Introduction: Head injuries are commonly referred to as traumatic brain injuries (TBIs), depending on the extent of the head trauma. It may be caused by a blunt or penetrating trauma. It is a major contributor to the health care burden, especially in resource-poor countries. Methodology: A 10–year multicentric, retrospective study between January 2015 and December 2024, across northeastern Nigeria. Data on the demographics (age, sex), mechanism of injury (closed/open), aetiology, results of available radiological investigations, types of surgery done, and the outcomes at 6- and 12-month postoperative periods were extracted. Result: A total of 428 (11.3 % of all head-injured patients) had surgery, with 326 (75.9 %) for closed-head injuries and 102 (24.1%) for open-head injuries. Mostly males, with a M:F ratio of 5:1. Ages ranged from 6 months to 76 years, with adults (≥ 17 years) constituting 72.8%. Aetiology included road traffic accidents (81.1%), falls from heights (7.9%), gunshots (4%), IEDs (3.3%), arrows (1.4%), daggers/knives (1.2%), and undocumented (0.4%). Surgeries were for various haematoma evacuations in 216 (50.4%), foreign body extractions in 78 (18.3%), skull fractures in 42 (9.7%), CSF leak in 15 (3.5%), debridement and dura closures in 51 (12%), and brain abscess drainages in 2 (0.4%). Outcomes were good in 65.4%, with severe disability in 0.8% and mortalities of 27.7%. Conclusion: RTA was the leading cause of head injuries among young males with several penetrating injuries. Good outcomes are achievable with surgical interventions when indicated. Strict preventive legislation among road users and conflict resolutions is highly recommended to reduce this burden.
Background: The United Nations Sustainable Development Goals highlight the importance of family planning in improving women's lives, with targets for universal access to sexual and reproductive health (Goal 3.7) and reproductive healthcare services (Goal 5.6). Despite the effectiveness of contraceptives in child spacing and preventing unwanted pregnancies, many women do not use contraceptives, and the prevalence of contraceptive use is significantly lower in Nigeria. Exploring the factors associated with and the prevalence of contraceptive use is crucial to understanding barriers to inform lasting solutions in women's health. Objectives: This study aimed to assess contraceptive use and identify factors associated with use among women of reproductive age within the community. Methodology: The study was conducted in Mil-Goma, a rapidly developing community in Bomo Ward of Sabon Gari Local Government Council (LGA) of Kaduna State, Nigeria, using a cross-sectional descriptive study design among women of reproductive age (15-49 years). The sample was determined using the single-population formula, yielding 196. However, a total-population study was conducted, including all women of reproductive age, to improve the analysis. Data were collected via a structured, interviewer-administered questionnaire on a mobile device over four days and analysed in SPSS version 25. Results: A total of 346 eligible clients were interviewed with a mean age of 26.74±7.92 years. The predominant ethnic group was Hausa/Fulani 307 (88.7%). Most respondents were Muslim (326, 94.2%). Respondents currently using a method were 43 (12.4%), of whom 15 (34.9%) used injectable as the predominant method. Family type (polygamous and non-polygamous) is found to be associated with contraceptive use (X2 = 6.900, p-value = 0.012). Conclusion: Our study found that the contraceptive prevalence rate was low, and several factors, like lack of education, unemployment, and Islamic belief, negatively influence the likelihood of using contraceptives among women in this community.
Background: Postpartum contraception is essential for ensuring appropriate pregnancy spacing and avoiding unintended pregnancies. Poor awareness and fear of side effects may contribute to low contraceptive acceptance in the postpartum period. Tertiary healthcare facilities are positioned to provide effective counselling to improve uptake of postpartum contraceptives. Objectives: To assess the level of awareness and identify determinants influencing the willingness to accept postpartum contraceptives among recently delivered women. Methods: A descriptive cross-sectional study carried out at postnatal wards of the University of Ilorin Teaching Hospital (UITH), Ilorin, from the 4th of August to the 29th of October 2022. Participants were consenting postpartum women who delivered at the facility during the study period and met the inclusion criteria. Structured questionnaires were administered to the participants following informed consent. The questionnaire had sections on participants' socio-demographic characteristics, knowledge of and acceptance of postpartum contraceptives, and the determinants of willingness to accept postpartum contraception. Results: There was a total of 603 deliveries during the study period. However, 420 women were eligible to participate, and 303 consented to participate. A total of 73.6% (223/303) of the participants were aware of postpartum contraceptives, and 59.7% (181/303) were willing to accept a method of postpartum contraception. Level of education, parity, age and social class were determinants of willingness to accept postpartum contraception. The most preferred method was implants (38.6%), and the least preferred method was sterilisation (1.3%). Conclusion: The level of awareness of postpartum contraceptives and willingness to accept them among postpartum women in this study was relatively high.
Background: Retained placenta is a significant cause of maternal and neonatal morbidity and death in developing nations, particularly among unbooked and high-risk mothers. Objective: To assess the prevalence, clinical features, treatment approaches, and complications associated with retained placenta at Delta State University Teaching Hospital (DELSUTH). Methodology: This was a retrospective descriptive study from January 2011 to December 2020. Data were extracted from patients’ clinical records using a structured pro forma. Variables included were socio-demographic characteristics, place of delivery, clinical features, treatment modalities, and outcomes. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 28. Results: The prevalence of retained placenta was 1.2%. The mean age of the study population was 29.62 ± 6.49 years, with most patients being multiparous (52.4%), unbooked (71.4%), and possessing secondary education (52.4%). More than half (52.4%) were delivered at home and at traditional birth attendants’ places. Common clinical presentations included snapped cord (47.6%) and active bleeding (38.1%). The most frequently used treatment method was manual removal of the placenta (61.9%). The common maternal complications were postpartum haemorrhage (81.0%) and postpartum anaemia affecting over half of the women (57.1%). Blood transfusion became necessary in 85.7% of cases. Among neonatal complications, NICU admissions accounted for 47.6%, while prematurity and stillbirths occurred in 23.8% and 19.0% of cases, respectively. Conclusion: Retained placenta is associated with adverse pregnancy outcomes, and the women commonly affected are those with unsupervised pregnancy and delivery or supervision of unskilled birth attendants. Discouraging deliveries outside standard health institutions and encouraging emergency obstetric care are crucial in reducing the burden of this preventable obstetric complication
Background: Central diabetes insipidus (CDI) is characterised by hypotonic polyuria resulting from impaired arginine vasopressin (AVP) secretion by the posterior pituitary. Clinically, CDI must be differentiated from nephrogenic diabetes insipidus (NDI)—renal resistance to AVP's antidiuretic effects—and primary polydipsia (abnormal thirst). NDI is rare in adults except in those treated with lithium; thus, the key challenge is distinguishing CDI from disorders of excessive thirst. While the differential diagnosis is often straightforward, the gold standard water deprivation test (WDT) presents interpretative difficulties. Measuring plasma AVP concentrations enhances diagnostic accuracy, but the required radioimmunoassay is technically demanding and available only in specialised centres. Following a definitive biochemical diagnosis of CDI, further investigation is needed to identify the underlying cause of AVP deficiency. These case examples outline a diagnostic approach to polyuria and revisit the limitations of WDT and desmopressin response testing, particularly in resource-constrained settings. Methodology: Four patients who were referred for additional biochemical testing had their medical records retrieved from the Archives and examined. Every piece of information that could identify patients was anonymised. The bladder was emptied about eight (8 am) in the morning. Due to the lack of an osmometer, blood and urine samples were collected, and the osmolalities of plasma and urine were calculated. Water depletion is uncommon in patients with low-normal or low plasma osmolality, and polyuria is likely the result of an appropriate reaction to a high intake; in contrast, the test was terminated in patients with high-normal or high plasma osmolality and urine osmolality greater than 750 mmol/kg. Blood and urine are drawn again at 9:00 a.m., and plasma and urine osmolalities are computed hourly for 8 hours. Diabetes insipidus or tubular disease is indicated by the failure of three consecutive urine specimens to be concentrated. The DDAVP test, a powerful synthetic counterpart of vasopressin, was administered to those thought to have diabetes insipidus. Urine and plasma samples were taken an hour following an intramuscular injection of 2 µg DDAVP. Results: Case one (1) WDT was conducted, and plasma osmolality remained within the reference interval while urine osmolality remained hypo-osmolar. Significant elevation of urine osmolality after desmopressin. The diagnosis made was Cranial DI. Case two (2) WDT was conducted, and despite adequate fluid deprivation and subsequent administration of 1-Desamino-8-D-Arginine Vasopressin (DDAVP), urine osmolality was persistently low. Findings favour Nephrogenic DI. Case three (3) WDT was conducted, and plasma osmolality increased to the upper limit of the reference interval during the test. Urine osmolality continued to increase but remained < 750 mOsm/kg. Results suggest partial ability to concentrate urine with an increase in plasma osmolality following fluid restriction. Findings were suggestive of Partial DI. Case four (4) WDT was conducted, and plasma osmolality increased above the upper reference limit. Urine osmolality continued to increase but did not exceed 750 mmol/kg. Findings favoured Psychogenic polydipsia. Conclusion: Distinguishing central diabetes insipidus from nephrogenic diabetes insipidus and primary polydipsia requires thorough diagnostic testing, including the water deprivation test and desmopressin response, highlighting the challenges in resource-limited settings and the necessity for accurate biochemical evaluations
Background: The natural history of adenoid hypertrophy involves complex age-dependent changes in both adenoid tissue and nasopharyngeal dimensions, yet comprehensive age-stratified analyses in African populations remain limited. Objectives: To characterise age-dependent differences in adenoid size, nasopharyngeal depth, adenoid-nasopharyngeal ratio (ANR), and clinical symptom severity in Nigerian children with adenoid hypertrophy. Methodology: This prospective cross-sectional study enrolled 200 children (aged 3-12 years) with clinically suspected adenoid hypertrophy from the University of Maiduguri Teaching Hospital between April 2024 and March 2026. Participants were stratified into three age groups: 3-5 years (n = 98), 6-8 years (n = 62), and 9-12 years (n = 40). ANR was calculated using Fujioka's method, and clinical symptoms were scored using a standardised questionnaire. Age-associated patterns were analysed using Pearson's correlation, one-way ANOVA, and multiple regression analysis. Due to the cross-sectional design, findings represent age-associated patterns rather than individual growth trajectories. Results: Mean adenoid size showed minimal age-related change (2.14±0.38 cm, r=0.058, 95% CI: -0.080 to 0.193, p=0.412), while nasopharyngeal depth increased significantly with age (2.52±0.42 cm to 3.41±0.47 cm, r=0.781, 95% CI: 0.722-0.829, p<0.0001). ANR demonstrated a strong negative correlation with age (r=-0.795, 95% CI: -0.836 to -0.744, p<0.0001). Clinical symptom scores decreased significantly with age (r=-0.812, 95% CI: -0.850 to -0.764, p<0.0001), with 86.7% of 3–5-year-olds having severe symptoms versus 22.5% of 9–12-year-olds. Conclusion: In this cross-sectional study, nasopharyngeal depth was significantly greater in older age groups relative to adenoid size, a pattern associated with lower symptom severity in older children. These cross-sectional associations do not directly demonstrate individual growth trajectories, but they support age-appropriate interpretation of radiographic measurements in adenoid hypertrophy assessment. Prospective longitudinal studies are needed to confirm within-subject developmental patterns.
Background: Low- and middle-income countries face a high cervical cancer burden but have limited preventive programs, such as cervical screening, often restricted to tertiary hospitals with trained staff. This study evaluated the cervical cancer knowledge of rural healthcare workers in a northeastern Nigerian community and the impact of training on their screening skills. Methodology: Eighteen female community health extension workers and women’s health providers were trained on cervical cancer screening, with a focus on risk factors, prevention, and sample collection. Cervical smear preparation was also demonstrated. Pre- and post-training questionnaires assessed changes in knowledge. Smears were examined for adequacy. Data were analyzed using SPSS with significance at p <0.05. Results: Most (61.1%) participants had good pretest knowledge, identified HPV as a cause, and recognized risk factors like sexual activity and HIV infection, symptoms like abnormal vaginal discharge and bleeding, and Pap smear as an effective screening method. Post-training, 88.9% (16/18) showed significant improvement in knowledge (p = 0.026). Knowledge was independent of professional cadre (p = 0.784). Cytology smears were adequate in 86.7%. Conclusion: Training CHWs can empower them to support cervical screening in resource-limited communities, thereby strengthening screening coverage.
Background: Human immunodeficiency virus (HIV) infection is associated with significant cardiac morbidity in children. However, comprehensive data from many parts sub-Saharan Africa, which bears the highest burden of paediatric HIV, remains limited. This study determined the prevalence, pattern, and determinants of cardiac disorders among HIV-infected children and compared findings between those on antiretroviral therapy (ART) and treatment-naïve children in northeastern Nigeria. Methodology: This hospital-based cross-sectional study enrolled 310 HIV-infected children aged 6 months to 14 years at the University of Maiduguri Teaching Hospital, Nigeria (January 2018–December 2019). Participants underwent standardised clinical evaluation, chest radiography, 12-lead electrocardiography (ECG), and transthoracic echocardiography. Cardiac disorders were defined using age-appropriate standardised criteria. Data were analysed using SPSS version 25.0, with multivariate logistic regression to identify independent predictors of cardiac abnormalities. P<0.05 was considered statistically significant. Results: Mean age was 107.5±40.7 months; 171 (55.2%) were male. The overall prevalence of cardiac disorders was 55.5% (172/310). Echocardiography detected abnormalities in 119 (38.4%), ECG in 90 (29.0%), and chest radiography in 24 (7.7%). Common echocardiographic findings included decreased ejection fraction (17.1%), chamber enlargement (11.3%), and dilated cardiomyopathy (6.8%). ECG abnormalities were predominantly right ventricular hypertrophy (11.6%) and sinus tachycardia (11.3%). Among 205 children on ART, 83 (40.5%) had cardiac disorders compared to 39 (37.1%) of 105 treatment-naïve children (adjusted OR=1.18, 95% CI: 0.72–1.94, p=0.525). Advanced WHO clinical stage (aOR=3.42, 95% CI: 1.56–7.51, p=0.002) and absence of virologic suppression (aOR=2.67, 95% CI: 1.08–6.59, p=0.033) were independently associated with echocardiographic abnormalities in children on ART. Tachycardia demonstrated 78.3% sensitivity and 82.1% specificity for predicting echocardiographic abnormalities. Conclusions: Cardiac disorders are highly prevalent among HIV-infected children in northeastern Nigeria, with subclinical abnormalities detectable by echocardiography in over one-third. Advanced immunosuppression and poor virologic control are key determinants of cardiac involvement. Routine cardiac evaluation, including echocardiography, should be integrated into paediatric HIV care programmes; tachycardia may serve as a simple clinical screening tool.
Background: Children with acute illness are prone to energy dysregulation, marked biochemically as dysglycaemia with or without elevated blood ketone levels. Dysglycaemia has been linked to poor clinical outcomes without recourse to the ketone level. Objectives - To determine blood ketone levels among children with Dysglycemia and the association between ketone levels and clinical outcome. Methodology: It was a cross-sectional study carried out at the Emergency Paediatric Unit of the University of Maiduguri Teaching Hospital among Children aged 1 month to 15 years. Children with dysglycaemia were tested for blood ketone levels. Data was analysed using SPSS Version 25. Results: Of the 340 subjects, 135 (39.7%) had dysglycaemia, out of which 81 (23.8%) were hyperglycaemic and 54 (15.9%) hypoglycaemic. Fifty-eight (43.0%) of those with dysglycaemia had elevated blood ketone, consisting of 12 (20.7%) in the hyperglycaemic group and 46 (79.3%) in the hypoglycaemic group. Age < 5 years {OR = 34.455 (2.147-550.458), p=0.012}, duration since last meal ≥ 24 hours {OR= 142.92(3.094-6589.604), P=0.011}, severe sepsis {OR=151.26(9.184-2495.760), P= <0.001} and hypoglycaemia, {OR= 50.529 (12.968-196.457) and P = < 0.001 were all independent predictors of elevated blood ketone level. Dysglycaemic subjects with elevated blood ketone were approximately 3 times more likely to die than those with normal blood ketone {UOR=3.4 (0.983-11.583) and P=0.043}. Conclusion: There was a high prevalence of dysglycaemia among acutely ill children. Elevated blood ketone levels among this cohort were associated with a bad outcome. We recommend routine determination of blood ketone level in children identified with dysglycaemia for closer monitoring and prognostication
Background: Schistosomiasis is a waterborne snail-transmitted parasitic disease and a major public health challenge in sub-Saharan Africa, mostly affecting populations living in low-resource countries where water supply and sanitation are poor and inadequate. It is the most predominant neglected tropical disease (NTD) after malaria and intestinal helminthiases in global parasitism. The study was conducted to determine the prevalence of Schistosoma haematobium among primary school pupils in Gangare and to relate the prevalence to age groups, gender, and the water sources used by the pupils. Methodology: Thirty (30) millilitres of urine were collected into universal containers, including the last portion of the urine specimen. Ten millilitres of the specimen were transferred into a centrifuge tube and centrifuged at 2,000 rpm for five minutes. A drop of the sediment was placed at the centre of a clean, grease-free slide and examined under ×10 and ×40 objectives. Results: Of the 200 urine samples examined, 14 were positive for S. haematobium, giving a prevalence of 7.0%. The 11–13 years age group had the highest prevalence at 9.2%, while the lowest, 5.3%, was in the 8–10 years age group. Males had the highest prevalence, 8.7%, while females had the lowest, 4.1%. Subjects who bathe and wash in stream or river water recorded the highest prevalence of 26.4%, while subjects drinking tap water recorded the lowest prevalence of 6.7%. Conclusion: This study showed that there was a low prevalence of Schistosoma haematobium among primary school pupils in Gangare Jos North Local Government, which may be attributed to increased awareness and government intervention.
Background: Dilated cardiomyopathy (DCM) is a leading cause of heart failure in sub-Saharan Africa, where it frequently presents in the first two decades of life. Despite strong evidence for a genetic contribution, African populations remain profoundly underrepresented in genomic research, limiting variant interpretation and the clinical utility of next-generation sequencing (NGS). Methodology: Systematic search of relevant databases (e.g., PubMed, Web of Science, or EBSCOhost) using keywords, a combination of keywords, and controlled vocabulary (like MeSH terms). Results: This perspective review synthesises recent advances in understanding the genetic architecture of DCM in individuals of African ancestry, including the discovery of ancestry-specific risk variants, and critically examines the systemic barriers that prevent the translation of genomic knowledge into paediatric and young-adult clinical care. Conclusion: We propose a stepwise framework for clinically actionable genetic testing for DCM in sub-Saharan Africa that encompasses tiered, cost-effective sequencing strategies, supervised task-sharing for genetic counselling, workforce development, and continental data-sharing networks. Implementing this framework would accelerate the transition of NGS from a research tool to an integrated component of cardiovascular precision medicine for children and young adults in the region.
Introduction: In recent times, Africa has been afflicted by unique disease burdens with high mortality rates. Despite the significance of medical research towards exploring problems and implementing strategies, research engagement is low. Medical students’ participation in research is underrated, as future physicians' research skills are crucial for evidence-based medical practice. Understanding their knowledge, attitudes, and barriers toward research is vital for promoting effective research engagement. Methodology: A cross-sectional study was conducted among undergraduate medical students at the University of Maiduguri. Data was collected with a pre-tested self-administered questionnaire on Google Forms. Data analysis was done using IBM Statistical Package for Social Sciences software (SPSS) version 27. Results were presented in frequency tables. The chi-square test was used to test the association between variables, with the level of significance set at 5% (p < 0.05). Results: The study participants had a mean age of 24.02 ± 2.85. Overall, 23.9% demonstrated good knowledge of research, 54.9% had an average level of knowledge, and 21.2% showed poor knowledge. Furthermore, 37.9% of respondents had previously participated in curricular or extracurricular research. The Chi-Square analysis identified significant correlations between higher class levels, direct entry students, and prior research experience with good research knowledge. Barriers to research engagement included lack of mentoring (82.2%), time constraints (77.3%), insufficient motivation or reward (71.6%), and lack of funding (67.8%). Conclusion: This study showed that despite medical students' average knowledge of research, they had a positive attitude towards participating in research.
Background: Vitamin D is a secosteroid with the elemental formula of C₂₇H₄₄O, and vitamin D2 and D3 are its two distinct forms. Cutaneous synthesis and diet are two main sources of delivering vitamin D. It is converted into its active hormonal form to exert its biological actions and plays an important, pleiotropic role, as the diverse activities of vitamin D are mediated through both genomic and non-genomic pathways. Aside from its traditional roles in the regulation of mineral homeostasis, vitamin D has also been shown to mediate a number of additional non-genomic or “rapid” actions at the non-transcriptional level in a variety of tissues. It has been shown to protect against endothelial dysfunction, smooth vascular muscle cell proliferation and migration, and modulation of the immune system, as well as the inflammatory response. Although some vitamin D is essential for cardiovascular health, excess may have detrimental effects, particularly on elastogenesis and inflammation of the arterial wall. The detection of Vitamin D receptors in almost all tissues of the body spurred wide interest in its physiological functions. The primary purpose of this review was to provide an overview of the metabolism, mechanism of actions, homeostatic regulations, and non-calcitropic roles of Vitamin D in the vasculature. Methodology: Literature search using the combination(s) of the following key terms: “cardiovascular System,” “Metabolism,” “Non-calcitropic Role,” “Regulation,” and “Vitamin D” was used to identify relevant studies that were used for this review. The search was restricted to articles written in English language, but no time limit restriction was used. Out of the retrieved studies, only those the relevant information as assessed by the authors were used to write this review.
Background: Miscarriage is a common adverse pregnancy outcome with significant impact on the woman’s health, her family and the community at large. Chlamydia trachomatis is the commonest Sexually Transmitted Infection worldwide and has been implicated in the aetiology of miscarriage. However, its role in spontaneous miscarriage is still unclear, as reports are conflicting. Objective: This study was to determine the association between Chlamydia trachomatis infection and spontaneous miscarriage. Methodology: This case-control study was conducted at the Gynaecological Emergency Clinic and Antenatal Clinic of the Abubakar Tafawa Balewa University Teaching Hospital, Bauchi. Eighty-five women with spontaneous miscarriage (case group) were compared with eighty-five women with ongoing pregnancy beyond twenty-eighth weeks of gestation and no prior miscarriage (control group) matched for age and parity. Sera were obtained from both groups and tested for Chlamydia IgG antibodies using ELISA. The data obtained, including their socio-demographic characteristics, were recorded and analysed using IBM SPSS version 26. Results: The overall sero-prevalence of Chlamydia trachomatis IgG among the participants in this study was 7.1%, while the prevalence for the case group was 10.6% and that for the control group was 3.5%. This sero-prevalence of Chlamydia trachomatis was not statistically significant between the cases and controls. (p=0.132, OR=3.237, CI=0.845-12.407). Conclusion: Demonstration of association of chlamydia with miscarriage was not established in this study despite Chlamydia trachomatis IgG being detected more in women with miscarriage than those without miscarriage, suggesting an increased risk for miscarriage from exposure to the organism. ELISA technique alone may not be sufficient if diagnosis of pregnant women is to be undertaken. A multi-centred prospective cohort study, employing the combination of ELISA and PCR, may yield further clarity in the future.
Background: The acute shortage of sonographers and healthcare providers with specialist training in sonography is a significant challenge to providing ultrasound services in primary healthcare centres in regions where resources are scarce. Objective: This study aimed to determine the feasibility of implementing POC USS training using the ISUOG guide for training ultrasound-naive healthcare providers in primary healthcare centres to achieve some level of competence in limited obstetric ultrasound. Methodology: A point-of-care obstetric ultrasound training program for primary healthcare providers was conducted in collaboration with the Borno State Primary Healthcare Development Board at the Mubil Women’s Outpatient Clinic and Ultrasound Services in Maiduguri. The target group consisted of nurses, midwives, and Community Health Extension Workers (CHEWs). A five-day obstetric ultrasound training was conducted from December 16th to 20th, 2024. Using the six-step approach proposed by the International Society for Ultrasound in Obstetrics and Gynaecology (ISUOG) as a guide for the training. Descriptive statistics were used for data analysis. The Statistical Package for Social Sciences (SPSS) version 21.0 was used for data analysis. Results: A total of 3(50%) participants were Nurses/Midwives, while 3 (50%) were CHEWS, and 3 (50%) were computer literate, while 3(50%) were not. There was a significant difference in the participants' pre- and post-test performance, p < 0.05. There was uniform positive feedback from the participants regarding the content and scope of coverage and the nature of the training delivery. Conclusion: This pilot implementation has demonstrated that some level of ultrasound competency is achievable among ultrasound-naive Nurses/midwives and CHEWs within a short timeframe using focused and intensive didactic and hands-on training.
Background: Sexually transmitted infections (STIs) remain a significant global health burden, particularly among young adults. Despite growing awareness of HIV/AIDS in Nigeria, knowledge and preventive practices for other STIs remain inadequate. Medical students, as future health care provider, could play a critical role in STI prevention and education. Objective: To assess the knowledge, awareness, attitudes, and preventive behaviours related to STIs among medical students of Ambrose Alli University, Ekpoma, Edo State, Nigeria. Methodology: A descriptive cross-sectional study was conducted among 392 students from the College of Medical Sciences, Ambrose Alli University, Ekpoma. Participants completed structured self-administered questionnaires addressing socio-demographic characteristics, STI knowledge, sexual practices, and attitudes. Data were analysed using SPSS version 20, and a chi-square test was used to assess associations between demographic variables and STI behaviours. Results: Over 90% of respondents demonstrated good knowledge of STIs, including transmission routes, symptoms, complications, and prevention. Despite this, only 25.5% consistently used protection, and 49.2% had never undergone STI testing. About 68.6% of students were sexually active, and 11.7% had previously been diagnosed with an STI. Gender- and age-based differences in STI practices were not statistically significant. Healthcare professionals were the most commonly cited source of STI information. Conclusion: While awareness of STIs was high among respondents, protective practices and screening behaviours were suboptimal. There is a critical need for behaviour-focused interventions and strengthened campus health services to close the knowledge–practice gap.
Background: Achieving a tension-free wound closure of large myelomeningocele remains a major concern for all neurosurgeons. Even though this could be achieved by a simple method of undermining the skin surrounding the defect, it can be riddled with technical challenges. As such, surgeons developed various methods to achieve wound closure without tension on large myelomeningocele defects. In this paper, we report our experience in the wound closure of large myelomeningoceles in a regional neurosurgical centre in northwestern Nigeria and review the literature. Methodology: A retrospective study that reviewed all patients with large myelomeningoceles who had surgical intervention at Usmanu Danfodiyo University Teaching Hospital (UDUTH) from January 2021 to December 2023. Data was obtained from the patients' case notes. Results: A total of six patients with large myelomeningocele were operated on during the study period. Five were males with a male-to-female ratio of 5: 1. All the patients presented during infancy with a mean age of 3.5 months. Hydrocephalus was the most common associated abnormality. All had excision and simple wound closure after undermining the skin surrounding the defects. Five (83.3%) patients had no complications in the post-operative period. One patient (16.7%) had a pseudomeningocele that was treated by wound exploration and dural repair. Conclusion: By undermining the edges of a large myelomeningocele, tension-free closure is achieved with favourable outcomes.
Background: The birth of macrosomic babies (those with a birth weight of ≥4000 grams) is always a cause for concern for both patients and obstetricians due to the associated increase in perinatal morbidity and mortality. Objectives: To determine the prevalence and risk factors of fetal macrosomia and compare the outcomes of macrosomic babies' and normal birth weight babies' deliveries. Methodology: A case-control study design was employed to compare the outcomes of deliveries from macrosomic babies and those with normal birth weight from January 1, 2019, to December 31, 2020, at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. The labour, antenatal, and postnatal wards registers were used to obtain the hospital numbers of the patients, which were then used to retrieve their folders from the medical records department. Information was extracted from the folders using a proforma design for the study. For each macrosomic baby delivery, the next normal-weight baby delivery was taken as a control. Data obtained was analyzed using SPSS version 25, and the results were presented as simple percentages in a frequency table. Chi-square and student t-test were used for statistical analysis as appropriate. A p-value of < 0.05 was considered statistically significant. Results: There were 216 deliveries of macrosomic babies out of 6556 deliveries during the study period, giving a prevalence of 3.3%. The mean birth weight of the babies was 4.33 kg. Compared to mothers who deliver normal-weight babies, mothers of macrosomic babies were significantly older than 35 years (P < 0.001) and grandmultiparous (P < 0.001). There was a higher rate of cephalopelvic disproportion (P<0.001) and increased risk of Caesarean delivery (P=0.006) in the mothers of macrosomic babies compared to mothers who gave birth to normal-weight babies. The majority of the macrosomic babies were males (P<0.001) and were more likely to have more birth trauma, perinatal asphyxia, and admission to the special care baby unit with P values of 0.010, 0.001, and <0.001, respectively. Conclusion: The prevalence of fetal macrosomia was 3.3%, with a predilection for male fetuses. Fetal macrosomia was associated with advanced maternal age and grandmultiparity. Deliveries of macrosomic babies should be conducted in a tertiary centre and by an experienced obstetric team, given the increased risk of operative delivery, birth trauma, shoulder dystocia, and PPH.
Background: Cervical incompetence, defined as the inability of the cervix to support a pregnancy to term due to a functional or structural defect of the cervix, is an important obstetric condition. The pregnancy outcome of patients with cervical incompetence can be improved with the application of cervical cerclage. Objectives: To determine the prevalence and risk factors of cervical incompetence and pregnancy outcome following insertion of cervical cerclage. Methodology: This was a hospital-based descriptive retrospective study that reviewed all cervical cerclages performed for cervical incompetence at the University of Maiduguri Teaching Hospital (UMTH) over 13 years. (January 2011 and December 2023). The data obtained included sociodemographic characteristics of the study patients, risk factors for cervical incompetence, and pregnancy outcomes. Data management and statistical analysis were performed using SPSS version 25. Results: The prevalence of cervical cerclage was 9.1/1000 deliveries, and the mean age of the study population was 30± 6.3 years, and the mean parity was 2.5±1.5. All the patients (100%, 56/56) were married, and 37.5% (21/56) were housewives. The identified risk factor in the majority of the cases studied was the previous history of manual vacuum aspiration, 46.4% (26/56), and following insertion of cervical cerclage, 46.4% (26/56) of the study patients had term live births. Conclusion: Cervical incompetence is not uncommon in our environment, and the pregnancy outcome of the patients can be improved using cervical cerclage.
Background: Medical admission patterns provide valuable insight into prevailing disease burdens and healthcare system performance, particularly in low- and middle-income countries undergoing epidemiological transition. Data from North-Eastern Nigeria remains limited despite the region’s unique demographic and health challenges. Aims and Objectives: To evaluate the pattern and spectrum of medical admissions at the University of Maiduguri Teaching Hospital (UMTH), North-Eastern Nigeria. Methodology: This was a retrospective descriptive review of medical admissions at UMTH over 18 months (October 2018–March 2020). Patients aged ≥12 years admitted to the medical wards were included. Sociodemographic data, admitting subspeciality, disease categories, and specific diagnoses were extracted from hospital records. Data were analysed using SPSS version 23 and presented as frequencies, percentages, medians, and ranges. Results: Of 3,076 medical admissions recorded, 2,974 patients were analysed. The sex distribution was nearly equal (49.4% males, 50.6% females), with a median age of 46 years (range 12–110). Most admissions occurred amongst patients aged 31–60 years. Admission rates peaked in the last quarter of 2019 and then declined sharply in early 2020. Nephrology accounted for the largest proportion of admissions (44%), followed by cardiology (11%) and Neurology (10%). Renal disorders were the leading disease category (47.1%), predominantly chronic kidney disease, with hypertensive nephropathy as the most common aetiology (51.7%). Cardiovascular diseases (11.4%) were mainly hypertensive heart disease with heart failure, while stroke accounted for nearly half of neurological admissions. Infectious diseases constituted 8.2% of admissions, with malaria, tuberculosis, and HIV infection being the most frequent. Conclusion: Medical admissions at UMTH are dominated by non-communicable diseases, particularly hypertension-related renal and cardiovascular conditions, affecting predominantly middle-aged adults.
