Background: The incidence of breast cancer is increasing and the presentation is often late in our environment with poor prognosis. Breast self-examination (BSE) remains an important diagnostic tool for the early detection of breast cancer in a resource-limited community. Nurses being in closer contact with patients should be in the forefront in educating the general public on BSE. Objectives: This study investigates the knowledge, attitude and practice of BSE among female nurses in Aminu Kano Teaching Hospital (AKTH) with regard to the number that practice, method and the frequency of BSE. Materials and Methods: The study is a descriptive cross-sectional study of female nurses employed in AKTH using self-administered questionnaire. Respondents were selected by simple random sampling methods from the register of nursing staff at AKTH. The data collected were on socio-demographic profile, knowledge, attitude and practice of BSE. The relationships between these factors were studied. Results: All the nurses studied are aware about BSE, with 91.2% practicing it. There is appallingly poor knowledge of its timing, frequency and method. Only 45 (41.2%) of the respondents practice BSE monthly, and none of the respondents can accurately describe the exact method of BSE. Conclusion: There is universal awareness of the BSE among nurses, with dismal awareness of its purpose, method, timing, and frequency among the female nursing staff studied. However, there is a lot of enthusiasm to encourage others to do it. Therefore, nurses need to be also further trained and educated about the procedure.

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Introduction: Studies of psychological distress among university students identified academic stress as highest in medical students followed by allied-health students and least in those not in any of these two disciplines. The immediate antecedents include poor academic performance, substance abuse, and subsequent drop out. Future impacts as burnouts and poor services delivery can be exorbitant. This study therefore aimed to document the prevalence of psychological distress among two groups of clinical students of College of Medicine, Bayero University Kano. And also report influence of demographics, resilience and social support on the observed prevalence. Methodology: The participants were 122 clinical students from two departments of clinical sciences that is, medicine and physiotherapy. All gave consent before administration of the study instruments consisting of sociodemograhic questionnaire, Hospital Anxiety Depression Scale (HADS), Resilience Scale (RS) and Oslo Social Support Scale (OSS-3). Results: Overall, 63.1% of participants were males while 57.4% were females. The mean age of medical versus physiotherapy students are respectively 22.47 years and 22.17 years. Psychological distress as measured by HADS is higher in medical students (depression [57.4%] and anxiety [61.6%]) compared to physiotherapy students (depression [42.6%] and anxiety [38.4%]). Physiotherapy students had higher resilience and lower social support compared to medical students. The participants' mean scores on HADS, RS, and OSS-3 is only statistically significant for the RS. Conclusion: It was noted that psychological distress due to academic stress is more among Medical students compared to physiotherapy students. Interventions strengthening social support and improving resilience should be included as part of students' training.

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Introduction: Previous studies have shown that medical students globally experience various degrees of psychopathologies such as depression, anxiety, and stress while in medical school. Objective: This study aimed at assessing the symptoms of depression, anxiety, and stress in a sample of Nigerian medical students. Materials and Methods: A cross-sectional and descriptive design was adopted for this study. A total of 240 medical students from the second to sixth years studying at the Lagos State University College of Medicine, Lagos, Nigeria were invited to participate in the study. They completed a proforma form that collected their sociodemographic variables and short version of the Depression Anxiety and Stress Scale. Results: A total of 240 medical students participated in the study. The age range was between 25 and 34 years, (mean 25 years; SD = 4.5); 120 (50%) were females and only 9 (3.75%) were married while a large majority of the participants 229 (95.4%) were single. A small number of the participants 9 (3.8%) and 34 (14.2%) smoked cigarettes and consumed alcohol, respectively. The DASS analysis showed that 15 (6.3%), 23 (9.5%), and 148 (61.6%) experienced symptoms of depression, anxiety, and stress, respectively. Conclusion: The study demonstrated that Nigerian medical students also manifested with various symptoms of psychopathology. Nigerian medical students should be taught stress and change management strategies to assist them to cope with the stressful nature of medical training.

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Introduction: Infections from HIV, Hepatitis B and to some extent Hepatitis C viruses constitute a major public health challenge in sub-Saharan Africa, and there are evidences to suggest that there is faster progression of HIV in those co-infected with either HBV or HCV. The aim of this study was to determine the prevalence of HBV and HCV infections among HIV-infected patients, and describe the socio-demographic features and correlates of HIV and HBV/HCV co-infected patients at Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Materials and Methods: This was a cross-sectional study carried out among HIV-positive individuals seen at the adult HIV clinic of AKTH. Four Hundred and forty (440) consecutive HIV-positive adult patients who consented to the study were screened for markers of HBV and HCV using Enzyme-linked Immunosorbent Assay (ELISA) technique. CD ₄ Count and serum ALT were also obtained from the recruited patients. Socio-demographic characteristics and Body Mass Index (BMI) were obtained. Differences and relationships between groups were determined using students t-test and Chi-square test where appropriate, and a P < 0.05 was regarded as significant. Results: Prevalence rates of Hepatitis B and C virus infections obtained were 12.3% and 1.6%, respectively. Individuals who were 40 years or younger were the most affected. HBV co-infection was more common among males than females (16.9% vs 9.2%, respectively, P = 0.0153). Mean serum ALT among participants with HIV alone was 31.6 International Units (IU), but was significantly higher (45.3 IU) for those with HIV/HBV co-infection, P = 0.048. Mean CD ₄ count for HIV/HBV co-infected participants (259.7 c/mm ³ ) was significantly higher than that for participants with HIV alone (240.0 c/mm ³ ), P = 0.0170 whereas the mean BMI was not significantly different between participants with HIV alone (21.3 kg/m ² ) versus HIV/HBV co-infected participants (22.2 kg/m ² ), P = 0.1385. Conclusion: Co-infection with hepatitis B virus is common among HIV-infected patients in our setting and this further reaffirms the need for routine baseline screening for this marker, as it is a major consideration in the initiation and choice of highly active antiretroviral therapy. Furthermore, those found to be negative should be immunized with HBV vaccine to improve the prognosis of their HIV status.

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Background/Aim: Low birth weight (LBW) is associated with a higher risk of mortality and long term consequences for the survivors. This study determines the incidence and risk factors for LBW babies in Maiduguri. Context/Setting: This study was done in the Departments of Obstetrics and Gynaecology of the University of Maiduguri Teaching Hospital and the State Specialist Hospital, Maiduguri. Materials and Methods: This was a prospective study involving 854 pregnant women and their babies between 2 ^nd February 2009 and 29 ^th July 2009. Socio-demographic, obstetric, medical factors, obstetrics interventions and foetal birth weights were obtained and recorded. Association between variables were examined using student's t-test and Chi-squared test and multivariate logistic regression analysis a P < 0.05 was considered significant. Results: The incidence of LBW was 16.9%. The risk factors for LBW were non-use of haematinics index pregnancy (OR = 13.04; 95% CI = 12-36; P value 0.000); previous history of stillbirth (OR = 8.11; 95% CI = 6-19; P value 0.000); hypertensive disorders of pregnancy (OR = 6.12; 95% CI = 5-14; P value 0.000); ante-partum haemorrhage (OR = 5.85; 95% CI = 4-9; P value 0.000); less than 4 ANC visitsn (OR = 4.94; 95% CI = 3-12; P value 0.000); previous history of premature delivery (OR = 4.39; 95% CI = 4-11; P value 0.000); previous history of LBW (OR = 3.65; 95% CI = 2-21; P value 0.000) and non-use of intermittent preventive therapy in the index pregnancy (OR = 3.24; 95% CI = 1-16; P value 0.001); and teenage mother (OR = 2.75; 95% CI = 2-27; P value 0.006). Conclusion: This study showed high incidence of LBW. Obstetric factors (problems and intervention of the current pregnancy) and previous obstetric performances played crucial role in the occurrence of LBW in our study. Qualitative antenatal care should be made available and provided to pregnant women at all levels of care.

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Acute kidney injury (AKI) is a relatively common condition in children. Management is daunting in resource-limited settings. This is a case report of a 5½-year-old girl who developed AKI secondary to hemolytic-uremic syndrome and managed with improvised peritoneal dialysis. A 5½-year-old girl presented to the emergency unit with features of acute renal failure following a febrile illness. A diagnosis of hemolytic-uremic syndrome was made. Peritoneal dialysis was commenced using improvised dialysis fluid, peritoneal catheter and drain set. She had an average of five cycles daily for 16 days with significant improvement in her clinical and laboratory parameters. After 4 weeks on admission, she was discharged home in a clinically stable state. The management of AKI, though challenging, can be achieved with improvised peritoneal dialysis in resource-limited settings.

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Background: The quality of drinking water is an important environmental determinant of health. Widespread production and consumption of inadequately processed or contaminated packaged drinking water can lead to waterborne disease outbreaks. To safeguard public health, it is important that available packaged water is duly registered and regularly analysed. Aim: This study was carried out to determine the bacteriological quality of ten selected brands of sachet water produced and sold in Samaru Zaria metropolis. Materials and Methods: From the brands of sachet water being sold in samaru, ten most popular brands were identified and selected based on patronage by consumers and distributors. A total of 20 samples, two from each of the ten brands of sachet water were bought from water vendors every fortnight for 1 month (may - june 2013). Results: The total coliform count ranged from 2-18+/100 ml. Isolates were identified to be Klebsiella spp., 0[40%] Proteus spp., [30%] Pseudomonas spp. [20%] and Chromobacterium violaceum [10%]. All were negative for thermotolerant coliforms, Salmonella, Shigella and Vibrio cholera. Conclusion: The results of this study showed contamination with micro-organisms found naturally in water, soil or vegetation which indicates a problem with the overall quality of water production but showed no contamination with sewage or animal waste. Microbiological assessment of drinking water quality should be done periodically with the regulatory body National agency for food and drug administration and control (NAFDAC) ensuring good quality assurance and maintenance of internationally defined drinking water standards.

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Background: Endotracheal intubation is an integral part of airway management and is key to the practice of safe anesthesia. Prediction of a difficult airway can help reduce the incidence of failed or difficult intubation. We studied the use of “L-E-M-O-N” (Look-Evaluate-Mallampati-Obstruction-Neck mobility) scoring system to predict difficult intubation and determine the prevalence of difficult intubation among adult surgical patients. Materials and Methods: One hundred and sixty (160) consecutive ASA I–III surgical patients between 18 and 65 years of age were recruited from October to December 2011. A variety of airway tests using the “L-E-M-O-N” scoring were done during preoperative assessment; and at induction of anesthesia, airway assessment using Cormack and Lehane was performed and the results were recorded by a standardized record sheet. The variables evaluated were gender, age, weight, height, body mass index (BMI), dentition and a variety of airway tests using the “L-E-M-O-N” scale. SPSS version 17.0 was used for statistical analysis; and a P value <0.05 was considered significant. Results: Prevalence of difficult intubation using Cormack and Lehane score only was found to be 8.1%. The “LOOK” features had sensitivities of 99.1%, 96.6%, and 92.5% for facial trauma, large incisors, and beard or moustache, respectively, and positive predictive values of 0%. Combination of predictors in the “L-E-M-O-N” score showed that, as the mean “L-E-M-O-N” score of the patients increased, the likelihood of difficult visual laryngoscopy also increased. Conclusion: Combination of airway predictors in the “L-E-M-O-N” scoring system significantly improves the ability to predict difficult intubation.

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Background: Peptides of the renin angiotensin aldosterone system (RAAS) have been implicated in the pathogenesis of malaria infection; however, available data are limited. Thus, this study was aimed at determining the association between hypertension and activity of angiotensin converting enzyme (ACE) in malaria patients attending Sheikh Muhammad Jiddah General Hospital, Kano State, Nigeria. Materials and Methods: Four hundred and fifty consenting adults (300 malaria positive and 150 control participants) were evaluated. Data on sociodemographic characteristics were obtained using a questionnaire. ACE level was determined as described by Cushman and Cheung (1971) and blood pressure (BP) was evaluated using standard methods. Statistical Analysis: ACE activity and BP were expressed as mean ± SEM. Comparison between groups was carried out using one-way analysis of variance. Pearson's Chi-square (χ²) test was employed to establish association between Plasmodium infection, hypertension, sex, age, educational, and occupational status. P <0.05 was regarded as statistically significant. Results: A total of 300 (66.6%) patients tested positive for malaria, of which 60 (20%) were hypertensive. The prevalence differed significantly by gender, age group, and occupational status. The serum ACE activity was significantly lower in male (1.54 ± 1.04 μmol/min/ml) and female (2.01 ± 1.29 μmol/min/ml) patients with malaria compared to controls (7.09 ± 2.42 and 7.48 ± 2.42 μmol/min/ml, for males and females, respectively); and this further decreased with severity of infection. Moreover, the ACE activity of malaria patients with hypertension (11.67 ± 0.5 and 10.60 ± 0.40 μmol/min/ml) was significantly higher than nonhypertensive (3.20 ± 1.31 and 3.16 ± 0.74 μmol/min/ml) male and female patients, respectively. Conclusions: There was a significant association between the activity of ACE and hypertension in malaria infection, showing that ACE might play a significant role in the outcome of malaria.

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Background: Job satisfaction has been associated with lots of benefits. The provision of health services depends on several factors but the availability and retention of human resources is particularly important. This study aims to determine job satisfaction among healthcare workers in a tertiary hospital in Kano and find if there are any, determining or related factors. Materials and Methods: This was a cross-sectional study conducted between May and June, 2017 on health workers working at a tertiary hospital in Kano, Nigeria. A modified closed-ended self-administered job satisfaction survey questionnaire was used. Data collected were analyzed with IBM Statistical Package for the Social Sciences, version 21 Windows statistical software. Results: The participants' ages ranged from 18 to 62 years with a mean age of 38.94 ± 8.07 years. There were 119 (74.4%) males and 41 (25.4%) females with a male/female (M:F) ratio of 3:1 (χ² = 19.415; P= 0.000). Overall, out of the 157 (98.1%) of the participants that responded to the job satisfaction question, 142 (90.4%) indicated they were satisfied with their jobs and 15 (9.6%) were dissatisfied. Satisfaction based on sociodemographic variables showed that there were no significant associations between them. There were also no significant associations between the professional categories, years in service, monthly salary, job schedule of the participants, and job satisfaction. The main reasons for job satisfaction were monetary and service to humanity. Conclusion: Majority of health workers in Kano were highly satisfied with their jobs because of the need to serve and also for the income.

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Introduction: Sexual stimulants are preparations used for increasing pleasure during sexual intercourse. The study sought to determine the use and effect of such preparations on women of reproductive age group in Kano, northern Nigeria. Materials and Methods: A self administered questionnaire was used to obtain information from 500 women to determine if they use sexual stimulants and the effects of the drugs on them (if any). Results: There were 423 women that responded. Majority 228 (53.9%) of them use sexual stimulants. Most (47.4%) of them were between the ages of 21 and 30 years, married (85.5%), multiparous (46.9%), and attained tertiary education (58.3%). About 39.9% of the respondents benefited from increased sexual pleasure and satisfaction, 20.2% obtained extra favors from their husbands while 29.9% did not benefit anything from the preparations. About 37.3% developed complications, which included coital laceration (5.9%), copious vaginal discharge (16.5%), vulval itching and rashes (17.5%), lower abdominal pains (14.1%), painful intercourse (16.5%), vaginal dryness (13.0%), and irregular menses (5.9%). Conclusion: A large number of women use sexual stimulants mainly sold by traditional healers. There is need for setting up more orthodox care for sexual dysfunction. There is need for more community health education on female sexual dysfunction.

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Background and Objective: Fine needle aspiration cytology has assumed a great importance in the pre-operative diagnosis of palpable breast lesions in several hospital and clinical settings worldwide. This study aims to audit its diagnostic utility and validity in a tertiary hospital, and to review some of the diagnostic pitfalls in interpretation of breast cytology. Materials and Methods: The study comprised of breast cytology reports and their subsequent tissue biopsy diagnoses recorded over a 5-year period from January 2008 to December 2012. Results: A total of 1162 breast cytology reports were made over the review period out of which 200 had histological confirmation. Out of the 200 cases, 109 (54.5%) were benign (C2), 20 (10.0%) cases were suspicious probably benign (C3), 27 (13.5%) cases were suspicious probably malignant (C4) and 44 (22.0%) were malignant (C5). The cytology reports were correlated with subsequent histological diagnoses. Of the 109 benign C2 reports, 99 were confirmed on tissue histology as truly benign (true negatives) and the remaining 10 cases were malignant (false negatives). Forty-three of the 44 malignant (C5) cytology reports initially made were confirmed as malignant on tissue histology (true positives). The remaining malignant (C5) cytology case was, however, revealed to be benign (false positive). The overall suspicious rate (C3 and C4) was 23.5%. The absolute sensitivity was 81.0%, specificity was 99.0%, positive predictive value (PPV) (C5) of 97.7%, negative predictive value (NPV) (C2) of 90.8%. The false positive rate (FPR), false negative rate (FNR) and suspicious rates (SR) were 1.2%, 12.0% and 23.5%, respectively. Conclusion: Fine needle aspiration cytology of the breast has recorded high absolute sensitivity and specificity in our centre with a marginally high false positive rate. It has thus continued to have relevance as an important pre-operative diagnostic tool in the management of palpable breast lesions in our hospital.

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Background: Sickle cell anemia (SCA) is an inherited disease caused by production of abnormal hemoglobin chains within the red blood cell. In Nigeria, West Africa, the incidence of SCA is 3%. The most common abdominal manifestations include abdominal pain (mesenteric crisis), hepatomegaly, splenomegaly, autosplenomegaly, and cholelithiasis. Objective: To evaluate the abnormal transabdominal ultrasonographic (TAUS) findings in children with sickle cell anemia in Sokoto, Northwestern Nigeria. Materials and Methods: Pediatric patients with SCA attending the sickle cell clinic at the Department of Pediatrics, Usmanu Danfodiyo University Teaching Hospital Sokoto were scanned at the Radiology Department of the Hospital by transabdominal ultrasonography (TAUS) using Apogee 800 plus Ultrasound scanner with a variable frequency probes at 5-12 MHz. The patients were in their steady states. They were also screened for viral hepatitis B and C. Results: The commonest TAUS findings in this study was hepatomegaly in 70 (98.6%) patients followed by splenomegaly in 15 (21.1%), autosplenomegaly in 3 (4.2%), and gallbladder sludge in 2 (2.8%) patients. Conclusion: Transabdominal ultrasonographic imaging of patients with sickle cell anemia revealed a high prevalence of abdominal abnormalities, especially of the liver, spleen, and gallbladder.

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Context: Cervical cancer is the leading cause of cancer related deaths among women in developing countries. Lack of awareness and comprehensive cervical cancer screening programmes offered in most developing countries are partly responsible for the high burden of disease. In developed countries, routine use of Papanicoloau smear, in part, has led to a decline in cervical cancer incidence and mortality. Objective: To determine the level of awareness, utilisation and factors associated with awareness of Pap smear test as a tool for cervical cancer screening among health care workers (HCW) in Maiduguri north-eastern part of Nigeria. Subjects and Methods: This was a cross-sectional questionnaire based study conducted among 150 health care workers in Maiduguri, between January and March 2010. Simple descriptive statistics was employed in the analysis of data. Results: A total of 150 participants were recruited for the study. The majority (141) of respondents were aware of Papanicolaou smear and 23.3% of the female respondents had done the test previously. Majority (90.8%) of the men were willing to pay for their spouses to do the screening; some of them (20.0%) were indifferent if their spouses perform the cervical screening without their consent. The major reason given for carrying out the test was for prevention of the disease. The major source of information was the hospital (84.7%). Majority of the women were willing to do the test if offered the opportunity either free (70.6%) or with payment (29.4%). A number of socio-demographic variables played crucial roles in awareness and utilisation of Pap smear. These included higher level of educational status ( P = 0.000) of the respondents, increased maternal age ( P = 0.001) and high parity ( P = 0.003). Conclusion: There is poor utilisation of Pap smear among HCW despite high level of awareness and availability of screening services. A number of socio-demographic variables play crucial roles in awareness of Pap smear. The reasons for the low utilisation among health care workers, who are the custodians of health care need to be investigated to improve their utilisation of Pap smear.

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The incidence of diabetes globally is reaching an epidemic proportion and with it carries the risk of complications and diabetic foot disease inclusive. The pathophysiology of diabetic foot disease is multifactorial and includes neuropathy, infection, ischaemia and abnormal foot structure and biomechanics. Early recognition of the aetiology of these lesions is important for good functional outcome. Managing the diabetic foot is a complex clinical problem requiring a multidisciplinary collaboration of health care workers to achieve limb salvage. Adequate off-loading, frequent debridement, moist wound care, treatment of infection and revascularisation of ischaemic limbs are the mainstays of treatment. Even with proper management, some of the foot ulcers do not heal and are arrested in a state of chronic inflammation. These wounds can frequently benefit from various adjuvants, such as aggressive debridement, growth factors, bioactive skin equivalents and negative pressure wound therapy. We reviewed current literature including original and review articles obtained through a search of PubMed database, Medline, Google scholar and hand searching of bibliographies of published articles using the keywords: Diabetes, diabetic foot, neuropathy, peripheral arterial disease and ulceration. The enormity of the challenges associated with the management of this important complication of diabetes, coupled with the various progresses being made in this area, and the need to streamline the principles of management, especially in our environment prompted us to review this subject matter.

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Sickle cell disease (SCD) is characterized by recurrent vaso-occlusive crisis (VOC). VOC is an important index of disease severity and has been shown to correlate with the risk of multi-organ damage and early death. Although the vulnerability to VOC among patients with SCD may be genetically predetermined on the basis of genotype and haplotype variability, nonetheless, VOC is usually triggered by a wide spectrum of etiologic risk factors, which range from physiological to nonphysiological factors on the one hand, and from psychological to physical factors on the other hand. An understanding of these risk factors and their pathophysiologic mechanisms is important for the hematologist to accurately identify potential etiologic risk factors for VOC. Thus taking preemptive action that will prevent undue exposure of patients to the risk factors and/or prepare the patient to uneventfully withstand the risk factors if exposure is unavoidable. This will ultimately obviate frequent VOC with its attendant risk of organ damage and early death in patients with SCD. Hence, in this study we conducted a broad and comprehensive review (using “sickle cell painful vaso-occlusive crisis” and relevant sub-terms in PubMed, Google Scholar, and other search engines) of various etiologic risk factors for VOC and the pathophysiologic mechanisms through which they trigger pain in patients with SCD.

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Background: Although vaccines currently approved for routine childhood immunization are safe and effective, frequent adverse events following immunization (AEFI) often cause ill-health and sometimes loss of public trust in immunization programs. This study assessed the level of knowledge, perception, and reporting attitude of primary healthcare (PHC) workers of AEFI in Sabon Gari local government area of Kaduna state. Materials and Methods: A descriptive cross-sectional survey using simple random sample method was used to select 110 PHC workers. Data were analyzed using IBM Statistical Package for the Social Sciences version 21. Results: Majority (92.2%) knew about AEFI and over 80% of the healthcare workers had been trained on AEFI and knew signs and symptoms of AEFI. More than 50% of respondents had good knowledge on AEFI but only 17.8% had good reporting practices. Sixty-six percent of healthcare workers had encountered an AEFI and 56.7% had ever reported an AEFI. There was a statistically significant relationship between age of healthcare workers (P = 0.001), previous training (P = 0.036), working experience (P = 0.001), and knowledge on AEFIs. Conclusion: The study revealed that PHC workers had good knowledge, perception, and reporting attitude toward AEFI surveillance. There is a need for training and retraining of staff as well as provision of internet access to ease electronic reporting system of AEFI surveillance.

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Background: The academic and psychological demands of undergraduate medical education may result in high-stress levels among students. High stress has been associated with poor academic performance, negative impact on physical and mental health. This study aims to determine the prevalence of stress among undergraduate clinical students of Bayero University Kano Medical School. Materials and Methods: This was a cross sectional study conducted among 224 clinical medical students from levels 400–600. The Cohen's Perceived stress scale (PSS-10) was used to assess the severity of among the students. The Chi-square test was used to determine associations and a significant association was considered at P < 0.05. Results: A prevalence of high stress of 59.8% was observed with a mean PSS score of 20.76 ± 5.58. The highest mean score of 22.29 ± 5.58 was observed among 400 level clinical students. There was no significant difference between both genders. A significantly higher proportion of students undergoing medicine, pathology, paediatrics and surgery postings were observed to be experiencing a higher level of perceived stress compared to those in Obstetrics and Gynaecology, (χ² = 1617, df = 4, P < 0.05). Similarly, a higher proportion of students whose fathers are educated had a significantly higher stress compared to their counterparts from uneducated backgrounds, (χ² = 5.54, df = 1, P < 0.05). Conclusion: Further studies to determine the causes of stress need to be carried out. This will assist the students and teachers to appropriately manage stress.

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Background: Type 1 diabetes is the most common form of diabetes in children; its symptoms may be subtle and frequently misinterpreted. Presentation with diabetic ketoacidosis (DKA) may be associated with significant morbidity and mortality in the paediatric population. Objective: To examine the prevalence of Type 1 diabetes in children at the Aminu Kano Teaching Hospital, Kano. Design: Retrospective study of case files of children with diagnosis of Type 1 diabetes mellitus (T1DM). Patients and Methods: It was a retrospective review of case files of children younger than 18 years with diagnosis of T1DM over 4 years (January 1, 2012,–December 31, 2015). Results: A total of 7929 patients were seen during the study period, out of which 18 were diagnosed with T1DM, giving a case prevalence rate of 2.3/1000. Sixteen (89%) of the 18 patients were first presented with DKA. The mean age at presentation was 8 years, and there were more females 13/18 than males 5/18 among the subjects. The most prevalent presenting symptoms were dehydration 16 (89%), fever 14 (77.8), abdominal pain 12 (66.6%), polyuria and polydipsia 12 (66.6%). Two of the sixteen patients with DKA died with cerebral oedema during admission. Conclusion: DKA is the most common pattern of presentation of T1DM in our environment. This highlights the need for intensified efforts in education of health workers and the populace at large for quick presentation and prompt diagnosis and optimal management of childhood diabetes.

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Background/Aim: The practice of informed consent prior to any surgical procedure should form the fundamental element that serves to protect both patient and surgeon from prosecution. The aim of this study was to assess knowledge, attitude and perception of women towards informed consent prior to Surgery in Obstetrics and Gynaecology department of Aminu Kano Teaching Hospital. Materials and Methods: This was a cross-sectional study conducted among 398 women who had undergone surgery at the Obstetrics and Gynecology department of the Aminu Kano Teaching Hospital, Kano State, Nigeria. Data was obtained following surgery but prior to discharge and was analyzed using SPSS version 17. Results: Three hundred and ninety eight women were recruited. The mean age was 30.3 years ± 5.2. All respondents believed signing a consent prior to surgery was important and believed it was a legal document involved in decision making process. Ninety seven percent of the respondents were satisfied with the explanation given to them prior to the surgery however, 15.8% had some reservations to the explanations while 3% were not completely satisfied with the explanations. Conclusion: Awareness and knowledge of consent was high in this study and the respondents had positive attitude towards signing consent.

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Background and Objective: Thyroid gland lesions occur globally with geographical variation in incidence and histopathological pattern related to age, sex, dietary and environmental factors. There is, however, no published histological study from northwestern Nigeria; hence, we undertook this study to describe the spectrum, frequency, age and sex distribution of thyroid gland lesions seen in Kano, as well as compare the findings with previous studies done in Nigeria and elsewhere. Materials and Methods: This is a retrospective descriptive study of all thyroidectomy specimens received from January 1 ^st , 2002 to December 31 ^st , 2011 at the histopathology department of Aminu Kano Teaching Hospital, Kano, Nigeria. Results: Five hundred and twenty-two thyroid gland lesions were diagnosed during the ten year period with a female to male ratio of 6.4:1. The ages range from 5 months to 86 years with a mean age at presentation of 36.3 years and relative peak age of incidence occurring in the 30-39 years group. The most common entity was goitre (57.2%) with a mean age at presentation of 37.5 years. It was followed by thyroid adenomas (15.7%) and thyroid carcinomas (12.6%). Specifically among cancers, papillary carcinoma predominated (53%), followed by follicular carcinoma (33.3%) and medullary carcinoma (9.1%). There were 36 cases (6.9%) of thyroglossal duct cysts and 28 cases (5.4%) of toxic hyperplasia while thyroiditis was uncommon with only 2 cases (0.4%). Conclusion: This study shows that thyroid gland diseases are common in Kano and are seen in both genders with a striking female preponderance. It revealed a higher incidence of papillary carcinoma over follicular carcinoma, a reverse of the finding of an earlier clinicopathological study on thyroid gland diseases in Kano. The age and sex incidences as well as the histological featuresof thyroid lesions in this study are, however, similar to reports from other local and international studies.

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Background: The need for blood and blood products requires an efficient blood transfusion service. This study was undertaken to provide pro data on the distribution of ABO and Rhesus blood groups that would assist in planning and coordinating blood transfusion services for the cosmopolitan city of Kano. Materials and Methods: A total of 5000 consecutive blood donor samples were grouped for ABO and Rhesus 'D' antigen by tile and tube methods at Aminu Kano Teaching Hospital (AKTH) over a one-year period. Results: Blood group O had the highest prevalence of 2860 (57.2%) followed by blood group B of 1035 (20.7%), then A of 1025 (20.5%) and the lowest being AB of 80 (1.6%). A total of 4741 (94.8%) of the study group were Rhesus 'D' positive while 259 (5.2%) were Rhesus 'D' negative. Conclusion: The ABO blood group had blood group O as the most prevalent blood group in the study population while the lowest was AB. The Rhesus blood group positive was 94.8% while Rhesus negative blood group was 5.2%.

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Background/Aim: Foetal weight cannot be measured directly in utero, but it can be estimated or predicted from foetal and maternal anatomical characteristics. This study was undertaken to examine the relationship between birth weights and certain maternal anthropometric measurements (weight, height and BMI). Context/Setting: This study was done in Aminu Kano Teaching Hospital (AKTH), North-West, Nigeria. Aminu Kano Teaching Hospital is a 500-bed tertiary hospital located in Kano, the most populous state in Nigeria. Materials and Methods: This was a prospective study. Interviewer-administered questionnaires were used to retrieve sociodemographic and obstetrics information. Two-hundred (88.9%) pregnant women responded completely. The weight, height and BMI of the women were measured. Unclothed newborns were weighed immediately after delivery. The data obtained was analysed using SPSS version 16.0 statistical software. The accuracy of maternal weight, height and body mass index in predicting birth weight was compared using Student's t-test, Chi-square test and Pearson's Coefficient of Correlation and P < 0.05 was considered statistically significant. Results: The mean maternal age was 28.2 ± 5.7 years. The mean parity was 3 ± 2. The mean gestational age at delivery was 38.5 ± 2 years. The mean actual birth weight was 3.27 ± 0.53 kg. The mean maternal weight was 72.03 ± 11 kg. Maternal weight showed a strong positive correlation with birth weight ( r = 0.48) and this was statistically significant ( P < 0.001). The mean maternal height was 1.64 ± 0.55 m. The mean maternal BMI was 27.9 ± 4.33. Maternal BMI showed a weak positive correlation with birth weight ( r = 0.28) and this was statistically significant ( P < 0.001). Maternal weight and BMI are better predictors of birth weight than maternal height. Conclusion: Maternal weight and BMI are good predictors of birth weight and can be recommended for use as screening test in poor resource setting.

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Background: The association between Down syndrome (DS) and congenital heart disease (CHD) was first recognised by Garrod in 1894. Several studies have reported about 40-60% prevalence of CHD in DS and a predominance of left to right shunts like atrioventricular septal defects (AVSDs), ventricular septal defect, patent ductus arteriosus and atrial septal defect. Objectives: This study was carried out to find out the prevalence and types of CHD among children with DS. Materials and Methods: This was a retrospective study of the echocardiographic data collected over a 24-month period, between October 2009 and September 2011. The echocardiographic diagnosis of all children with DS referred was reviewed. Results: A total of 35 cases of DS were seen. The age ranged from 0.5-30 months. About 60% of the children with DS were aged 6 months and below. There were 19 males and 8 females giving a M: F ratio of about 2:1. A total of 77.1% of the children with DS had CHD. The most common CHD is AVSD (40%), followed by atrial septal defect (22.25%). A total of 22.25% had normal echocardiographic study. Conclusion: Early referral and screening of all babies born with the clinical phenotype of DS should be encouraged due to the high prevalence of CHD.

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Context: Human intestinal parasites have always been a major health problem in the developing countries. This study was aimed at determining the prevalence of intestinal parasitic infections among artisans and establishes a relationship between the prevalence of intestinal parasitic infections and risk-factors. Materials and Methods: A total of 353 participants which consisted of 272 males and 81 females were recruited for this study with age ranging from 18 to 65 years. Stool specimens were collected from the participants and analysed using the standard technique. The data obtained were analysed using Chi-square (χ² ) to compare the frequency data while the odd ratio was calculated for potential risk factors. Results: Out of 353 subjects, 118 (33.4%) subjects had intestinal parasitic infections. Age, gender, marital status, occupation, educational status and source of food did not significantly affect (P = 0.219, P = 0.920, P = 0.276, P = 0.087, P = 0.074 and P = 0.442, respectively) the prevalence of intestinal parasitic infections. The use of well/rain water (odds ratio [OR] =2.721; 95% confidence interval [CI] = 1.452, 5.100; P = 0.002) and presence of diarrhoea (OR = 6.169; 95% CI = 3.665, 10.474; P < 0.0001) were significantly associated with intestinal parasitic infections among artisans. Defecating in nearby bushes resulted in a significantly increased prevalence of intestinal parasitic infections among artisans (P < 0.0001). The intestinal parasites recovered were Ascaris lumbricoides, hookworm, Trichuris trichiura and Entamoeba histolytica. A. lumbricoides had the highest prevalence (77.8%). The male gender had the highest prevalence in all the four intestinal parasites recovered in this study. Conclusion: Overall prevalence of 34.4% of intestinal parasitic infections was observed among artisans in Benin City. The source of water, type of toilet and presence of diarrhoea significantly affected the prevalence of intestinal parasitic infections among artisans. A. lumbricoides was the most prevalent parasitic agent recovered in this study.

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