The purpose of the present article was to review the physics and radiation factor of the orthopantomograph and to describe the diagnostic anatomy visualised on the imaging modality. Literature search was done via PubMed, EMBASE, Cochrane electronic databases and Google Scholar. The keywords for the search were orthopantomograph, anatomy, maxillofacial region and physics. The search was restricted to articles written in English Language and published within the years 1940–2016. The search was further limited to review, free full-text articles. The available literature was reviewed, and the physics and radiation exposure of patients undergoing orthopantomograph imaging were discussed. The radiation exposure was compared to the complete mouth series intra-oral periapical radiographs. Furthermore, the diagnostic anatomy of the maxillofacial region, as visualised on the orthopantomograph, was reviewed. The clinical relevance of the various anatomic structures was also discussed. The knowledge of maxillofacial anatomy on the orthopantomograph can be challenging due to distortion and superimposition of anatomic structures. However, a good understanding of the normal enables the clinician to identify the abnormal.

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Background: The diagnosis and treatment of drug resistant tuberculosis (TB) has presented a unique challenge to the control of TB in Nigeria. Various studies have reported the presence of drug resistant TB, and some treatment centres have been established to treat cases. This study sought to establish the prevalence of rifampicin-resistant TB in our state with a view to advocating for more commitment to efforts toward the treatment and control of drug-resistant TB, including establishment of more treatment centres in the geopolitical zone. Materials and Methods: A retrospective review of laboratory records of 1882 patients whose sputum samples were sent to the Gene Xpert Laboratory of our facility between January 2014 and April 2015 for Mycobacterium tuberculosis (MTB) and rifampicin resistance assay was done using the Gene Xpert MTB/RIF assay. The patients were presumptive TB cases, suspected TB treatment failures, and suspected drug resistant cases from various health facilities in the state. Results: Of the 1882 patients, 68.4% were females and 36.6% were males; patients were aged between 1 and 70 years. MTB was detected in 18.8% (355/1882) of the patients. Forty-three of the 355 MTB positive patients were rifampicin resistant giving a prevalence of RIF resistance of 12.1%. A total of 62.8% of the RIF resistant cases were males whereas 37.2% were females. Forty-one percent of the RIF Resistant cases were aged between 21 and 30 years, 51.2% were human immunodeficiency (HIV) positive, 44.2% were HIV negative, whereas 4.6% had unknown HIV status. A higher number (62.8%) of those with RIF resistance were referred from other facilities compared to 37.2% from the host facility. There was significant association between RIF Resistance and sex, HIV status, and the facility. Conclusion: This study has established that there is a high prevalence of rifampicin resistance in the state. There is need to increase commitment to efforts being made towards treatment and control of DRTB in this zone.

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Introduction: Transfusion transmissible infections (TTIs) may potentially lead to serious harm to recipients of blood transfusion. Cytomegalovirus (CMV) can be transmitted through blood transfusion, and its impact is the most severe among immunocompromised recipients. Its transmission can be reduced through screening of blood donors, blood and blood products for CMV antibodies, leuco-depletion or pathogen inactivation. Objective: This was a cross-sectional study conducted among 250 blood donors between October and December 2012 in Aminu Kano Teaching Hospital, Kano, Nigeria. To determine the prevalence of human immunodeficiency virus (HIV) I and II antibodies, HBsAg, hepatitis C virus (HCV) antibodies, syphilis and anti-CMV IgM and IgG antibodies. In addition, the type of donation and donation patterns were also assessed. Materials and Methods: Five milliliters were collected from the participants. One milliliter was dispensed into ethylenediaminetetraacetic acid (EDTA) container and mixed gently, the remaining 4 ml were dispensed into a plain bottle and was centrifuged; serum obtained was divided into two one was stored at − 20°C which was later used to test for the anti-CMV IgG/IgM antibodies, whereas the other portion was used for routine screening of TTIs. The EDTA sample was used to assess haemoglobin concentration. An interviewer administered simplified questionnaire was used to obtain information on demographic and other variables related to donation habits. Association between the socio-demographic characteristics of the blood donors and the anti-CMV antibodies was analysed. Similarly, association between the anti-CMV antibodies and the other routinely screened TTIs was assessed. Results were tested for evidence of statistical association. Results: Majority of the blood donors were males 242 (96.8%). One hundred and seven (42.6%) of the blood donors were within the age group of 25–34 years. Only 10.8% of the donors were voluntary donors whereas the remaining were family replacement donors. Prevalence rates of 100% and 4.4% were found for anti-CMV IgG and anti-CMV IgM antibodies, respectively. HBsAg, HIV I/II, anti-HCV antibodies and syphilis were prevalent in 6.8%, 1.2%, 0.8% and 0% of the donors, respectively. Conclusion: Seroprevalence of anti-CMV IgG and anti-CMV IgM antibodies among blood donors in this study was found to be 100% and 4.4%, respectively. Therefore, routine predonation screening for anti-CMV antibodies may not be cost effective. Leucocyte depletion and pathogen inactivation methods are better options. However, these can better be achieved when centralized system of blood transfusion is adopted. Therefore, there is a need to enhance the functional capacity of our national blood transfusion service.

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Background: The prevalence of penile cancer differs from region to region across the globe. The highest prevalence was reported in some parts of the developing countries in South America and Africa. However, its epidemiology in our population is unknown. Our study, therefore, aimed to describe the frequency, the age of presentation, and the histological spectrum of penile cancers seen in Kano, Northern Nigeria. Materials and Methods: This study was an 18-year retrospective appraisal from 1998 to 2015 of all the histological diagnosed penile cancers recorded at the Aminu Kano Teaching Hospital, Kano, Nigeria. Where necessary, a new slide was reprocessed from tissue block for re-evaluation. Results: Six penile cancers were diagnosed during the study period. Patient's age ranged from 50 to 75 years (mean 59.70 years). Three patients (50%) were in the 50–59 years age group. All the six cases were squamous cell carcinomas, five (83.3%) were well differentiated and one (16.7%) was poorly differentiated. Conclusion: This review affirmed the low prevalence of penile cancer in our population which may not be detached from the common tradition of circumcision in our populace.

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Background: The purpose of the study was to determine the periodontal status of the children in orphanages as there are very few studies done in this area both at home and abroad. The few studies conducted previously indicated a need for intervention in the oral health of these children. Patients and Methods: Children of some of the orphanages in Lagos constituted the target population. A questionnaire was administered to each participant followed by dental examination. Oral hygiene status was evaluated according to Green and Vermilion Simplified Oral Hygiene Index (OHI-S). Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN). Results: A total of 91 children and adolescents, age 6–17 years were examined. Overall, periodontal disease prevalence was 63.7%, with calculus being the highest component (60.4%). Conclusion: This study indicates that, even though dentifrices were provided for use, children and adolescents exhibited high percentage of calculus. Hence, intervention in terms of regular dental checks and dental treatment are required.

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Schwannoma is a rare benign slow growing nerve sheath tumor, but can sometimes be malignant. The disease has an incidence of 1 among 100,000 people. It is the third most common intraspinal tumor after meningioma and glioma. We report an unusual clinical presentation of Cervical Spinal schwannoma in a young man.

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Background: The intrauterine system (IUS) is an intrauterine device which releases levonorgestrel (LNG). It is used in preventing pregnancy for up to 5 years as well as to treat heavy menstrual bleeding. Data documenting the use of IUS is very limited in our setting. Objective: To review the use of the LNG IUS and the reasons for its use. Materials and Methods: In this study, we reviewed records of all clients who attended the reproductive health clinic of the Ahmadu Bello University Teaching Hospital, Zaria and selected an intrauterine device as a method of contraception and or therapeutic option. The study was conducted from January 2007 to December 2013. Data was analysed using the Statistical Package for the Social Sciences (SPSS) version 20. Results: A total of 1104 women opted for an IUD as a method for contraception, of which 68 (6.1%) women used LNG IUS. The mean age of the women was 31.9 years ± 6.8 years. Over half (54.5%) had between 2 and 4 children. There were only 6 (11.8%) women who used the IUS for reasons other than contraception during the study period, majority had the device inserted for contraception. Side-effect was the major reason for discontinuation (29.4%) followed by the desire to have a baby (27.9%). The most common side-effect was irregular vaginal bleeding (23.5%). Conclusion: The uptake of LNG IUS (Mirena®) for contraception or therapy is very low in our setting. There is a need to educate both the healthcare providers and clients regarding the contraceptive and non-contraceptive benefits of Merina.

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Background: A pilot study of 89 cases published 13 years ago (2003) revealed that bladder cancer was the second most common urologic malignancy in Kano with squamous carcinoma as the most frequent type (53%), with the peak prevalence in 5^th/6^th decades and an overwhelming male preponderance (M:F = 5.2:1). This study endeavors to update on developments in bladder cancer profile since then. Materials and Methods: This was a 15-year (2001–2015) retrospective review of all histologically diagnosed bladder cancers at Aminu Kano Teaching Hospital, Kano. Results: Three hundred and twenty-seven bladder cancers were diagnosed during the study period. Peak age groups were the 5^th and 6^th decades, with a mean of 51.2 years (±SD 11.74) and a male preponderance (7.6:1). Urothelial carcinoma was the most common histological type (49.6%), followed by squamous carcinoma (44.6%). Conclusion: Larger more representative sample size (327 cases) in this study compared to the earlier one (89 cases) 13 years ago largely accounted for the observed modest changes in histologic types, age, and sex distribution. Although the changes are modest, the general trend is towards that of the developed world – increasing urothelial carcinomas and increasing age profile.

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Background: Post-sterilisation contamination is the ability of the organisms to penetrate through the wrapping material and settle on the enclosed instruments. Safeguarding the sterility of sterile dressing packs during transportation and storage is an important requirement of a sterile supply packaging system. We evaluated the use of locally available and affordable tailoring lining material popularly known as gumstick. The objective of this study was to ascertain the efficacy of gumstick lining material in safeguarding the sterility of wrapped surgical dressing instrument. Materials and Methods: The post-sterilisation sterility was confirmed by culturing the sterile packs and then exposed to contaminants by leaving the packs on a microbiology working bench. The wrapped packs were then contaminated with suspensions of control strains of some selected bacteria, then swabbed and cultured. The surgical packs were also exposed to environmental contaminants, swabbed and cultured. Results: All cultures yielded no growth proving that the wrapped surgical instruments are bacteriologically sterile and gumstick provides the needed protection against contamination of surgical packs. Conclusion: Gumstick lining material is therefore recommended as packaging material for surgical instrument particularly in resource-constrained settings.

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Background: The standard induction dose (2.5 mgkg⁻¹) of propofol in some patients, especially the elderly can result in cardiopulmonary depression often associated with delayed recovery from anaesthesia. Pretreatment with a small dose of sedative or anaesthetic agent prior to administration of induction agent reduces the dose and adverse effects of the required agent. Objectives: This study compared the effects of midazolam pre-treatment on the induction dose of propofol and aimed to determine the following: (1) The induction dose of propofol in patients with midazolam pre-treatment and those on placebo. (2) The time of induction of anaesthesia using propofol in midazolam pre-treated adults. (3) To compare haemodynamic variations in placebo and midazolam pre-treatment groups. (4) The incidence of complications in both the groups. Materials and Methods: Eighty American Society of Anesthesiologits grade I and II patients aged 18–55 years were enrolled and randomly allocated into two groups (A and B) of 40 each. Two minutes before induction of anaesthesia, group A received 0.02 mgkg⁻¹ of intravenous midazolam whereas group B received equivalent amount of intravenous 0.9% saline. In both the groups, anaesthesia was induced with propofol using syringe pump at 70 mgmin⁻¹ until loss of verbal contact (LOVC) was achieved. The time to reach LOVC and the corresponding amount given were noted. Haemodynamic parameters were recorded at 60 s intervals for 5 minutes afterwards. Results: Midazolam pre-treatment significantly reduced the induction dose requirement of propofol and induction time (P < 0.0001). The incidence of adverse effects of propofol such as hypotension, apnoea and injection pain was significantly higher in the control group (P = 0.03). Conclusion: Midazolam pre-treatment effectively reduces both the induction dose of propofol and time of induction, as well as results in better haemodynamic stability and fewer adverse effects.

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Pseudoachondroplastic dysplasia is a rare inherited disorder characterized by skeletal malformations resulting to short stature. These individuals are usually normal at birth but due to the abnormal skeletal growth or dysplasia, the skeleton becomes weakened and malformed. The skeletal deformities increase as the individual grows and gains weight. Affected individuals may have radiographic features simulating vitamin D deficiency. In addition, affected individuals may have spinal abnormalities including abnormally increased lumbar lordosis and kyphosis.This case is being presented because of its rarity and simulation of rickets in the growing young child.

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Background: Several studies, have been conducted to compare the efficacy of various screening tools in detection of depression among people with epilepsy (PWE); one recurrent tool in virtually all the studies is the Hospital Anxiety and Depression Scale (HADS) because of its wide popularity in general screening for depressive disorders. However, in recent times, its utility has been questioned. Psychometric studies of HADS-D in PWE in Nigeria is sparse, and hence the need for this study. Objective: To determine the psychometric properties of the HADS-D among PWE in Northwestern Nigeria. Materials and Methods: Using a cross-sectional study design, 255 participants were recruited for the study. Participants who met the inclusion criteria were consecutively recruited from patients with epilepsy attending the outpatient clinics of Health Centre Kumbotso and Aminu Kano Teaching Hospital (AKTH) psychiatry and neurology clinics. They all completed the HADS-D and a face-to-face psychiatric interview, using the Mini International Neuropsychiatric Interview (MINI). Analysis of data was done using Graph Pad Prism software (version 5.03, Graph Pad Software, Inc.CA 92037 USA). Ethical approval was obtained from the institutional review board of AKTH. Results: Two hundred and fifty-five participants comprising 147 (57.6%) males and 108 (42.4%) females were studied. Depressive symptoms were present in 20 (7.8%) and 52 (20.4%) participants as detected by HADS-D and MINI, respectively. Out of the 235 participants identified as noncases by HADS-D, 37 (15.7%) met the criteria for a depressive disorder using MINI. Psychometric parameters at 95% confidence interval of HADS-D obtained were as follows: sensitivity = 28.9% (17.1–44.1%), specificity = 97.5% (94.4–99.2%), positive predictive value = 75% (50.9–91.3%), negative predictive value = 84.3% (79.0–88.7%), and likelihood ratio = 11.7%. Conclusion: In conclusion, this study showed that HADS-D has low sensitivity and less utility in screening for depression among PWE.

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