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: 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: High incidence of zinc (Zn) deficiency, especially among under-five children, is widely reported in developing countries including Nigeria. Objective: The aim of this study was to provide data on the Zn status of under-five children in Enugu State. Materials and Methods: This was a descriptive cross-sectional study of under-five children in Enugu South (urban) and Nkanu West (rural) local government areas (LGAs). A total of 409 children (244 urban and 165 rural) were enrolled in the study. Non-fasting venous blood (2 mL) was obtained from a total of 409 under-five children and the serum Zn was determined by using an atomic absorption spectrophotometer. Serum Zn level of < 70 µg/L was defined as Zn deficiency. Results: Although 222 (54%) of the children were adequate, 187 (46%) were deficient in Zn. Of the 165 children from the rural area, 73 (44%) were deficient in Zn, whereas in urban area, of 244 children, 112 (46%) were deficient in Zn (<70 µg/dL). The mean serum Zn level (73.86 ± 15.99 µg/dL) of the urban under-five children was significantly (P = 0.009) higher than that of the rural children (68.25 ± 9.04). In the rural setting, higher incidence of Zn deficiency occurred among the male subjects (32 [52.8%]) compared to the female subjects (35 [37.6%]) although the difference was not statistically significant (P = 0.08). Conclusion: The results indicate a high incidence of Zn deficiency in the studied population, which seems higher in the rural than in the urban LGA. Nutrition educational programs, intake of food rich in Zn and supplements should be promoted to improve Zn intake especially in infant and young child feeding practices.

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Background: Information on causes of death is needed to assess trends in disease burden, prioritize interventions, plan for their delivery, and ascertain the effectiveness of disease-specific interventions. The aim of this study was to review the postneonatal mortality pattern in the different pediatric emergency units of the tertiary hospitals across the country, and to propose ways of strengthening the emergency units for more effective health service delivery. Materials and Methods: Available literature on mortality in pediatric emergency units across the tertiary health institutions in Nigeria was reviewed. Neonates as well as studies that combined ward admissions with emergency room admissions were excluded. Analysis was mainly descriptive and results presented using prose, tables, and charts. Results: A total of 11 studies were analyzed. The crude mortality rate was 82 per 1000 admissions. Approximately 60% of the deaths occurred within the first 24h of presentation. The major causes of death were severe malaria (17.9%), sepsis (14.5%), acute gastroenteritis (13.7%), pneumonia (8.9%), and protein-energy malnutrition (97.7%). Sepsis and severe anemia had the highest case fatality rates, with 20.0% and 19.6%, respectively. Late presentation, unconsciousness, seizure, and severe pallor were some of the identified risk factors. Conclusion: Communicable diseases remain the major cause of mortality in our emergency units. Strengthening and restructuring of the emergency units in terms of manpower and services will help in lowering the mortality rates.

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Background: Early booking in the first trimester is recommended, and it is known to be of great benefit for the mother and the fetus. Aim: The aim of this study was to determine the profile and predictors of early prenatal booking among pregnant women in Enugu, Nigeria. Materials and Methods: A cross-sectional study was conducted on 200 consecutive pregnant women attending booking clinic at the University of Nigeria Teaching Hospital, Enugu, Nigeria. Statistical analysis was both descriptive and inferential at 95% confidence level, and carried out using the Statistical Package for the Social Sciences (SPSS) software, version 22.0, IBM SPSS, Chicago, Illinois. A P value of less than 0.05 was considered statistically significant. Results: The mean gestational age at booking was 18.6 ± 8.4 weeks. Although 37% (n = 74) of the women booked early in the first trimester; only 36% of the respondents (n = 72) were aware of the right time to book for prenatal care. More than half (56.8%, 42 of 74) of the women, who booked early for prenatal care, had problems in their last pregnancies, whereas 43.2% (n = 32 of 74) of them had problems in their index pregnancies. Parity, secondary level of education, and problems in the previous and index pregnancies were significantly associated with early booking after adjusting for other variables in the multiple logistic regression analysis (P < 0.05). Conclusion: Pregnant women in Enugu still book late for prenatal care. There is a need to create more awareness in this regard among women of reproductive age. Factors contributing to early booking in Enugu, include parity, secondary level of education as well as problems in the previous and index pregnancies.

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Background: Male reproductive dysfunction is a common health concern and can affect the quality of life. This study evaluated the curative effect of aqueous extract of the bark of Boswellia dalzielii on flutamide-induced testicular toxicity in Wistar rat. Materials and Methods: Sixteen male Wistar rats were randomly divided into four groups of four rats each, labeled Groups A–D. Group A was the negative control, Group B (positive control) received 10 mg/kg body weight of flutamide. Groups C and D were given 10 mg/kg body weight of flutamide per day for 7 days and discontinued, they were treated with 100 and 300 mg/kg body weight of aqueous extract of B. dalzielii, respectively, from days 8 to 21. All administrations were carried out orally. Results: There was a dose-dependent increase in body weight, raised serum testosterone levels, and increased cellular proliferation following administration of B. dalzielii on flutamide-induced testicular toxicity. Conclusion: The result of this study suggests that the aqueous extract of the bark of B. dalzielii has a therapeutic effect on flutamide-induced testicular toxicity.

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Background: The benefit of multiple antenatal registration for a current pregnancy is not proven with respect to pregnancy outcome. Aim: The aim of this study was to determine the association between multiple antenatal registration for a current pregnancy and maternal and neonatal complications. Materials and Methods: This was a cross-sectional study of 420 eligible women who delivered at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria, from July 2017 to September 2017. Structured pretested questionnaires were administered to consecutive 420 consenting women who delivered at the study center. Data analysis was both descriptive and inferential at 95% confidence interval (CI). A value of P < 0.05 was considered statistically significant. Results: The incidence of multiple booking was 52.1%, whereas the commonest reason was for a second opinion, 121 of 219 (55.3%). Maternal complications occurred in 12 of 121 (9.9%) of the participants who had multiple antenatal booking and in 10 of 201 (5.0%) of those who had a single-facility registration. This difference was however not statistically significant (P = 0.111, odds ratio [OR] 2.10 95%, CI 0.88, 5.03). Neonatal complications occurred in 17 of 121 (14.0%) of participants who had multiple antenatal booking and in 16 of 201 (8.0%) of participants who had a single-facility registration group. This difference was also not statistically significant (P = 0.090, OR 1.89 95%, CI 0.92, 3.90). Conclusion: There was no association between multiple antenatal registration and pregnancy outcome in terms of maternal and neonatal complication compared with single-facility antenatal registration. There is a dire need for health education to encourage single registration with a skilled birth attendant.

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Objective: The objective of this study was to evaluate the extent of recall of consent information by daycare prostate biopsy patients in a low-literacy setting and to compare the extent of recall 1 week against the extent of recall 2 weeks after formal consent session. Materials and Methods: This is a cross-sectional study where consecutive patients for daycare prostate biopsy at a tertiary hospital were recruited from February to November, 2017. After giving informed consent for the study, the participants were randomized to receive formal consent session 1 week (Group A) or 2 weeks (Group B) to the planned date of procedure. Extent of recall was ascertained on the procedure day using semi-structured researcher-administered questionnaire from only participants who checked in with Generalized Anxiety Disorder 7 (GAD-7) score ≤ 9. Data were analyzed using Statistical Package for Social Sciences software, version 21.0, IBM Co., Armonk, NY, USA. Results: At 15.8%, the recall of the risks associated with the planned procedure was poorer than the recall of nature of the disease condition (75.8%), and the recall of nature of the planned procedure (54.7%). Aggregate recall on consent information was not influenced by age (P = 0.57) or formal education status (P = 0.13) of participants, and did not vary between the two groups (P = 0.53). Conclusion: Recall of consent information on risk of planned procedure is poorer than that on the nature of disease and on the nature of planned procedure. There is no evidence that aggregate recall on consent information among daycare prostate biopsy patients changes significantly in the short term (one week) irrespective of formal education status and patient age.

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Carotid cavernous fistula (CCF) is not an uncommon occurrence in patients involved in road traffic accident with head injury. It involves an abnormal communication between the cavernous sinus and the carotid arteries presenting with clinical features. Its pathogenesis could be traumatic or spontaneous. Our patient was a 32-year-old woman involved in a road traffic accident with head injury. Emergency cranial computed tomography scan revealed subarachnoid hemorrhage and suspected aneurysm of the left internal carotid artery. Subsequent computed tomographic angiography and magnetic resonance angiography were negative for aneurysm or CCF, but a latter digital subtraction cerebral angiography showed florid signs of CCF (dilated cavernous sinus and left ophthalmic vein), though, no clinical features of CCF were observed in this patient. The patient was subsequently referred to another hospital with a neurointerventional radiologist for management. In conclusion, this case shows that the absence of clinical features and negative noninvasive imaging investigation does not exclude the diagnosis of CCF.

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Background: Superficial soft tissue abscesses (SSTAs) constitute a considerable proportion of the pediatric surgeon’s workload. SSTAs are abscesses involving skin, subcutaneous tissues, muscles superficial to bones, and deep body cavities such as pleural and peritoneal cavities. However, scientific publications assessing patterns of presentation in children, identifying the common bacterial etiological agents, and calculating multiple antibiotic resistance (MAR) index of positive abscess culture results in our environment are not common. Aims and Objectives: The aim of this study was to determine the pattern of presentation of SSTAs in children in our environment, determine their common bacterial etiological agents, and calculate MAR index. Materials and Methods: An observational study was conducted on children with SSTA over a 21-month period at the Federal Medical Center, Umuahia, Abia State, Nigeria. All patients had incision and drainage, packing of cavity with gauze drain, and a sample of the pus sent for aerobic culture and sensitivity. MAR index was calculated for each positive isolate after sensitivity testing. Data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) software, version 20.0 (SPSS, Chicago, Illinois). Results were presented as mean values, ratios, percentages, and in tables. Results: There were 40 patients with 45 abscess sites: 22 males and 18 females aged 7 days to 14 years (median of 21 months). Symptom duration before presentation ranged from 2 to 14 days. The most common site of abscess was the lower limb (12 of 45, 26.7%). Blunt trauma was the most common predisposing factor to abscess formation (17 of 45, 38%). MAR index ranged from 0.25 to 1 with a mean of 0.49. Staphylococcus aureus was the most common organism grown in all positive cultures (23 of 25, 92%). Conclusion: In our environment, most SSTAs in children occur in the lower limbs; S. aureus is the most common etiological bacterial agent involved in SSTAs, and blunt trauma is the most prevalent predisposing factor in SSTAs. Mean MAR index is high in this study.

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