Chemical Pathology is the study of the changes that occur in diseases in the chemical consitution and biochemical mechanisms of the body. These changes may be either cause or effect. As a fundamental science, it applies physiology and biochemistry to the elucidation of nature and cause of disease. As an applied science, it seeks by analysis of body fluids and tissues to aid clinician in diagnosis and treatment.^[1]

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Ideally, after any form of prostatectomy or bladder tumour resection, some form of irrigation of the bladder (continuous or intermittent) is necessary in most cases to avoid the problem of blood clot retention and in some cases to reduce the incidence of post-prostatectomy infective complications.^[1] This could be achieved by either a 3-way Foley Catheter inserted per urethram into the bladder, or by a through and through irrigation with 2-way Foley catheter inserted into the bladder per urethram and another through a suprapubic route. Because of the longer hospital stay associated with the later method, the use of 3-way catheter has found favour among urologists especially since the patients concerned are mostly elderly and any method that cuts down on the hospital stay is welcome. Recently, it has not been easy to secure 3-waj catheters of the right size and balloon capacity, while 2-way catheters of all sizes and balloon capacities are widely available. In an attempt to avoid a suprapubic cystostomy after prostatectomy and resection of bladder tumours, for a through and through irrigation, we resorted to an alternative method using a 2-way catheter. and a paediatric feeding tube.

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One of the major obstacles to effective health care delivery in Nigeria is the mal-distribution of health facilities and manpower. Within the existing health institutions, there is also an imbalance between curative care and preventive or promotive activities in both urban and rural settings. A National Youth Service Scheme under which fresh graduate doctors are required to provide Primary Health Care through the Basic Health Services Scheme to well defined populations, especially those in the rural areas was expected to redress these defects. With more than two decades since the inception of the scheme, this study assesses the extent to which the objectives of the scheme have been met, especially in relation to community based health promotive and preventive Primary Health care activities of Youth Service Scheme Doctors. Strategies for improving the impact of the programme on primary Health Care delivery to the affected communities are also discussed.

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A descriptive study identifying the various factors affecting accident distribution in the mines, was carried out in Enugu, the capital of Enugu State of Nigeria. The study population comprised of underground miners, who were followed up for period of six months, during which data were collected on a monthly basis, using structured questionnaires. A total of 142 accidents were recorded giving an incidence rate of 430 per 1000. Falls off the roof and haulage accidents accounted for 46.5% and 23.2% of all types of accidents respectively. Statistically significant relationship were established between age, type of job, mining experience and accident. The effects of the working environment on accidents were assessed and strategies for the reduction of the high rate of accidents discussed.

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Food poisoning is a public health emergency caused by a variety of agents including bacteria, chemicals, Parasites, inherently poisonous foods, and food allergies. Bacterial food poisoning is the most important in public health practice hence is the subject of this account. Because of its unpredictability of occurrence an “Action plan” preferably written, is formulated for dealing with an outbreak. An account of the management of bacterial food poisoning outbreak in one of the premises under the responsibility of preventive Medicine at Riyadh Military Hospital is presented to illustrate the activation of such an action plan. A brief review of reported food poisoning incidents caused by a variety of bacteria is given with recommendations towards outbreak prevention. The adoption of stringent food hygiene at every stage of food production and the monitoring of staff especially in institutional catering as preventive strategies are emphasized.

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The child survival revolution introduced by UNICEF in the mid eighties to improve child health and development in developing countries in reviewed. The components of this revolution acronymed GOBIFFF include Growth monitoring, Oral rehydration therapy, Breastfeeding, Immunization, Family planning (spacing) Food supplementation and Female education. The relevance of these components (strategies) to child survival is discussed. The importance of sustainability of these programmes by developing countries especially after the donor agencies currently supporting them withdraw, is stressed.

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Homeopathy is the teaching of the German professor of Medicine, Samuel Hahnemann (1755 - 1834).^[1] It is a systematic science which correctly applies the laws of nature to stimulate the healing energies of the human being. Homeopathic medicine is based on three principles, namely: the law of similars, which states that an agent which produces a disease can also cure that diesease. Secondly, the systematic testing of drugs on healthy persons and thirdly, the applicatation of very small doses. Homeopathy is not limited to certain diseases but is unversally applicable to all diseases. It is under the umbrella of what is called “holistic health”. The basic concept is that each of us is an integrated whole, each of us is a unique individual, whole and complete, functioning as a totality in relation to the universe surrounding us. All states of health or disease must be viewed in this context. To the extent that we deviate from this perspective, we experience disharmony and “dis-ease.” Conversely, the more we live within this principle, the more we enjoy a balanced state of harmony and vitality. In this context, symptoms are seen as attempts by the body to heal or to signal distress, and they are respected as such - in marked contrast to the standard medical approach in which symptoms are viewed as disturbances to be suppressed. The understanding of the basic principles of homeopathy is considered necessary in order to remove the prejudice against it by some orthodox medical doctors.

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Despite its harmful effects on the health of women, female genital mutilation or female circumcision is practiced in many developing countries. In Nigeria the incidence ranges from 29.5% in the urban areas to over 90% in the rural areas. Reasons for the practice are mainly cultural and moral, followed by religious and other reasons. Decision to carry out circumcision was taken by men in 40% of cases and female in 43%, suggesting that awareness campaign against the practice should also be directed to men. Attitudes of respondents to female circumcision suggest condemnation of the practice by those who hitherto see it as criterion for social acceptance, and is associated with level of education of the respondents.

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28 cases of HIV-associated nephropathy in adults were seen at the University of Nigeria Teaching Hospital, Enugu, Nigeria between October 1995 and September 1996. Out of this number 11 (6 males and 5 females) were in Acute Renal Failure (ARF) due to septicaemia. Their ages ranged from 26 years to 57 years with a mean of 40 years. 9 of the eleven cases recovered with appropriate antimicrobial treatment and left the hospital. The remaining 17 (12 Males and 5 females) had classical HIV nephropathy with nephrotic range proteinuna, anaemia, rapidly advancing renal failure and normal sized kidneys on ultrasound. They did not respond to steroid, cyclophosphamide or conservative CRF regimen. The mean age of patients was 36 years (range 24 years to 57 years). The mean duration of clinical AIDS before development of renal failure was 10 months (range 4 to 24 months). 50% of the patients had died of end stage renal disease (ESRD) within 6 months. It is concluded that HIV associated nephropathy is common in blacks in Nigeria and ARF in patients with HIV is usually due to septicaemia and has good prognosis with appropriate treatment but CRF due to HIV nephropathy has very poor prognosis. The ultimate solution for HIV nephropathy for now is preventive.

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Sultamicillin, a double ester in which ampicillin and beta-lactamase inhibitor sulbactam are linked via a methylene group, was compared in a randomised controlled trial, with ampicilin as prophylaxis for prostatectomy. A 7-day course of peri-operative sultmicillin 375mg twice daily was compared with a 7-day course of Peri-operative ampicillin four times daily. It was found that sultamicillin significantly reduced the post-operative bacteriuria and frequency of infective complications. Sultamicillin was well tolerated and no significant haematological or biochemical side effects were detected. It is administered by mouth and only taken twice daily. These qualities make it much preferred by patients. The use of sultamicillin in prostatectomy prophylaxis would appear to be justified.

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Many types of canula are currently in use for Hysterosalpingography.^[1] Foley's paediatric size Catheter has attracted little attention.2 150 patients were investigated for infertility by hysterosalpingography using Foley's Catheter, between January, 1992, and December, 1994. Uterine cavity was midline in 48.6% of those investigated. 60% had regular borders, 74% showed bilateral tubal patency while in 14.6% tubal patency was unilateral. Problems arising from use of Foley's catheter and measures taken to reduce them are highlighted.

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Renal disease associated with HIV infection has been well documented in adults. Although data in children is still limited, renal disease does occur in the Paediatric population. HIV-nephropathy has been reported in adults in Nigeria but there has been no report yet in Children^[1]. This has been the experience globally. The limited data obtained in children reveal that 30% to 55% will have renal disease or urinary and electrolyte abnormalities sometime during the course of their illness^[2],[3] and 3% to 29% will have more definite evidence of renal disease^[3],[4]. Earlier reports suggested that HIV infection in children was usually rapidly fatal but with improved facilities for treatment and familiarity with the disease there is increased life expectancy now in these children. Hence renal manifestations of the disorder have been recognised more frequently.^[3] Recent reports have revealed that 350,000 children have died of AIDS this year (1996) and that 63% of people with AIDS live in black Africa.^[5] Studies have confirmed also that even after excluding intravenous drug users, black persons comprise 89% of patients with HlV-associated nephropathy.^[6] This racial preponderance in blacks was even found to be more profound in children, whereby 94% of children with HIV-nephropathy were black.^[2],[4] The reason for this apparent predilection is unknown. The aim of this communication is to create an awareness of this complication in children since more cases of HIV infection are now being identified.

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