Background: Neural tube defects constitute a considerable part of the workload of the paediatric neurosurgeon. Although much less frequently encountered than myelomeningocoeles, encephalocoeles cause a lot of psychological trauma to parents and concerned others. A prompt and appropriate neurosurgical intervention is almost always necessary Material & Methods: The authors observationally studied patients with encephaloceles that were managed at their tertiary center. Consecutive prospective data were collected on demographics and clinical, imaging, associated anomalies, parents' profiles including the antenatal history and treatment modalities of the cohort over 5 years period. Descriptive statistics were used and the data were analyzed with SPSS version 21. (Armonk, NY:IBM Corp) Results: 34 patients were managed over the period under review. The age at initial presentation varied from 1 day to 8 years, with a mean age of 32.5 weeks. Up to 23.5% presented within the 1st week of life. This rises to 50% at 8 weeks, and 82.4% by age of I year. 22(64.7%) males and 12 (35.3%) females. Ratio M: F - 1.8:1. Resident in rural area (58.8%). Vaginal delivery 100% with one ruptured encephalocele (2.9%). Posterior encephalocele 23 patients (67.6%), anterior 8 (23.5%). Mean maternal and paternal ages were 28.5years (SD of 5.5) and 37.4 years (SD of 7.1) respectively. The most common associated abnormality was hydrocephalus in 6 patients (17.6%). No mortality. Conclusion: Encephalocoeles are not uncommon in Enugu, with a male pre-ponderance. Most were occipital. Hydrocephalus is the most common associated anomaly. There is high degree of unawareness. No mortality

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Introduction : Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system and it is the second leading cause of cancer death in men . A man's lifetime risk of prostate cancer is one in six. Early diagnosis and treatment helps in preventing mortality from prostate cancer .Nigerian males have been shown to have a high incidence of Prostate cancer . Yet, previous studies have documented poor knowledge of prostate cancer and its screening among them. Methodology: A descriptive cross sectional study conducted in Birnin Kudu, a town in North-Western Nigeria. Multistage sampling technique, followed by systematic random sampling was used to select 270 respondents. A pretested, structured , interviewer administered questionnaire was used for data collection. Data analysis was done using the Statistical Package Software for Social Sciences, version 20 Results: Majority of the respondents (60.4%) were aware of Prostate Cancer but most of them (51.3%) have poor knowledge of prostate cancer. Screening for prostate cancer was very low, with only 13.2% of the respondents having screened themselves for prostate cancer. There was a statistically significant association between knowledge of prostate cancer and uptake of prostate cancer screening (p=0.0064). Conclusion: The study revealed poor knowledge of prostate cancer and its risk factors among respondents and a very low practice of prostate cancer screening . There is need for intense and sustained health education campaign on prostate cancer and the importance of screening for it in the study area.

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Background: Employee job satisfaction and retention are crucial elements of health system performance. This paper assessed determinants of job satisfaction and retention of different cadres of health workers in publicly owned health facilities in Nigeria. Method: Job descriptive index questionnaire and a 3-item intention to leave scale were used to assess 180 health workers in publicly owned health facilities in three Local Government Areas of Enugu State, southeast Nigeria. Results: General job satisfaction (ρ = 0.001), satisfaction with work (ρ = 0.001) and satisfaction with co-worker (ρ = 0.003) differ among doctors, nurses and community health technicians (CHTs). Satisfaction with pay is inversely associated with marital status (ρ = 0.043) only among CHTs. Years of experience predicted satisfaction with work only among doctors (ρ = 0.015). Job location predicted satisfaction with promotion only among CHTs only (ρ = 0.022). Satisfaction with supervision was not predicted by socio-demographic factor (ρ < 0.05). Gender (ρ = 0.007) and facility type (ρ = 0.006) were associated with satisfaction with co-worker only among CHTs. Satisfaction with pay, work, promotion, co-worker and general job satisfaction (ρ < 0.05) predicted intention to leave only among nurses (R² = 22%, ρ < 0.05). Conclusion: Identifying cadre-specific drivers of job satisfaction and retention provides evidence for designing and implementing effective financial and non-financial incentives. There is need to revise and implement human resources for health policy to ensure improved retention of different cadres of health workers.

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Background: Tuberculosis (TB) is a chronic bacteria air borne disease that primarily affects the lungs. The awareness of the symptoms and signs of TB including modes of transmission was found to be influenced by patients' socio-demographics. It was important to understand the extent of this relationship in our study and at the end the results were used to produce strategies and initiatives on TB control and management. Aim: The aim of this study was to investigate the influence of patients' socio demographic factors on the knowledge of the symptoms and signs of TB including modes of transmission and at the end use the results to produce strategies on TB control and management. Subjects and Methods: The study was cross-sectional and involved the use of interviewer-administered questionnaire for collection of data from the study participants on their knowledge of the symptoms and signs of TB including modes of transmission. Systematic sampling method was used for the study due to the ordered nature of the sampling frame. The data was entered in Statistical Package for Social Sciences (SPSS 16) for analysis. The discrete data were described using frequencies and percentages, while the continuous variables were described using means and standard deviations. Results: Awareness of the symptoms and signs of TB among the respondents was high. The result showed that only about 1.6% of the respondents had good knowledge about the modes of TB transmission and a large sum of 98.4% had poor knowledge. Respondents who were aged 31-40 years had the highest level of knowledge of the symptoms and signs of TB with a statistical significance at (x² = 11.38, p=0.01). Knowledge of symptoms and signs of TB increased with the level of education (x² =6.03, p=0.11) and paid employment (x² =5.56, p=0.01). Single respondents were 2.19 times more likely to have good knowledge of the symptoms and signs of TB when compared to the married respondents (95%CI: 0.79- 99.85), p=0.08. Conclusions: Tuberculosis remains a devastating public health problem in Nigeria. There was a high level of awareness of the symptoms and signs of TB but very low knowledge about the modes of transmission amongst the respondents. Abating, controlling and managing the rate of TB infection will mean foremost the education of the most vulnerable groups (the uneducated and the unemployed) and the affected communities on the symptoms, signs, causes and modes of TB transmissions. This strategy on educating the patients must be differentially organised for each group to achieve the maximum impact.

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Background/Objective: This study is aimed at determining if bowel enema further reduces complication rate in Nigerian men undergoing transrectal prostate biopsy. Methods and Materials: A prospective case controlled study conducted in a hospital setting involving patients who met indications for prostate biopsy. Forty patients were equally assigned into two groups of bowel enema and no bowel enema for transrectal prostate biopsy and were discharged home on antibiotics after the procedure. The patients visited the clinic on the 2^nd, 7^th and 30^th day after the procedure where a purpose designed questionaire was administered to measure the complication rate of fever, haemospermia, rectal bleeding, urethral bleeding,acute urinary retention associated with the procedure. Results: There appeared to be no statistically significant difference between bowel enema and no bowel enema in the development of fever (p=0.22), haemospermia (p=1.0), rectal bleeding (p=0.22), prostatic abscess (p=1.0), urethral bleeding (p=0.22), blood transfusion (p=1.0) and acute urinary retention (p=1.0). Conclusion: An overnight fast with antibiotic prophylaxis remains a relatively safe procedure and gives similar outcome as a combination of bowel enema, rectal washout and antibiotic prophylaxis before biopsy. As such, bowel enema and rectal washout before biopsy provides no clinicallysignificant outcome advantage, and potentially increases patient cost and discomfort.

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