AIMS AND OBJECTIVES: The study aims to assess the outcome of excision and end-to-end anastomotic urethroplasty in the management of post traumatic urethral stricture in at one of the teaching hospitals in Nigeria. MATERIALS AND METHODS: All cases of post traumatic urethral stricture disease managed by excision and end to end anastomosis between January 2000 and December 2006 were retrospectively studied. The data collected included the patients age, cause of stricture, location, length and the outcome of surgery. RESULTS: A total of 47 patients excision and end to end anastomotic urethroplasty were carried out during the period. Twenty patients (42.6%) had bulbar stricture and 27 (57.4%) had pelvic fracture urethral distraction stricture involving the posterior urethra. There was a 100% success rate in the 20 patients with bulbar urethral stricture at a minimum follow up of 1 year while the success rate for the 27 patients with posterior urethral stricture was 70.4%. Complications included one case each of perineal wound infection and of urethrocutaneous fistula which were managed conservatively. CONCLUSION: Excision and end to end anastomotic urethroplasty gives excellent results for the treatment of short segment post traumatic bulbar strictures and should be used as the primary treatment for such strictures.

BACKGROUND: Slipped Capital Femoral Epiphysis (SCFE) is the commonest pathology affecting the adolescent hip with an incidence of approximately 2 per 100,000 population. Blacks are more commonly affected than Caucasians. Of many treatment options available, in-situ-pinning appears to be the most widely employed. AIMS AND OBJECTIVES: To determine the epidemiological pattern and the outcome of in-situ pinning for slipped capital femoral epiphysis in Nigerian adolescents. PATIENTS AND METHODS: This is a six-year retrospective review of all the cases of slipped capital femoral epiphysis treated by in-situ pinning between 1st January 1998 and 31st December 2003 at the National Orthopaedic Hospital, Igbobi, Lagos, Nigeria. RESULTS: Thirty-one patients with 35 affected hips were managed with in-situ pinning during the period of review. Twenty-one females (67.7%) and 10 males (32.3%) with a F:M ratio of 2.1:1 were affected. The mean age for all the patients was 12.45 years (range 6 - 16; SD ΁ 1.79). The most common presenting complaint was hip pain seen in 48.4% of cases. Satisfactory results were obtained in 13 hips (37%) while the results in the remaining 22 hips were unsatisfactory. The most common complication was limb length discrepancy. CONCLUSION: This study shows that SCFE is not an uncommon condition in orthopaedic practice in Nigeria. The high rate of unsatisfactory results is associated with the severity of the slips and the unavailability of image intensifier at the time of surgery.

BACKGROUND AND OBJECTIVES: Swelling, pain and trismus are acute reversible inflammatory complications of impacted mandibular third molar (M3) surgery. They contribute to the deterioration of quality of life and loss of several useful working hours. This study aimed to investigate whether the use of a surgical drain following M3 surgery can minimise these inflammatory complications. PATIENTS AND METHODS: Eighty consecutive patients who gave consent were enrolled into the study. Patients were assigned into two groups (drain and no drain) by systematic sampling method which was modified to ensure matching of patients by age, sex and spatial relationship of the impacted mandibular third molar. The patients in the drain group (n=40) had a Foley's catheter drain inserted into the wound after the surgical procedure while the patients in the no drain group (n=40) had their wound closed without the use of drain. All patients had primary wound closure with 3.0 black silk sutures after the procedure. Demographic data, cheek dimension and maximal mouth opening were recorded before the procedure. Pain, swelling and trismus were evaluated in the two groups at 24 hours, 48 hours and 7th day after surgery. RESULTS: Post operative swelling and visual analogue scale score for pain were comparatively lesser in the drain group patients. The maximal interincisal distance was also more in the drain group patients. CONCLUSION: The findings from this study indicated that there is a significant benefit of using a surgical drain in minimising postoperative oedema, pain and trismus following surgical removal of impacted mandibular third molar.

AIMS AND OBJECTIVES: This study compared the biologic activity of three different cyst types and assessed the value of the AgNOR technique as an aid to diagnosis. BACKGROUND: The nucleolar organiser region (NORs) reflect replicatory activities within the cells. It has been found to be of diagnostic value in the prediction of the biologic behaviour of some tumors and even oral epithelial dysplasia. MATERIALS AND METHODS: Thirty histologically diagnosed H & E sections of cystic lesions consisting of ten (10) radicular, ten (10 dentigerous and ten (10) odontogenic kerotocysts were randomly selected from the record of biopsy services of the Lagos University Teaching Hospital. The paraffin blocks of the selected sections were retrieved for AgNOR staining. For each cyst type the mean and standard deviation of AgNORs/100 cells was calculated and compared with other cyst types using an analysis of variance and student's t-tests. RESULTS: RESULTS of this study show a statistically significant higher means AgNORs cyst. (p = 0.0016; p = 0.00049 and respectively). However, no statistically significant difference in mean AgNOR score/cell was found when the radicular and dentigerous cysts were compared. CONCLUSION: These variations reflect the difference in the proliferation rate of the odontogenic keratocyst, radicular and dentigerous cysts.

AIMS AND OBJECTIVES: Health care workers (HCWs) are exposed to blood and other body fluids in the course of their day to day activities in the health care setting. Standard precautions are designed to reduce the risk of transmission of microorganisms from both recognized and unrecognised sources. This study is to determine the knowledge and practice of standard precautions among health care workers in Federal Medical Centre, Asaba, Delta State, Nigeria. SUBJECTS AND METHODS: This descriptive, cross sectional study was carried out among Health Care workers in Federal Medical Centre Asaba, Delta State. A total population of all the doctors and laboratory workers was used while the nurses were selected using a stratified sampling method. A semi-structured, self-administered questionnaire was the tool for data collection. RESULTS: A total of 167 respondents participated in this study. The mean age of the HCWs was 36.9 ± 6.8 years made up of 47 (28.1%) doctors, 100 (59.9%) nurses and 20 (12.0%) laboratory workers. There were more females (65.3%) than males (34.7%) in the study. One hundred and thirty seven (82.0%) respondents had heard about standard precautions. Only 63 (37.7%) of them had correct knowledge of it. There was fair practice and adherence to the standard precautions by those who knew of it. CONCLUSION: Findings from this study emphasised the need for intensive enlightenment programme to educate health care workers on various aspects of standard precautions and infection control programmes and policies.

AIMS AND OBJECTIVES: Domestic refuse remains a major environmental concern in large cities around the world. Its management also continues to be a major challenge. The aim of this study was to assess the effect of health education on the knowledge, attitude and practices of domestic refuse management (DRM) among community members in Sokoto metropolis. MATERIALS AND METHODS: A quasi experimental study design was employed to investigate two sampled (intervention and control groups) population of 225 subjects in the study areas. RESULTS: The mean knowledge score (%) of the study subjects was high and similar (p=0.82), in both the intervention and control groups at baseline, but differed significantly (p<0.0001) at post-intervention. The mean attitude score (%) was high and similar (p=0.38), in both the intervention and control groups at baseline, but differed significantly (p=0.008) at post intervention. The mean observed practice score (%) was low and similar (p=0.42), in both the intervention and control groups at baseline, but differed significantly (p<0.0001) at post-intervention. CONCLUSION: This study has identified the underlying problem of our DRM system to be inherent in the practice component in the triangulation of knowledge, attitude and practice of DRM. The implications of the study findings for healthcare policy, planning and implementation cannot be over-emphasised.

BACKGROUND: Violence against women, in its various forms, is endemic in communities and countries around the world, cutting across class, education, race, age, religious and national boundaries. AIMS AND OBJECTIVES: This descriptive cross-sectional study was conducted to identify various forms of gender based violence affecting women in Kano metropolis, determine factors responsible for gender based violence and use this to suggest ways of preventing gender based violence. SUBJECTS AND METHODS: Respondents for this study were selected from the eight metropolitan Local Government Areas of Kano State, Nigeria. Six hundred adult males and females were selected through a multi-stage sampling technique by the use of questionnaire as the data tool. RESULTS: More than three quarters 436 (75.7%) of the respondents knew that women are subjected to various forms of verbal abuse in their homes by their spouses. Deprivation of assess to health care and education was identified by 454 (78.8%) and 490 (85.15) respondents as challenges faced by women at homes. Majority of the respondents 498 (86.4%) identified financial reason, four hundred and forty (76.4%) respondents mentioned unfaithfulness and three-quarters 434 (75.3%) of the respondents said refusal of sexual advance is a reason for violence activities witnessed by women in their respective homes. There was a statistically significant relationship in opinion of male and female on coercion of wife for sexual activities when she is tired and when she is not in the mood (p-value=0.0000). CONCLUSION: Government and Non Governmental organisation should intensify activities to promote awareness and advocacy on violence against women. Involvement of males in all programmes relating to violence against women should be done especially since the perpetrators in most cases are men

AIMS AND OBJECTIVES: To determine the influence of maternal height on the mode of delivery even when matched for maternal characteristics. The study is a prospective cohort study comparing the mode of delivery in 57 short stature women (d"150 cm) with age and parity-matched, taller control women (n = 57). MATERIALS AND METHODS: A total of 114 parturients were studied, 57 of whom had a height of 150 cm or lower and constituted the study group, while the other 57 taller women were matched with respect to parity (i.e. belonging to same parity group of either nulliparity, para 1-3, para 4+) and maternal age group (i.e. <20, 20-34, 35+ years) to the shorter women and constituted the control group. Patients were also matched by gestational age (28-37 weeks, 38-42 weeks, 42+ weeks) and birth weight (<2500g, 2500-3999g, 4000+) groupings. RESULTS: Caesarean section rate in the short women was higher (42.1%) than in taller women (21.1%), P= 0.016, as was the incidence of cephalopelvic disproportion (35.5% versus 10.3% respectively, P = 0.010). Nevertheless, neonatal outcome remains good; the 5-min Apgar score <7 was 21.1% versus 15.8% respectively, P =0.469, while the stillbirth rate was 10.5% versus 7.0), P = 0.508. CONCLUSION: Short stature is independently associated with an increased risk of intrapartum caesarean section in Nigerian women and advocate early recourse to caesarean section to avoid undue delay.

BACKGROUND: Medical malpractice is a global problem of professional negligence resulting in damage or harm to a patient due to deviation from accepted standards of practice. Radiology service delivery to patients from all the four major medical disciplines and the ever increasing imaging arsenal potentially increase the incidence of adverse events in radiology. It is pertinent therefore, that radiology practitioners become conversant with the regulatory role of the medical malpractice system in the protection of the right of patients. AIMS AND OBJECTIVES: To document the knowledge base of medical malpractice in current literature in order to arouse the awareness of radiology residency trainees and trainers to this all-important professional practising issue. MATERIALS AND METHODS: Literature materials on medical malpractice in general and Radiology in particular were reviewed. Four illustrative case reports from past experiences were highlighted. Discussion was carried out on the historical perspective, classes, defendant status, legal requirements and prevention of medical malpractice. RESULTS: Discovery of x-ray in 1895 shifted focus of medical malpractice matters to Radiology. Practically all imaging techniques, including US, CT, MRI have been subject of malpractice lawsuits. Cognitive and perceptual diagnostic errors constitute 70% of malpractice cases against radiologists. CONCLUSION: Adequate professional training, informed consent by the patient and improved doctor-patient relationship are basic to standard medical practice.

Choroid plexus papilloma is a rare but known cause of hydrocephalus among children. We report the case of an 8 month old girl who clinically was thought to have post-infective Hydrocephalus. Cranial CT however showed an associated intra-ventricular tumour which after surgical resection was reported as a Choroid plexus papilloma. This is the first time such a case is being diagnosed at our hospital and very few cases have been documented in literature from sub-Saharan Africa. This case highlights the available treatment and good prognosis that is possible with Choroid plexus papilloma. It also highlights the need for a high index of suspicion for less common causes of an enlarging head especially when the clinical picture is not typical as demonstrated in our patient. The seeming rarity of this disease in our environment may be partly due to the limited availability of CT scanners in many centres and the paucity of Neuroradiologist and Neurosurgeons in sub-Saharan Africa.

Dental implant surgery has traditionally been done through raising flaps, until recently when flapless surgery was advocated. The major challenges of implant placement include correct implant localisation / angulations and osseointegration. In this regard, many types of surgical guides have been proposed. This is a case report of implant placement using flapless guided surgery with a simple surgical guide. A 31 year old female with missing right maxillary canine and left 1st premolar was treated in a private hospital in Lagos, Nigeria. Two implants (BASIC: Bio Anatomical System Implant Corporation USA) with titanium-oxidised surface were proposed for placement. The patient was treated according to the protocol in the BASIC treatment manual. In summary, it involved design and fabrication of a surgical guide and flapless guided implant surgery. This minimally invasive flapless procedure offered less chair time with no complication. The accompanying 3 month osseointegrating period offered a comfortable post surgical period for the patient without compromised treatment outcome. The design technique involved the use of a periapical (P.A) radiograph, impression casts, P.A film overlay. All of which are affordable in a developing environment.