Context: Postnatal care remains the most neglected component of maternal and child health. It is determined by postnatal practices, which may be beneficial, innocuous or harmful as prevalent in low and middle income countries including Nigeria. Aim: To compare postnatal care practices among mothers in urban and rural communities. Settings and Design: A comparative cross-sectional design was used to assess postnatal care practices among 130 mothers each in urban and rural communities of Kano using multistage systematic sampling. Materials and Methods: Data were collected from mothers who delivered a live baby within the preceding year using an interviewer administered semi-structured questionnaire. Statistical analysis used: Data collected was analysed using the SPSS Statistics for Windows, Version 21.0. Results: Findings show poor postnatal care practices like delay in initiation of breastfeeding (77.2% and 88.4%, respectively), poor cord care (97.6% and 100%, respectively) and ingestion of potash gruel (35.4% and 65.9%, respectively) were abundant. Postnatal care practice was significantly associated with respondents' education and husband's education in the urban area (and age of respondents in the rural community (P < 0.05). Marital setting was the only predictor of postnatal practice (odds ratio = 0.25, 95% confidence interval [0.09–0.69]), where mothers in a monogamous setting had a 75% likelihood of good practice as compared to their polygamous counterparts. Conclusion: The preponderance of bad postnatal practices found among mothers in both urban and rural settings indicates the level of danger that mothers and their newborns are exposed to in the studied communities.

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Ultrasonography or sonography is a rapidly evolving imaging technology, which uses high-frequency sound waves that are transmitted into the body and echoes from the tissue interfaces are detected and displayed on a monitor. In recent years, its application in maxillofacial practice has gained importance as a diagnostic tool. Therefore, the aim of this manuscript is to review the literature for narrative assessment of the diagnostic value of ultrasound in maxillofacial practice and to compare the significance of ultrasound to other diagnostic modalities. The PubMed CENTRAL, MEDLINE, Springerlink and Cochrane library databases were searched using the MeSH terms subject headings: Ultrasonography, maxillofacial practice, maxillofacial sonography, echogenicity, physics of ultrasonography, diagnostic ultrasonography, greyscale, Doppler and maxillofacial imaging. The search was restricted to free-full text and articles written in the English language published from 1989 to 2018. A total number of 36 articles retrieved were reviewed by the authors restricted to review paper, original research and case report which described the diagnostic modality of US in maxillofacial practice. US have become one of the valuable diagnostic imaging modalities in maxillofacial practice owing to its affordability, availability and safety to tissues as it employs non-ionising radiation.

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Context: Ultrasonography is a non-invasive, inexpensive and safe imaging modality for diagnosing ocular pathologies, which aids in diagnostic accuracy and patient care. Aim: The aim of the study is to determine the pattern of ocular pathologies using ultrasonography at Murtala Muhammad Specialist Hospital. Settings and Design: This is a retrospective and descriptive study on sonographic pattern of various ocular pathologies. Materials and Methods: A total of 290 patients with various ocular pathologies were retrospectively reviewed within the study period from January 2017 to July 2018, in whom fundal examination was not possible due to media opacities and/or intraocular haemorrhage. Statistical Analysis Used: The data generated were analysed using SPSS version 21.0 program (SPSS Inc., Illinois, USA). Results: Cataracts were the most common ocular pathology detected sonographically, accounting for (45.5%) followed by vitreous haemorrhage (14.8%) and then retinal detachment (7.9%). Cataract has the highest frequency in all age groups with the highest frequency (34.1%) in 61–75 years of age group, while retinal (39.1%) and vitreous detachments (66.7%) have the highest frequency in the 16–30 and 61–75 years of age groups, respectively. The retinal detachment (52.2%) was more frequent in females, while cataract (54.5%) and vitreous haemorrhage (74.4%) were more frequent in males. Retinoblastoma (60%) and endophthalmitis (100%) were seen more on the right side, but the retinal detachment, cataract and vitreous haemorrhage were seen more on the left side. Conclusion: Ultrasonography is an important tool in the diagnosis of various ocular pathologies.

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Context: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains an important global health problem. People living with HIV (PLHIV) experienced physical, social and mental health challenges that can affect their quality of life (QOL). Aim: To determine the health-related quality of life (HRQOL) of HIV-infected adults. Settings and design: This was a cross-sectional study conducted in the APIN centre. One hundred and seventy-eight PLHIV were selected by a multistage sampling technique between 10 January 2018 and 31 March 2018. Materials and Methods: The world Health Organization QOL-HIV Bref Questionnaire was used to collect the information. Statistical analysis used: Data were analysed using SPSS version 23.0 statistical software We determined significant factors using Chi square and logistic regression at a 5% level of significance. Results: The physical domain has the lowest mean score of 13.25 ± 2.25, while the spiritual/religion/personal belief domain had the highest mean score of 14.955 ± 3.336. Clustered of differentiation 4 (CD4) count, adherence and currently ill status were significantly associated with QOL. The odds for good QOL were 13 times higher among those with CD4 count ≥500 cells/mm3 compared to those with CD4 count < 500 cells/mm3 (adjusted odds ratio [aOR]: 13.03; 95% confidence interval [CI]: 4.58-37.5). The odds for good HRQOL were six times higher among those with good adherence compared to those with poor adherence (aOR: 5.62;95%CI: 1.83-17.26). Conclusion: The study revealed that the spiritual/religion/personal belief domain has the highest QOL score, while the physical domain had the least score. Adherence, currently ill and CD4 count were predictors of good QOL.

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Background: Increasing consumption of vended foods may pose a significant public health threat associated with food-borne illnesses. Context: Increasing consumption of vended foods may pose a significant public health threat associated with food borne illnesses. Aim: To assess and compare the determinants of personal hygiene practices among street food vendors and canteen food handlers in a commercial city of northwestern Nigeria. Settings and design: Using interviewer-administered questionnaire, comparative cross-sectional design was used Materials and Methods: As much as 310 (in each group) street food vendors and canteen food handlers, selected using a multistage sampling technique. Data analysis used: The data was analyzed using SPSS Version 22.0 Results: The proportion of street food vendors practicing correct personal hygiene measures were 214 (70.2%), compared with 213 (74.0%) canteen food handlers, respectively. There was a significant association between street food vendor's sex, ethnicity, educational status, hepatitis A or typhoid vaccination status, and the correct practice of personal hygiene (P < 0.05). Sex was found to be an independent predictor of personal hygiene practice (adjusted odds ratio = 4.7, 95% confidence interval = 1.3–16.7) among street food vendors with female street food vendors being five times more likely to observe correct personal hygiene practice than their male counterparts. Conclusions: Personal hygiene practice was found to be good among both street food vendors and canteen food handlers. However, there is a need for improvement if food-borne diseases are to be controlled; therefore, the government should ensure training and enforcement of all regulations to improve the personal hygiene practice thereby reducing the burden of food-borne illnesses.

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Context: Dental caries have a detrimental impact on the affected persons, be they children, adolescents, or adults. Aim: To find out the prevalence of dental caries and its relationship with intelligence quotient (IQ) among Southern Saudi Arabian children. Settings and Design: A nonprobability convenience sampling procedure was adopted. Methods: As much as 458 eligible children were selected for the study. Estimation of level of IQ was done by using “Raven's Coloured Progressive Matrices 1998 edition 11.” DMFT/ dmft index was used to assess the prevalence of dental caries among the participants. Statictics used: The collected data were subjected to statistical analysis using Statistical Package for Social Sciences Version 22. Frequencies, percentages, mean, and SDs were applied to report the caries prevalence. Chi-square test and unpaired t-test were applied to test the association between two categorical variables. P valueslessthan 0.05 were considered statistically significant. Results: The prevalence of dental caries was 52.62% with mean total DMFT of 1.48 ± 1.93. Prevalence of primary dmft was 80.13% with mean dmft of 4.60 ± 3.67. The presence of dental caries among primary teeth was statistically significant according to the IQ. Conclusion: The prevalence of dental caries was found to be 52.62% for permanent teeth and 80.13% for primary teeth. The IQ of most children falls under the Grade III category of Raven's Coloured Progressive Matrices grading system. The current study revealed an inversely proportional relationship between IQ grade and the prevalence of dental caries.

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Context: The use of standardised outcome measures (SOMs) is an essential part of rehabilitation and is widely endorsed as an excellent practice. Aim: The purpose of this descriptive study was to identify the factors associated with the use of OMs among physiotherapists working in neurorehabilitation units in tertiary hospitals of North-Western Nigeria. Materials and Methods: Physiotherapists managing neurological conditions in North-Western Nigeria were asked to complete a structured self-administered questionnaire that has two sections. Section I comprises items consisting of demographic information and Section II comprises items regarding the knowledge, attitude, use, perceived benefits and factors that hinder the use of SOMs among physiotherapists managing neurological conditions. Results: over 72.9% of the respondents were familiar with OMs; majority (77.1%) had poor attitude even though they had positive perception about the use of OMs. The respondents reported four most crucial factors hindering the use of OMs in neurological physiotherapy practice in tertiary hospitals in North-Western Nigeria, which are unavailability of appropriate tools, lengthy completion time of OMs, inadequate office space and lack of training on how to use OMs. Conclusion: The main findings of this study revealed that majority of the Participants were aware of the use of outcome measures in clinical practice, they perceived it as essential and useful, however, they have poor attitude and seldom make use of the Oms.

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MayThurner syndrome (MTS) also known as iliocaval compression, occurs as a result of left common iliac vein compression by the right iliac artery. The syndrome is characterised by persistent leg swelling, venous ulcer, deep-vein thrombosis (DVT) and pulmonary embolism. However, it is rarely diagnosed with one of the causes of DVT. We hereby present a 31-year-old woman with persistent left lower limb DVT caused by MTS.

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Context: Traditional bone setting is a public health concern because of the late hospital presentation and resulting socioeconomic consequences. Aim: This study aimed to determine the prevalence and factors associated with preference of traditional bone setting among patients attending orthopedic clinics in Kano, Nigeria: Design: Descriptive cross-sectional design was used. Materials and Methods: Up to 370 patients were selected using a two-staged sampling technique. Statistical Analysis: Data were collected using interviewer administered questionnaires and analyzed using SPSS version 22.0 with P ≤ 0.05 considered statistically significant. Results: The respondents age ranged 1 − 82 years with a median age of 29 (IQR = 20, 40) years. Majority of the patients (77.6%, n = 287) were older than 24 years of age with more than one-quarter (36.2%, n = 134) engaged in trading activities. Period prevalence (Within the last one year of visiting TBS) was 60.5% (95% CI: 55.4–65.6) while the point prevalence was 2.4% (95% CI: 1.1–4.6). Main reasons highlighted for the preference of traditional bone setting include low costs (8.6%, n = 32) and accessibility (6.5%, n = 24). Patients on admission had less probability of ever visited TBS (aOR: 0.4, 95% CI: 0.2–0.7), and patients with formal education were less likely to currently visit TBS (aOR: 5.0, 95% CI: 1.2–21.7) Conclusion: The prevalence of patronizing traditional bone setters is of significant public health concern despite the reported consequences. Therefore, the stakeholders should ensure regulated practices of the bone setters by providing them with appropriate guidelines including supervision of their practices.

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Context: Nutritional and functional impairments are assumed to be inevitable consequences of aging and they attract little attention in the primary care setting. Aim: To determine the association between malnutrition and functional status of the elderly to advocate for their routine screening in the primary care clinics and similar settings. Settings and Design: A cross-sectional descriptive study involving 352 patients of age ≥60 years who presented at the Family Medicine Clinic. Methods and Materials: The nutritional status was assessed using the Mini Nutritional Assessment tool, whereas functional capacity was assessed using Katz and Lawton index for the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), respectively. Statistical Analysis: Chi-square test and logistic regression analysis were used to determine associations between variables and nutritional status, and determinants of nutritional status, respectively. Results: The mean age of respondents was 67.9 ± 7.6 (60–95) years; 215 (61.1%) were women. The prevalence of malnutrition was 25.9% and of risk of malnutrition 53.1%. Advancing age (odds ratio [OR] = 4.93, 95% confidence interval [CI] =1.42–1.71, P ≤ 0.001), low monthly income (OR = 9.29, 95% CI = 0.20–43.50, P = 0.005) and being functionally dependent (OR = 14.706, 95% CI = 1.26–3.35, P = 0.03 for ADL; OR = 17.51, 95% CI = 5.07–37.31, P = 0.004 for IADL) were the determinants of malnutrition in the elderly patients. Conclusion: The prevalence of malnutrition and those of at-risk of malnutrition was high. Advancing age, low income, and functional dependence were the independent correlates.

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Context: With regard to disposal of medical and dental hazardous wastes, proper guidelines have been set in place by the occupational safety and health administration. However, the same cannot be said of patients concerning appropriate disposal of gauze routinely placed to control bleeding from extraction socket and other oral surgery procedures. Aim: The aim of this study was to determine whether the post-extraction instructions given to patients on the disposal of blood-soaked gauze were adequate across Nigeria. Materials and Methods: We conducted a survey through an electronically transmitted self-administered closed anonymous questionnaire adapted from Franklin and Laskin, 2014. This survey was conducted amongst dentists who are involved in exodontia in the dental schools or in the adjoining university teaching hospitals in Nigeria. Results: There were 95 participants who completed the questionnaire out of 120 dental surgeons to whom the questionnaires were sent giving a response rate of about 79.1%. Of the 95 participants, 75 (78.9%) were male and 20 (21.1%) were female giving a male-to-female ratio (M:F) of 3.75:1. About 46 (48.4%) agreed to providing patients with post-operative instruction sheet after extraction or any other oral surgical procedure whereas 47.4% do not provide. Amongst those who gave instruction, the majority (23.2%) asked the patients to dispose of it in the bin followed by 4.2% who just asked the patients to dispose of it. Conclusion: This study has shown that majority of the dentists in Nigeria do not provide adequate information regarding disposal of gauze placed in the mouth postoperatively, and this may potentially pose a risk to transmission of deadly blood-borne infection with the attendant negative health effect.

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Context: Cerebral palsy (CP) is one of the commonly occurring physical disabilities, beginning in early childhood and persisting through the lifespan. Hearing impairment is a common problem in children with CP. The type of the hearing loss is mostly sensorineural, but conductive hearing loss from middle ear disease is a possibility. Aim: The aim was to assess the tympanometric findings in children with CP. Materials and Methods: This was a cross-sectional study conducted amongst children with CP and matched (age and gender) controls in Kano, Nigeria. Ethical approval was obtained from the institution's Ethics Committee. Simple random sampling was used to enrol 330 participants. Consent was obtained and a structured questionnaire was used to collect data on the history, ear examination and tympanometric findings. The data collected were analysed using Statistical Product and Service Solutions version 21. Results: One hundred and sixty-five children with CP and the same number of matched controls participated in the study. The mean age of CP patients and controls was 4.49 ± 2.85 and 4.40 ± 2.92 years, respectively. Abnormal tympanograms were found in 51 (30.9%) of the children with CP as against 19 (11.5%) in the controls. Abnormal acoustic reflex was found in 28.5% of the cases compared to 12.1% in the control group. There was a statistically significant difference between the tympanometric findings of patients with CP and that of the controls (P = 0.0001). Conclusions: This study found a high prevalence of abnormal tympanograms in children with CP compared to controls.

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Retained gauze in the abdomen (Gossypiboma) is a serious complication of abdominal surgery that often leads to medicolegal lawsuits. The most important risk factor is a failure of gauze count before and after laparotomy. Other related factors in order of occurrence include abdominal, gynaecologic, urologic and vascular procedures. We herein present a case of retained gauze following prior laparotomy.

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Context: The management of mass casualty events caused by terrorist-related suicide bombings in densely populated areas is often challenging. Aims: This study describes the pattern of injuries, the emergency response following a suicide bombing in Nigeria in 2014 and compares the outcomes to those of other incidents. Settings and Design: A retrospective analysis of cases that presented to a major tertiary care center was done. Methods and Material: Medical records of 50 patients who experienced bomb blast or gunshot wounds during 28^th November, 2014 suicide bombing of the Kano Central Mosque were reviewed and 12 eyewitnesses were interviewed. Statistical analysis used: Descriptive analysis of quantitative data was done while major themes were identified from the key informant interviews. Results: Fifty patients were admitted at the acute care center within 4 hours. There was a male predilection (98%), with a median age of 30 years (IQR, interquartile range = 37.5 years). Most injuries were the result of multiple penetrating projectiles (secondary blast injuries), primarily involving blast-energized metallic fragments like screws, nails, bolts, ball bearings, and metal scraps. Eleven patients (22%) had minor lacerations, about a quarter (n = 12; 24%) had severe hemorrhage and were transfused, five (10%) had multi-system involvement, and mortality rate was 8% (n = 4). Interventions were aimed at preserving the lives of those injured. Conclusion: Most of the victims had major injuries which were appropriately managed although the hospital lacked an existing protocol on mass casualty management. Increased awareness, organized field triage mechanisms, and capacity building in health facilities will facilitate prompt emergency response.

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Context: Premature rupture of membranes (PROM) is a significant event as it may lead to maternal complications, increased operative procedure, neonatal morbidity, and mortality. Aim: To determine the predictors of successful vaginal delivery in pregnant women undergoing stimulation of uterine contractions following premature rupture of membranes (PROM). Settings and Design: This prospective cohort study was conducted at the University of Benin Teaching Hospital, Benin City, Nigeria. Materials and Methods: Seventy-four pregnant women between the gestational ages of 37 weeks and 41 weeks with a live singleton fetus in cephalic presentation and no contraindication to vaginal delivery who had stimulation of uterine contractions following term PROM were included in this study. The main outcome measure was the route of delivery. Statistical Analysis: The analysis was done with IBM statistical package for social science (SPSS) Statistics v21, and a P value ≤0.05 was considered statistically significant. Results: Sixty-two (83.8%) women had a vaginal delivery. The mean age and gestational age were 29.76 ± 3.69 years and 39.04 ± 1.15 weeks, respectively. The chance of vaginal delivery was increased with BMI <30 (RR = 9.091, 95% CI = 1.827–45.246). The duration between rupture of membranes and commencement of stimulation of uterine contractions was ≤8 h (RR = 4.889, 95% CI = 1.307–18.293) also increasing the chance of achieving vaginal delivery. The time interval to 4 cm cervical dilatation ≤4 h (RR = 4.167, 95% CI = 1.141–15.215) and time interval to delivery ≤8 h (RR = 12.222, 95% CI = 2.433–61.402) also favored vaginal delivery. Conclusion: When uterine contractions are stimulated for PROM at term, vaginal delivery is predicted by maternal BMI <30, duration of rupture of membrane ≤ 8 h, and time interval to 4 cm cervical dilatation ≤4 h. Also, it was found was that vaginal delivery becomes less likely when the time interval from stimulation to delivery exceeds 8 h.

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Context: Cardiorenal syndrome (CRS) encompasses a spectrum of disorders involving both the heart and kidneys in which acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other organ. Aim: To review the short-term outcomes and their predictors among patients admitted with HF complicated by renal impairment. Settings and Design: This was a cross-sectional study conducted at the Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods: Patients aged 18 years and above were consecutively recruited over a period of 11 months. Detailed history and physical examination as well as relevant baseline blood chemistry, full blood count, urinalysis, estimated glomerular filtration rate, ECG, echocardiography, and renal ultrasound were carried out on all patients. Statistical analysis used: The data was analyzed using SPSS Version 16.0. Student t-test and the nonparametric χ2 or Fisher's exact test were used to test for significance among the noncategorical and categorical variables, respectively. Results: One hundred and twenty four (72.9%) patients had CRS. Patients with CRS had a significantly higher mortality rate compared with those without the syndrome (25% vs. 13%; P = 0.031). There was no significant difference in the duration of hospital stay between patients with CRS and those without CRS (17.86 ± 13.11 vs. 15.85 ± 13.46; P = 0.378). Serum creatinine of ≥170 μmol/L and serum urea of >20 mmol/L were the identified predictors of mortality (95% confidence interval [CI] 1.098–6.243, RR = 2.618, P = 0.030; and 95% CI 1.106–6.757, RR = 2.734, P = 0.029, respectively). Conclusion: CRS is associated with a significantly higher mortality rate. Measures of the renal function, serum creatinine >170 μmol/L and serum urea of >20 mmol/L were identified as the predictors of mortality.

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Context: Family history of type 2 diabetes mellitus (T2DM), hypertension (HTN) and obesity, are known non-modifiable, independent and easily assessed risk factors for incident type 2 diabetes. Aims: This study was aimed at assessing the effect of self-reported family history on the levels of some metabolic markers (total homocysteine [tHcy], high sensitivity C-reactive protein [hs-CRP] and glycated haemoglobin [HbA1c]) among patients with type 2 diabetes. Settings and Design: Two hundred and forty participants subdivided into Group 1 (T2DM only), Group 2 (T2DM diagnosed with HTN) and Group 3 (controls) were enrolled in a cross-sectional pattern. Subjects and Methods: A structured questionnaire was used to obtain information on self-reported family history. Biochemical parameters were assayed using standard laboratory procedures. Statistical Analysis Used: SPSS version 20.0 was used for statistical analysis with significance at P ≤ 0.05. Results: Group 1: Family history of type 2 diabetes (FHD) (HbA1c, P < 0.001, fasting plasma glucose [FPG], P = 0.005, triglycerides [TG], P = 0.049), family history of HTN (FHTN) (HbA1c, P < 0.001, FPG P = 0.005), family history of obesity (FHO) (HbA1c, P < 0.001, high-density lipoprotein cholesterol [HDL-C], P = 0.049). Group 2: FHD (tHcy, P = 0.021, HDL-C, P = 0.026), FHTN (tHcy, P = 0.035), FHO (HbA1c, P = 0.003, FPG, P = 0.001, TC, P < 0.001, TG, P = 0.019, LDL-C, P = 0.001). Group 3: FHD (tHcy, P = 0.004, HDL-C, P = 0.035), FHTN (FPG, P < 0.001, tHcy P = 0.010, TC, P = 0.037, TG, P = 0.003), FHO (hs-CRP, P < 0.001, HDL-C, P = 0.007, TG P = 0.001, LDL-C P = 0.019). Conclusions: Self-reported positive family history may provide insights into the biochemical and metabolic profile of patients with type 2 diabetes.

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Ossified epidural haematoma is a rare finding in clinical practice. Neuroimaging such as computed tomographic (CT) scan plays an important role in its diagnosis and management. A 58-year-old man came for brain CT on account of 4-month history of epilepsy. He had a history of road traffic accident 4 years ago. A radiologic diagnosis of ossified epidural haematoma was made as the working diagnosis.

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