days for batches 1 and 2, respectively. Full blood count was carried out by using an automated blood cell counter. Results: Results showed that the administration of AQ for three days did not significantly alter the levels of red blood cells (RBCs), RBC indices, hemoglobin (Hb), packed cell volume (PCV), total and differential white blood cells (WBCs), platelet count, and platelet indices. However, CQ increased the RBCs, Hb, PCV, and eosinophils significantly (P < 0.05) compared with the control. CQ also increased the total WBCs significantly (P < 0.05) compared with AQ. Both drugs decreased neutrophil but increased lymphocyte count significantly (P < 0.05) compared with the control after three days of treatment. After seven days of administration, AQ significantly (P < 0.05) reduced RBC count, PCV, Hb, mean corpuscular hemoglobin concentration (MCHC), and neutrophils compared with the control; both drugs reduced platelet count and PCT significantly (P < 0.05) compared with the control after seven days of treatment. Conclusion: The administration of AQ or CQ at their recommended doses and duration is relatively safe. However, administering a combination of Artesunate and mefloquine, and not CQ, beyond normal duration might have negative effects on hematological parameters.

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Background: Albinism is a congenital skin condition which is caused by lack or deficiency of tyrosinase enzyme leading to partial or complete absence of melanin from skin with attendant solar skin damage which could lead to premature skin aging, skin cancer, and visual problems. Good knowledge and proper use of sunscreens could prolong the life of people living with albinism. Materials and Methods: This cross-sectional study involved 40 people living with albinism who were recruited consecutively after giving informed consent. The subjects then responded to a pretested questionnaire and had their skin also examined. Analysis of data was done with SPSS version 20. Results: About 92.5% (n = 37) know about sunscreen but only 22.5% (n = 9%) have known about it for more than 10 years. Based on the ages of the study participants, many had lived for more than 10 years before getting to know about sunscreen and hence have been unprotected from damaging effects of sunlight for long. The most important sources of information about sunscreen are doctors 32.5% and fellow albinos 22.5%. Most subjects (90%) had poor knowledge of what makes a good sunscreen and most (82.5%) used it inappropriately. Conclusion: While many knew about sunscreen, only a small fraction got the information early which is vital for commencement of skin protection early, hence forestalling damage. Doctors were found to be important source of information about sunscreen, although many subjects used it inappropriately.

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Background: It is not uncommon to hit children in Nigeria, hence there is an increased possibility of encountering children with non-accidental injury (NAI). Radiographers are one of the first-line caregivers in a hospital setting, hence it is important that they are able to identify and act appropriately in cases of suspected NAI in children Objective: The objective of this study was to establish Nigerian radiographers’ awareness and role both before and after identifying NAI in children. Materials and Methods: This was a descriptive cross-sectional survey that assessed radiographers’ awareness and role in identifying NAI in children. A Google Form link was distributed through various Nigerian radiographers’ WhatsApp groups, inviting interested radiographers to participate in the survey. Data were analyzed by using IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. Results were presented by using tables and charts. Results: Ninety-eight radiographers working across the federation participated in the online survey. A total of 53.1% of the respondents clearly understood what NAI meant, whereas 59.2% never participated in the imaging of a child for NAI investigation. Only 12.3% were confident that they were very competent in identifying radiological signs of NAI in children. Conclusion: Although most radiographers understand what NAI means, very few agree that they have been formally trained in pediatric imaging, hence they lack the expertise in acting appropriately in cases of suspected NAI in children. The radiographers strongly believe that they would benefit from proper training to handle cases of NAI in children.

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Background: Diastasis Recti Abdominis (DRA) or increased inter-rectus distance (IRD) is among the most common pregnancy-related physical disorders in women. Studies are scarce on its correlates in an African population. Objectives: The aim of this study was to determine anthropometric and maternal correlates of DRA in Nigerian parous women. Materials and Methods: Eighty nine (89) consenting parous women (20–45 years) participated in this observational study. The IRD was measured with an electronic digital caliper at the umbilical level alongside other anthropometric measurements (weight, height, waist circumference (WC), hip circumference (HC)). Information on participants’ age, mode of delivery (MOD), parity, and age of last child (AOLC) was obtained. Data were analyzed with descriptive statistics and inferential statistics of Pearson’s and Spearman’s rank correlations, respectively, with subsequent linear regression analysis at an alpha level of P < 0.05. Results: The IRD significantly correlated with WC (r= 0.213, P = 0.045) and waist-to-hip ratio (WHR), (r = 0.357, P = 0.001). Significant regression equations were determined for the prediction of IRD based on WC and WHR. However, the other variables studied showed no significant (P > 0.05) correlation with IRD. Conclusion: WC and WHR are predictors of IRD in parous women, and these should be considered as important variables in the management of DRA associated with pregnancy.

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Background/Objective: The emergence of the Internet several decades ago has brought global revolution in a lot of processes even among developing nations, including educational processes. We assessed the familiarity of the medical students with Internet tools and their preparedness with integrating e-learning into Internal Medicine teaching methods. Materials and Methods: A cross-sectional survey of two graduating medical classes of College of Medicine, using structured self-administered questionnaire, was carried out. The survey assessed the knowledge, utility, and application of Internet tools in medical education using five-point Likert scale. Results: A total of 227 (75%) of the cohort of 292 students responded, comprising 150 (66.1%) males and 77 (33.9%) females. The median age was 24 years (Interquartile range, 23–26 years). Of these, 219 (96.5%) owned Internet-enabled devices, whereas 104 (46.2%) had formal training on the use of computers. Two hundred and twenty-two (97.8%) could access the Internet, with Google and Twitter accounts being the highest and the least used tools, respectively. Two hundred and twenty five (99%; mean rating 4.5 on a scale of 5) indicated that Internet tools were useful in teaching Internal Medicine, specifically in the areas of lectures, assignments, and interaction with experts globally. The key benefits were utility as a regular self-assessment tool and flexible learning schedule (mean rating, 4.0, respectively). Overall, 213 (93.8%) suggested that the use of Internet tools and e-learning should be incorporated into the traditional method of teaching. Challenges with its use included cost of accessing the Internet (n = 126; 55.5%), lack of facility with adequate technology (n = 115; 50.7%), and availability of Internet (n = 96; 42.3%). Conclusion: Undergraduate medical students in our setting are familiar with the Internet and its potential utility for learning and undergraduate teaching of Internal Medicine.

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Background: Under-five children’s death is one of the vital indices of a society’s development and a telling evidence of their priorities and values. An audit of the common causes of mortality among under-fives is essential in ensuring optimum child survival. Aim: To determine the magnitude, causes, and determinants of under-five deaths at the Federal Medical Centre, Umuahia, Southeastern Nigeria. Subjects and Methods: A retrospective review of all postneonatal under-five deaths at the Children’s Emergency Room from January 2012 to December 2016, was carried out and the information was analyzed. Results: Of a total of 6141 under-fives admitted during the 5-year period, 197 died giving a mortality rate of 32 per 1000 LB. Boys accounted for 106 (53.8%) with no gender difference in the mortality rates (P = 0.262). The leading primary causes of death were sepsis, severe malaria, diarrheal disease, meningitis, pneumonia, and severe acute malnutrition, accounting for 95%. Deaths due to malaria occurred more among the preschool age group than that among infants and toddlers (P = 0.013), whereas those due to pneumonia were more prevalent among infants (P = 0.012). Diarrheal disease caused more deaths during the dry weather season (P = 0.009). Approximately 40% of the deaths occurred within 24h of arrival to the Emergency Unit. The most common complications leading to death were dehydration, severe anemia, shock, heart failure, and hypoglycemia. Conclusion: The leading causes of under-fives deaths in our center are preventable infectious diseases. Intensification of goal-targeted, disease-specific preventive measures is recommended.

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Background: Human immunodeficiency virus (HIV) infection is a global pandemic. Nigeria has the highest burden of pediatric HIV worldwide. HIV-infected children and their caregivers are predisposed to significant psychosocial disorder. This disorder may be provoked by some risk factors. Aim: To determine the factors responsible for psychosocial disorders among the caregivers of HIV-infected children in Enugu, Southeast Nigeria. Materials and Methods: This was a hospital-based comparative study. Participants who met the inclusion criteria were enrolled consecutively. The HIV status and other sociodemographic variables of the caregivers were obtained. General Health Questionnaire (28-item version) was used to assess their psychosocial status. Thereafter, the association between psychosocial disorders and their sociodemographic variables was ascertained. Results: A total of 154 caregivers of HIV-infected children (subjects) and 154 caregivers of HIV-negative children (controls) were enrolled in this study. The prevalence of psychosocial disorders among the subjects was 39% compared to that of 2.6% among the controls. The determinants of psychosocial disorders among these subjects were the child’s age group of 2–4 years (P < 0.001, odds ratio [OR] = 3.60), caregiver’s gender (P < 0.001, OR = 13.48), lower socioeconomic class (P < 0.001, OR = 37.14), divorced caregiver (P = 0.03, OR = 10.33), death of a spouse (P < 0.001, OR = 8.84), additional HIV-infected family member (P = 0.015, OR = 2.56), and unsupportive spouse (P = 0.027, OR = 2.113). Conclusion: The determinants of psychosocial disorders among the caregivers of HIV-infected children were the age of the HIV-infected child, female caregivers, lower socioeconomic class, marital status, additional HIV-infected family member, and lack of spouse support.

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Background: A significant number of people living with hemophilia and other bleeding disorders are reported to be either underdiagnosed or untreated in most developing countries. Objectives: To evaluate the frequency of hemophilia and some hemostatic parameters in persons with bleeding symptoms in Southeast Nigeria. Materials and Methods: This was a cross-sectional, hospital-based pilot study of 50 persons consecutively recruited with bleeding symptoms from four tertiary hospitals in Southeast Nigeria. Full blood count was carried out using Mythic 22 semiautomated analyzer, (Orphee, Geneva, Switzerland). Prothrombin time (PT) and activated partial thromboplastin time (APTT) mixing studies and one-stage factor assays were carried out using tube tilt technique. Bleeding score was assessed using the International Society on Thrombosis and Haemostasis bleeding assessment tool. Data were analyzed using the Graphpad Prisim, version 6.0, San Diego. Results: Only 2% of the subjects had hemophilia A, whereas 68% of the subjects had thrombocytopenic bleeding. Most (32.4%) had bleeding score of four. Analysis of variance of these variables showed a significant relationship with P < 0.0001. Post hoc analysis showed significant P values for platelet count versus bleeding score (P = 0.000, 95% confidence interval [CI]: 95.74–126.4) and APTT versus bleeding score (P = 0.000, 95% CI: 44.34–74.98). Conclusion: Bleeding assessment tools are important in evaluating persons with bleeding symptoms and it may be necessary to screen for hemophilia in these cases. Larger multicenter epidemiological studies are needed to determine the prevalence of hemophilia and other bleeding disorders in our environment.

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Background: In the Nigerian culture, barrenness is a near catastrophe for women. Hysterosalpingography (HSG), being a prime investigation for infertility, is widely used in developing countries because of its positive yield, accessibility, and cost-effectiveness. Aim: The aim of this study was to identify the pattern and the most common radiologic findings in the HSG of women with infertility in Enugu, southeast Nigeria. Materials and Methods: This was a cross-sectional study involving 160 female patients who presented at the gynecology clinic of a private hospital in Enugu, Nigeria with clinical impression of infertility. The women were in turn referred to the radiology center for HSG. Data were analyzed using RStudio. Results: A total of 254 radiologic features were obtained as some patients had more than one radiological findings. The age range of the participants was 20 - 46 years, and the most prevalent age group was 25 - 29 years (31.1%). The most common clinical type of infertility was secondary infertility.The most common abnormal cervical and uterine findings were synechia (80%) and fibroids (65%) respectively. Bilateral tubal blockage 29.4% was the most common finding in the fallopian tubes. Normal findings were seen in 5.44%. Conclusion: Synechia and fibroids were the most common abnormal radiologic findings in the cervix and uterus, respectively. HSG was found to be informative in infertility evaluation, hence should still be recommended as a first-line imaging modality in infertility.

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Background: Air pollution is a major concern as an occupational health hazard among petrol attendants. There is scarce literature on the effects of these pollutants on the pulmonary system of petrol attendants in south eastern Nigeria, hence the need for this study. Aim: The aim of this study was to evaluate the respiratory symptoms and cardiopulmonary indices of petrol attendants in Enugu Metropolis. Materials and Methods: This cross-sectional observational study recruited 128 consenting apparently healthy participants (64 petrol and 64 non-petrol attendants) with mean age of 28 years. Their respiratory symptoms, pulmonary functions (forced vital capacity [FVC], forced expiratory volume in one second [FEV₁], ratio of FEV₁/FVC%, peak expiratory flow rate [PEFR]), and some cardiovascular indices (heart rate [HR], systolic blood pressure [SBP], and diastolic blood pressure [DBP]) were assessed. St George Respiratory Questionnaire was used to obtain information on the participants’ respiratory symptoms. Data were analyzed with independent t test at a significance level of 0.05. Results: There was a significant reduction in FVC, FEV₁, and PEFR in the petrol attendants compared to the control (P < 0.05). There was also a significant increase in SBP, DBP, and respiratory symptoms in the petrol attendants compared to their control counterparts (P < 0.05). Cough and chest trouble were the most commonly reported symptoms experienced by the petrol attendants. Conclusion: Petrol attendants are at increased risk of respiratory and pulmonary disorders because of the frequent exposure to petrol vapors and other chemical pollutants around their breathing zone.

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Background: Rounded protruding gluteus has been asserted to be an important feature of feminine beauty and self-image. Currently, there is large influx of gymnasiums to achieve this end as claimed by gym operators amid the dearth in literature to support their claims. Aim: The aim of this study was to provide an empirical evidence to support or disprove claims about the effectiveness of resistance training exercises such as squats and donkey kick on the gluteal muscles. Materials and Methods: Randomized controlled trial involving 111 young females, aged 18–30 years, were equally assigned into the squat group (SG), donkey kick group (DKG), and control group (CG) using table of random numbers method. Outcomes, such as gluteal muscle strength (GMS), gluteal muscle bulk (GMB), and gluteal adiposity (GA), were assessed at baseline, third week, and sixth week and analyzed descriptively and inferentially (α = 0.05). Result: The post-intervention across group comparison revealed a significant difference in right (F = 4.829, P = 0.010) and left (F = 7.252, P = 0.001) GA, right (F = 12.467, P < 0.0001) and left (F = 10.235, P < 0.0001) GMS, and in the GMB (F = 8.280, P = 0.001). The post hoc test showed that the SG had the most profound effect in increasing GMS and GMB, whereas the DKG had a superlative effect on GA. Conclusion: Six weeks resistant training using squats and donkey kick can be used to improve gluteal muscle characteristic by building GMB, GMS and reducing GA of young female adults.

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Background: Low utilization of modern contraceptive is one of the key determinants of high fertility in Nigeria. Objective: The objective of this study was to determine the yearly prevalence and trend of contraceptive use among women of reproductive age-group who attended a family planning clinic in Ibadan, Nigeria. Materials and Methods: A clinical audit of contraceptive uptake was undertaken at the family planning clinic of University College Hospital, Ibadan, Nigeria, from January 1, 2011 through December 31, 2018. Information on the client’s age, type of contraceptive utilized, and total number of each contraceptive method used per year was obtained. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 20.0. Results: A total of 13,023 women utilized at least one form of contraceptive with mean age of 35.53 ± 9.1 years. Implant (31.2%) was the most widely utilized contraceptive, whereas bilateral tubal ligation (0.4%) was the least utilized. Other methods were intrauterine contraceptive device, injectable, condom (male and female), and oral contraceptive accounting for 26.9%, 19.3%, 16.7%, and 5.5%, respectively. A significant decrease was observed in the trend of use of modern hormonal contraceptive methods as compared to the nonhormonal methods over the 8 years studied (P < 0.001). Conclusion: Implant being the most utilized indicates that it is the most accepted and approved by clients in our clinic. The knowledge of contraceptive utilization trends can be used to monitor and appraise the acceptance and approval of each method and family planning programs over a period.

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Background: Many factors contribute to second-phase delay in accessing surgical care electively especially in low-income settings. The aim of this study was to evaluate second-phase delay in elective surgical care in a tertiary hospital. Materials and Methods: This study is a hospital-based cross-sectional survey conducted at a tertiary health institution in Nigeria from February to September 2017. Sampling units were households that accessed major elective surgical operation from the general surgery and urology units of the institution for an adult member (≥18 years of age) of the household. Analysis was performed using the Statistical Package for Social Sciences software version 20.0 (IBM SPSS Inc, Chicago, USA). Results: In total, 495 households representing same number of patients participated in the study. Second-phase interval was within one month in 16.2% of households. It was delayed 2–6 months in 55.2% of households, 6–12 months in 16.2% of households, and more than 12 months in 12.5% of households. Financial constraint was reported as reason for the observed second-phase interval in 54.7% of households with 93.4% of these households delayed for longer than one month and 38.0% for more than six months. Financial constraint was significantly more prevalent among larger households (OR 7.64; 95%CI 1.89–30.78; P < 0.01) and households in the lower wealth quartiles (OR 0.73; 95%CI 0.55–0.97; P = 0.03). Few households (7.1%) accessed health insurance for the prescribed major surgery and only 8.6% of those insured households reported financial constraints. Conclusion: Longer second-phase delay attributable to financial constraints is prevalent among larger households comprising mostly children, households in the lower socioeconomic quartiles, and uninsured households.

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Collaboration between physicians and the pharmaceutical, medical device, and biotechnology industries results in the development of products of great benefit to the public. However, when these interactions negatively influence professional judgments at the expense of the goals of medicine, it becomes a cause of great concern. The objective of this simple review was to bring to the fore the conflicts that exist between these two important areas of patient care and to suggest ways to prevent it in Nigeria. A literature search in the PubMed, Medline, and Web of Science databases was done using the terms conflict of interest, physician, pharmaceutical, medical practice, detailing, biomedical research, bioethics, prescribing pattern, singly or in combination to identify relevant articles. The results are arranged based on the themes of related published articles. This review shows that interactions between physicians and the pharmaceutical industry have multiple areas of conflict ranging from reduction in the quality of patient care, loss of objectivity in professional education, scientific integrity, and the public’s trust in medicine. Interaction between pharmaceutical sales representatives (PSRs) and physicians commonly occur in Nigeria, affecting prescribing behavior. There is no specific regulation in place to protect against ensuing conflicts. There is a need to put in place educational programs to increase awareness among physicians of the effects of such interactions, while also instituting and implementing stringent policies curtailing physician–pharmaceutical industry and PSR relationships.

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