Inversion of the uterus is a rare clinical problem. Non-puerperal inversion usually results from a tumor arising from the fundus of the uterus. We report two cases of chronic non-puerperal uterine inversion in a 38-year-old and a 54-year-old postmenopausal woman. They both presented with vaginal bleeding, a mass protruding from the vagina and lower abdominal pain. Diagnosis was made based on these clinical features. At first, vaginal myomectomy was performed and after that, a Kustner procedure and vaginal hysterectomy was performed in both cases. Early diagnosis and appropriate surgical treatment of the inverted uterus are important to prevent further complications.

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Assessment in medical education is very vital because of its far reaching implications not only for the students and their teachers but for the communities and world at large. This article attempts to review the assessment methods used in undergraduate medical schools, highlight their limitations while proffering solutions as recommended by experts in medical education. Assessment methods that are used in the undergraduate medical education can be broadly subdivided into two; assessment of knowledge and its application (Multiple choice questions, essay and viva voce) and assessment of clinical competence (long case, short case and objective structured clinical examination [OSCE]). There are five major criteria for determining the usefulness of a particular method of assessment: Reliability, Validity, Educational impact, Cost effectiveness and Acceptability. The major drawback of the long and short case examinations is the poor reliability or reproducibility due to case specificity, inter examiner and clinical case scenario variability. In 1975, Harden et al., introduced the OSCE to avoid the disadvantages of long case but acceptability may be an issue because of inadequate exposure to its principles and resistance to change by some teachers. Another objective version of the long case is the objective structured long examination records. Objective structured practical examination is also preferred to the traditional practical examinations in laboratory based courses. All assessment methods have their strengths and limitations. It is important that teachers in medical schools are aware of the limitations of the traditional assessment tools and embrace newer and more reliable methods of assessment.

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Objective: To determine the prevalence of gingivitis and periodontitis among an adult male population in Benin City, Nigeria. Materials and Methods: The drivers of a private motor transport company whose head office is in Benin City constituted the study participants. Data collection was through an interview-administered questionnaire and periodontal examination. Periodontal disease was assessed using community periodontal index while demographic characteristics, social habits and oral hygiene habits were elicited using interview-administered questionnaire. Results: The prevalence of gingivitis and periodontitis was 75.4% and 15.4% respectively. The prevalence of periodontitis was higher among older participants, those of lower educational attainment and longer driving experience, those that indulged in only once-daily teeth cleaning, tobacco users, regular alcohol and kolanut consumers. Conclusion: The prevalence of gingivitis and periodontitis in this study was similar to previous reports in Nigeria. The prevalence was higher in relation to the risk factors considered in this study thereby necessitating the need for an awareness campaign to enlighten the public about the harmful effects of tobacco, kolanut and alcohol on periodontal health. This study is also recommended among a larger number of people.

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Background: Data on the epidemiology of chronic kidney disease (CKD) from sub-Saharan Africa are still sparse. Preventive strategy through early detection and treatment has been advocated for CKD, especially in our environment where majority of patients present late and cannot afford the cost of renal replacement therapy which is not widely available. We investigated the prevalence of risk factors for CKD among the civil servants who volunteered after a public enlightenment campaign in Kano, northern Nigeria. Materials and Methods: We studied 225 apparently healthy civil servants who availed themselves of the opportunity to be screened for risk factors for CKD during the 2011 World Kidney Day activities. Relevant demographic and clinical data were obtained using a questionnaire. Weight, height, Body Mass Index (BMI), and blood pressure were measured. Spot urine samples were collected and tested for protein, sugar, and other parameters using a dipstick. Random blood sugar was measured with a glucometer. Results: The mean age of the study participants was 41.5 ± 9.68 years. Males constituted 83.6% of the respondents. Majority had a positive history of use of traditional medications, followed by the use of analgesic drugs, while very few (less than 5% each) admitted to alcohol ingestion or use of bleaching creams. While there was a significant family history of hypertension and diabetes, only about 3% had positive family history of kidney disease. Proteinuria was found to be present in 19.4%. Other risk factors found include hypertension (29.8%), obesity (11%), and diabetes mellitus (3.6%). Conclusion: Risk factors for CKD are common among civil servants in Kano. The most frequent CKD risk factors found among the study subjects were use of traditional medication, cigarette smoking, obesity, hypertension, and proteinuria.

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Background: Nigeria lags behind in the deployment of laparoscopic surgical services, even among the developing countries. In spite of the huge abundant human and materials resources at its disposal, public hospitals are still underfunded. However, some tertiary health institutions in our sub-region have been able to brave the odds to modernize their services. Aim: To review the early experiences of two general surgery units in laparoscopic surgery at two institutions in South-eastern Nigeria. Materials and Methods: A 3-year retrospective analysis of the laparoscopic general surgery operations carried out in Nnamdi Azikiwe University Teaching Hospital, Nnewi, and Federal Medical Centre Owerri, Nigeria, was done. Results: A total of 20 cases have been done in both hospitals: 9 laparoscopic cholecystectomies, 10 laparoscopic appendectomies, and 1 laparoscopic liver abscess drainage. There was no conversion to open surgery. The average duration of postoperative stay after cholecystectomy and appendectomy were 2.1 and 1.5 days, respectively. There was no major complication despite the challenging intraoperative adverse conditions. Conclusion: Laparoscopic surgery is safe in our region, but its evolution is still slow in our centers. Improved surgeon training and subsidization of the costs of the procedures may hold the key for accelerated development.

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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 use of prints as a mean of personal identification is one of the common methods in forensic anthropology and the most popular prints are fingerprints. The second print of interest is lip prints, which are normal lines and fissures in the form of wrinkles and grooves present in the zone of transition of human lip. The study was aimed to determine association of lip prints types and sex among Nigerian population. Materials and Methods: A total of 820 subjects (414 males and 406 females) participated in the study. The lip prints were obtained on microscopic glass slide and developed using carbon black powder, after which the print was divided into 10 quadrants and analyzed using magnifying lens. The data were analyzed using Chi-square test and P < 0.05 was considered as level of significance. Results: The result shows the percentage distribution of lip prints in males with highest prevalence of type V (31.28%) and the least of type I' (0.55%). In females type V (31.50%) was predominant while the least was type I' (0.59%). The statistically significant association of lip prints types with sex in all the lip quadrants ( P < 0.001) was found, except in lower right lateral (LRL) and upper median (UM ₀ ) quadrants. Conclusion: The lip print was found to be statistically associated with sex. Hence, lip prints can hold potential promise as supplementary tool in personal identification.

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Background: Vomiting is a common complaint in early pregnancy. It is experienced in 80% of pregnancies and usually remits after 14 weeks. The aetiology is unknown, although there are various likely mechanisms, including the role of human chorionic gonadotrophin and its probable thytrophic activity. Objective: To review the presentation of patients coming with vomiting in early pregnancy and identifiable causes, at Aminu Kano Teaching Hospital (AKTH). Materials and Methods : Consecutive pregnant women's records, who presented with vomiting in early pregnancy between January 1 2010 and December 31 2011 in the gynecological emergency unit of AKTH, were retrieved. Information on clinical presentation, laboratory tests and pelvic ultrasound scans were extracted. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 16 and P < 0.05 was considered significant. Results: One thousand eight hundred and fifty-six patients were seen. Sixty-one were due to vomiting in pregnancy, giving an incidence of 3.3%. Vomiting in pregnancy was the most common among those aged 21-30 years (48.3%), compared to those aged 31-40 years (16.7%). The differences was statistically significant ( P = 0.01). Most patients were in their first pregnancy or had only one previous delivery (50%). The condition was uncommon at higher parities. The differences were statistically significant ( P = 0.001). Majority of the patients presented at 6-15 weeks (96.6%) compared to 16-20 weeks (3.3%) gestation. The etiology of vomiting was unknown in 36.7% of the patients, was urinary tract infection (UTI) in 31.7%, malaria in 23.3%, gastroenteritis in 5% and peptic ulcer disease in 3.3%. Conclusion: The cause of vomiting in early pregnancy is unknown in a third of all cases studied. UTI is the commonest known cause of vomiting in pregnancy in our centre.

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