This descriptive study was carried out to determine food safety practices among food Vendors in secondary schools in Ilorin. Pre-tested questionnaire and observational checklist were administered to 185 respondents recruited using inclusion and exclusion criteria. One hundred and eighty-two (98.4%) of the subjects were females and only 6(3%) were teenagers. One hundred and two (56.8%) had no formal education while 72(39% had received training on food hygiene. Pre-employment medical examination practice was high 141(76%) but periodic medical examination was low 30(16%). Sixty-one (33%) and seventy-two(39%) respondents prepared food well in advance and reheat food before sale respectively. Vendors who prepared food well in advance (over 4 hours) were found to practise food re-heating more than those who prepared food within 4 hours before sale, and this is statistically significant. The major unhygienic practices observed among the food vendors were poor care of used utensils 100(54%), use of previously used water for washing and cleaning, lack of covering apron among the vendors 128(69%) and lack of wash hand basin for immediate cleaning 61(33%). Only 85(46%) of the respondents used soap and water to clean their utensils while the rest 100(54%) used unhygienic methods to clean their utensils. It was observed that respondents who used soap and water for cleaning, vended food at locations that were relatively closer to water source, compared to other vendors who used other methods to clean their utensils. This is also statistically significant. Unkempt fingernails, skin lesions and poor food protection from flies were some of the food contaminating risk factors observed in the study. The need exists for food vendors and other food handlers to be trained on basic principles of safe food handling.

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The objective of this study is to highlight the alarming rise in antimicrobial resistance among Shigella species in Jos, Plateau State. Stool samples of eight hundred and ten patients who presented at the Jos University Teaching Hospital with diarrhoea/dysentery were analysed using standard bacteriological techniques. The antimicrobial susceptibility of the isolates were determined. 25 Shigella species were isolated representing 3.1% isolation rate. The male to female ratio is 1.3:1, children aged 0-10 years constituted 16(64%) of the cases. Shigella flexneri (48%) was the most common sero-group. This was followed by S. boydii (24%), then S. sonnei (20%), and S. dysenteriae (8%). Most strains of shigella species were resistant to Ampicillin (96.0%). Chloramphenicol (96.0%), Cotrimoxazole (88%), Nalidixic acid (84%) and Tetracycline (75%). All strains were found to be sensitive to Ciprofloxacin. The drugs of choice in the treatment of Shigella infection in this environment should be Ciprofloxacin and Ofloxacin. Gentamicin was the third drug of choice its use is limited since the infection is not systemic. To avoid continuous abuse of antibiotics in our country there should be an effective legislation by the government to control the indiscriminate purchase of antibiotics.

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The prevalence rate of psychopathology and the relationship between psychopathology and some socio-demographic variables and consolidated current drug use were studied in 600 randomly selected senior secondary school students in Ilesa, south-western Nigeria. The 30-item version of the General Health Questionnaire and the WHO student drug use questionnaire were administered for the study. The findings revealed that the prevalence of psychopathology among the study population was 39.5%. There were significant positive associations between psychopathology and belonging to low socio-economic status, coming from a polygamous family and self-rated poor academic performance. The results also showed that although psychopathology was commoner amongst respondents who were engaged in current use of psychoactive substances than those who were not, the difference was not significant. The implications of these findings within the context of the limitations of the study and the importance of effective preventive and therapeutic student mental health services are discussed.

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The maximum cervical dilatation achieved by parturients who went through labour prior to their primary caesarean births were related to the mode of delivery in the subsequent birth to ascertain if there is a link between the two. The success rates of vaginal births after primary Caesarean sections (VBAC) for arrest and non-arrest disorders were also compared using information derived from the birth records of the hospital. The success rate for VBAC was significantly high in subjects whose primary caesarean sections were for non-arrest disorders compared to those who had arrest disorders (73.3% versus 55.6%; x2 = 5.25, p = 0.02). The maximum cervical dilatation reached before primary caesarean section did not significantly affect the success rate of VBAC in the subsequent delivery (x2 [trend] = 0.78, p = 0.68). Patients who had primary caesarean section for arrest disorder require full evaluation before being allowed to attempt vaginal birth in a subsequent pregnancy but the maximum cervical dilatation reached before primary caesarean section need not be factored into a decision for VBAC.

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The objective of this study was to explore the usefulness of the fractional excretion of magnesium (FEMg2+) in Nigerian chronic renal failure patients (mild to moderate) in determining the severity of renal insufficiency. Plasma and twenty-four hour urine samples were analysed for magnesium and creatinine in thirty-five chronic renal failure patients and twenty-five healthy controls. The mean fractional excretion of magnesium (FEMg2+) was 15.3%(13.6) in the patients and 6.1%(2.3) in the controls and this correlated negatively with the creatinine clearance in both groups (r = -0.343, p < 0.05) in patients and (r = -0.665, p < 0.001) in controls. There was a positive correlation between plasma creatinine and fractional excretion of magnesium in the patients (r = 0.463, p < 0.05) and controls (0.455, p < 0.05). FEMg2+ may therefore be a more sensitive indicator of renal insufficiency and may also be a better indicator of the progression of renal failure.

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This study was undertaken to establish local CD4+LC standards, which could be used as indicators of immune deficiency or monitor progress of HIV therapy, instead of relying on Caucasian standards, which may not exactly reflect Nigerian CD4+LC sub-populations. CD4+LC from 1232 Nigerian adults were studied. They included 852 apparently healthy individuals, 172 HIV-positive persons with no major AIDS defining illnesses (AIDSDIL) and 208 HIV infected individuals with AIDSDIL. The mean CD4+LC of healthy Nigerians (821 +/- 12) was more than two times higher than the mean CD4+LC of HIV-positive individuals without AIDSDIL (369 +/- 14) and almost five times higher than the mean of HIV-positive individuals with AIDSDIL (163 +/- 13) (p < 0.05). In addition, a CD4+LC of < 200 cells/uL can be considered as an AIDS defining laboratory criterion in Nigerians as the 208 individuals with AIDSDIL had a mean CD4+LC of 163 cells/uL. This study therefore establishes a local standard range for CD4+LC in healthy and HIV infected Nigerians which can serve as reliable indices for HIV induced immune impairment and for monitoring effectiveness of HIV therapy.

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This descriptive study assessed maternal attitudes to youth-related activities in Delta State. Using an adapted questionnaire, 300 women with adolescent children were chosen through a multistage sampling technique and relevant data obtained regarding their socio-economic status, perceptions and values as well as their knowledge of basic reproductive health concerns. Most of the women interviewed (95%), believed it was very important that young people completed secondary education and another 72% said they would normally set rules in their homes regarding what young people should read or watch. Sixty-seven percent of those studied, discussed sexuality issues regularly with their adolescent children, though only 46.4% of them were comfortable discussing these issue and about 50% admitted having enough information in such discussions. Another 76% of the women would approve of their children receiving reproductive health information and service including contraceptive condoms. The mothers studied believed that guided reproductive health information and services should be routinely provided for young people. The findings strongly suggest that the mothers who are important stakeholders in Adolescent Health would most likely be supportive of youth programmes. Most of the findings differ from those of other studies, and a qualitative study would be carried out to identify the reasons for these interesting findings.

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Histopatholgical findings in 242 lymph node biopsies received in Jos University Teaching Hospital over a 10-year period (1988-1997) were reviewed. Tuberculosis is the most predominant lesion (33.05%), followed closely by the non-Hodgkin's lymphoma (31.4%). Burkitt's lymphoma accounting for one-quarter of all the cases of non-Hodgkin's lymphoma had a peak age range of 8-10 years. Hodgkin's lymphoma, chronic non-specific lymphadenitis, sinus histiocytosis, reactive hyperplasia, metastatic carcinoma, dermatopathic lymphadenitis, Kaposis sarcoma and sarcoidosis accounted for 2.9%, 14.46%, 9.9%, 4.96%, 1.7%, 0.4%, 0.8% and 0.4% respectively. The cervical region was the commonest site affected (54.1%), followed by mesenteric (22.3%), axillary (13.2%) and inguinal (10.3%). BCG immunization was carried out only on 121(50%) of cases, out of which 60 had tuberculosis and 54(22.3%) received no BCG immunization, while 67(27.7%) had no records of BCG immunization. Only 5(2%) had HIV screening done, out of which one was positive.

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The present study was undertaken to determine the anthropometric risk indicators in the detection of infants with low birth weight. A total of 788 consecutive, singleton, live born infants had anthropometric measurements determined within 24 hours of life using standard methods. There were 389 (49.37%) males and 399 (50.63%) females; 136 (17.56%) of the infants were of low birth weight (LBW). Birthweight was significantly correlated with occipitofrontal circumference (OFC; r = 0.66), length (r = 0.86), mid-arm circumference (MAC; r = 0.88) and maximum thigh circumference (MTC; r = 0.95) (p < 0.001). Furthermore, OFC of 33.6 cm and 32.3 cm, length of 47.7 cm and 45.5 cm, MAC of 9.6 cm and 9.1 cm, and MTC values of 15.5 cm and 14.9 cm were the corresponding cut-off values with the best combination of sensitivity, specificity and predictive values (p < 0.001) for identifying infants with birth weights of < 2500 g and < 2000 g respectively. The use of these risk indicators would help to identify newborns for close supervision and care, as well as prevent mortality and postnatal developmental retardation.

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Systemic hypertension is a leading risk factor for cardiovascular disease among Blacks. Essential hypertension in this population is dominantly related to salt-sensitivity acting via various interactive mechanisms including volume changes, nitric oxide inactivation, angiotensin II and insulin resistance. Excess morbidity and mortality among Black hypertensives are related to twin problems of ignorance and poverty, late diagnosis, genetically determined racial biological factors and co-existing diabetes mellitus and obesity arising from "western" adopted affluent life-style. This paper reviews these peculiarities and their implications in the management of a Black Hypertensive.

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An audit of surgical emergencies was carried out to monitor acute trauma care and determine areas needing clinical improvement. This is essential for the development of institutional and national health policies on trauma and non-trauma diseases. All patients attending the surgical Accident and Emergency were studied prospectively from September 1999 to August 2000 to obtain their age, sex and diagnosis and to determine causes and injury-arrival time for trauma cases and the outcome of care for all cases. Out of 2,455 patients comprising 1,696 males and 759 females (M:F = 2.2:1) age range two weeks to 95 years, trauma accounted for 1,679 (68.4%). The median age (and the mode) of presentation overall and in males was in the third decade. Females had a 'plateau' age of presentation for the first four decades before the gradual fall to zero. Superficial skin trauma (lacerations, abrasions and bruises) represents the commonest presentation (16.1%) followed by fractures (13.9%), acute abdominal conditions (7.6%), head injury, HI (5.5%), multiple injury (4.1%), urinary retention (3.3%), burns and scalds (3.3%) and others. Eight-one patients died, comprising 54 males and 27 females, out of which 64 were trauma related deaths. Most common causes of death were HI (35 patients, 43.2%) and septicaemia (13 patients, 16.0%). Late presentation and poor finances contributed to the deaths in patients with septicaemia. Trauma is an important entity in our emergency practice. Prompt access to surgical care should reduce the morbidity and mortality from acute abdominal conditions and HI. The high incidence of urinary retention requires further analysis. Statistics of this nature can aid planning of care delivery and study of preventable deaths.

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The article focuses on providing medico-legal education for psychiatrists in the area of mental laws in Nigeria. This was done through the presentation of a recently concluded case of The State Versus I.A in which the author appeared in court to give evidence. A summary of the procedure before trial, the briefs of the prosecution and the defence, and the judgement were given. Some relevant sections of the Penal Code were quoted. Finally, salient points in the trial were also discussed. It was concluded that a good understanding of the mental laws by psychiatrists and medical personnel would lead to better presentation of evidence in court. Furthermore, a conference of stakeholders in mental health is also advocated.

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Abstracts in journals are important paragraphs in review or original articles, which help one to decide if such articles are worth reading. The layout and the content of abstracts have undergone tremendous changes over the years from traditional, unstructured to structured, informative format. Many journal editors abroad are moving fast with time in the adoption of the innovation, allowing only articles with structured abstracts to appear in their journals. Journals in Africa especially in Nigeria are lagging behind in this respect. This review article examines the relative advantage of structured abstracts over unstructured abstracts as documented by various reports on the subject and makes a recommendation for structuring abstracts in articles appearing in Nigerian Journals.

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This study examines whether cost is a factor in determining the choice of therapy in patients with mental illness. The focus therefore is to compare the cost of therapy (and not scientific basis or efficacy of treatment), in the short term, of traditional with orthodox mental health care. Sixty patients comprising 23 and 28 patients receiving therapies at orthodox and traditional psychiatric facilities respectively were interviewed. Information was obtained in the areas of sociodemographic data, duration of illness before presentation, duration of therapy, costs of consultation, medication, accommodation and feeding among others. It was found that traditional mental health care, in the short run, was three times more expensive than orthodox mental health care. Future health campaign programs should emphasize the fact that traditional mental health care is not just less effective, but costlier than orthodox mental health care. This might further discourage people from patronizing traditional mental health practitioners.

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The purpose of this study is to describe negative pressure pulmonary oedema due to undetected tracheal tube obstruction in a paediatric patient. A healthy 6 week-old scheduled for release of tongue-tie under general anaesthesia was noticed to be diagnosed at the preparation of the surgical site. The patient was quickly assessed, and ventilation with 100% oxygen was commenced. The heart sounds were still present. Two minutes later, pink frothy secretion was noticed in the lumen of the tracheal tube. Assisted manual ventilation was continued for about 3 hours in the intensive care unit (ICU). Clinical examination after 8 hours of oxygen therapy indicated stable vital signs and was discharged to the ward. Undetected tracheal obstruction due to unsupervised patient positioning may result in negative pressure pulmonary oedema in a paediatric patient. Improved communication between the surgical and the anaesthetic teams may prevent this morbidity.

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