Objective: Bilateral subcapsular orchiectomy (BSO) is said to be more aesthetic and psychologically satisfying when compared to bilateral total orchiectomy (BTO). This study compared the quality of life (QoL) of men with advanced prostate cancer who had BTO to those who had BSO, with an emphasis on their perception of self or identity as a man. Subjects and Methods: Sixty-one patients with advanced prostate cancer opting for bilateral orchiectomy were recruited. Pre-orchiectomy and at 1 month and 3 months post-orchiectomy, the Functional Assessment of Cancer Therapy for Prostate cancer (FACT-P) questionnaires were administered and scored. Results: Thirty (49.18%) patients had BTO (BTO group), while 31 (50.82%) patients had BSO (BSO group) for advanced prostate cancer. On comparison of the two groups, there were no statistically significant differences in FACT-P scores at 1 month and 3 months. The subscale scores also showed no significant statistical difference except for the physical well-being score at 3 months post-orchiectomy, which was lower in the BSO group (P = 0.041). The average scores of Item P5 (I am able to feel like a man) which were used to assess the sex-role identity declined on an average over 3 months with no statistically significant difference on comparison of the two groups. Conclusion: The QoL scores (FACT-P and FACT-G) assessed over 3 months post-orchiectomy did not differ on comparison of the BTO group and the BSO group. Performing a BSO in our region did not result in any psychological benefit when compared to performing a BTO.

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Background and Aim: Vitamin A deficiency (VAD) constitutes a major nutritional concern in developing countries. It contributes significantly to the morbidity and mortality of under-five children and can result in impaired resistance to infection as well as increased risk of death. The aim of this study was to determine the prevalence of VAD among Southwestern Nigerian children. Methods: Apparently healthy children aged between 6 months and 5 years were recruited for the study. Their serum retinol levels were determined by high-performance liquid chromatography. Results: Of the 170 children studied, nine (5.3%) had VAD, although none had severe VAD. The prevalence of VAD did not show statistically significant variation with age (P = 0.159), sex (P = 1.000), social class (P = 0.740), immunisation status (P = 0.197) or nutritional status (P = 0.090). Conclusion: The prevalence of VAD among Nigerian children appears to have reduced, compared with previous reports; however, further studies are required to assess the current national prevalence, so as to design programmes that can achieve further reduction in the proportion of children affected.

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Background: Trichomonas vaginalis infection is the most prevalent non-viral sexually transmitted infection worldwide. Interactions between this infection and human immunodeficiency virus (HIV) may cause adverse pregnancy outcomes such as preterm labour, premature rupture of membranes, chorioamnionitis, low birth weight and post-abortal sepsis. Aims: This study was aimed to determine the prevalence and risk factors of T. vaginalis infection amongst HIV-positive pregnant women attending antenatal care at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. Subjects and Methods: This was an analytical cross-sectional study in which 320 eligible participants which included 160 HIV-positive (case group) and 160 HIV-negative (control group) pregnant women were recruited at the antenatal clinic of LUTH. A structured pro forma was used to collect data from consenting participants after which high vaginal swabs were collected, processed and examined for T. vaginalis. The association between categorical variables was tested using the Chi-square test and Fisher's exact test where applicable. All significances were reported at P < 0.05. Results: The prevalence of T. vaginalis infection amongst HIV-positive and HIV-negative pregnant women were 10% and 8.1%, respectively (P = 0.559). Significant risk factors for T. vaginalis infection in the HIV-positive pregnant women were early coitarche (P < 0.005) and multiple lifetime sexual partners (P = 0.021). There was no relationship between the T. vaginalis infection and the immunological markers of HIV infection. Conclusions: While this study does not provide grounds for universal screening of pregnant women for T. vaginalis infection as a tool of reducing HIV acquisition, especially in pregnancy, campaign to create better sexual health awareness should be commenced as a way to contributing to the reduction in T. vaginalis infection during pregnancy and perinatal transmission of HIV.

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Agenesis of the corpus callosum is a heterogeneous, congenital neurodevelopmental condition that can be observed either in isolation or in combination with other brain abnormalities. Patients often present early with characteristic neurologic and physical manifestations. This case discusses a 10-year-old boy who presented to a tertiary health facility in Northern Nigeria with 6-month history of seizure disorder, cognitive impairment and urinary incontinence and had classical magnetic resonance imaging (MRI) findings consistent with partial corpus callosum agenesis in combination with other brain abnormalities. He was placed on daily oral carbamazepine and has done well with supportive care from family.

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Background: Dual-energy computed tomography (DECT) utilises the technique of simultaneous image acquisition of a body part at two different energy levels of the X-ray tubes. We used the DECT in this project to study its accuracy in non-invasive in vivo differentiation of uric acid (UA) calculi from non-UA calculi using the 3^rd generation dual-source computed tomography (CT) scanner. Materials and Methods: The DECT ratios of the various stones were noted and compared with the postextraction analysis of stones for composition. Sixty stones from 53 patients were included in the study, and their DECT results were compared with the post-extraction analysis (by infrared spectroscopy as the standard comparative method). Results: DECT was highly sensitive and specific in the diagnosis of various types of calculi based on their dual-energy ratio. It was found to be 100% sensitive and specific for differentiating UA stones from the non-UA stones. The DE ratio for the UA stones was found to be 0.98–1.13. Most of the stones belonged to non-UA category (85%), and only 15% were UA calculi. The sensitivity and specificity in differentiating a calcium oxalate from non-calcium oxalate calculus was 97.8% and 92.3%, respectively. Conclusion: DECT using the 3^rd generation CT scanners is highly sensitive in the determination of urinary calculi composition which will be very helpful to the treating surgeon in selecting the optimal modality of treatment as UA stones are amenable to medical therapy while most of the non-UA stones require surgical intervention.

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Background: Ninety percentage of children acquire human immunodeficiency virus (HIV) infection in the form of Mother-to-child Transmission (MTCT). In the absence of interventions, transmission rates range from 15% to 45%. This can be reduced to below 5% with effective interventions. The last published national guideline (NG) on prevention of MTCT (PMTCT) was in 2010. Clinical audits are essential in improving the quality of care delivered to patients. Objectives: The study objectives were to determine the rate of MTCT of HIV in exposed infants at a follow-up clinic between 2011 and 2014 and to determine the level of adherence to 2010 NG on the use of highly active antiretroviral therapy (HAART), polymerase chain reaction (PCR) testing, feeding options, antiretroviral (ARV) prophylaxis and the use of co-trimoxazole (CTZ). Methods: A retrospective review of data was done over 4 years. The population consisted of babies delivered through PMTCT programme and those referred to the clinic from other centres. Data analysis was done using the Statistical Package for the Social Sciences (SPSS) version 21. Results: Out of 699 babies enrolled, MTCT occurred in 22 babies (3.2%) and PCR testing was done in 445 babies (64.7%), most in the 1–2 months' age group. Breastfeeding was practiced in 402 (58.2%) babies, while about 88.0% of them received post-exposure ARV prophylaxis (PEP). CTZ prophylaxis was offered to only 226 (34.6%) babies. The regression model showed that maternal use of HAART and PEP for babies was independently associated with a reduction in transmission rate. Conclusion: The MTCT rate was 3.2%. There is a need to strengthen service provision to adhere to NG, especially on breastfeeding and CTZ prophylaxis.

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Objective: This study sought to determine the prevalence, patterns and feasibility of screening for psychoactive substance use among pregnant women in an antenatal clinic in Nigeria. It also aimed to determine the relationship between psychoactive substance use risk severity and psychiatric morbidity. Methods: A cross-sectional study was undertaken among 395 pregnant women previously booked for ante-natal care. A sociodemographic questionnaire, the Alcohol Smoking and Substance Involvement Test (ASSIST) and the 20-item self-reporting questionnaire-20 were interviewer administered. The t-test and ANOVA were used to analyse the relationship between substance use risk severity of probable psychiatric symptoms and lifetime use of psychoactive substance/risk severity, respectively. Results: Participants reported lifetime (50.4%) and preceding 3 months (17%) use of alcohol. Nicotine and sedatives use was rare (n = 2; 0.5%). About a tenth (11.6%) screened positive for psychiatric morbidity. Those reporting alcohol use were significantly more likely to report a greater severity of probable psychiatric symptoms (1.79 vs. 0.92; t = 3.43, P < 0.002). Significant differences were observed according to severity of risk (moderate risk [2.08] vs. low risk [1.72] vs. never used [0.92], F = 6.043, P = 0.03). Conclusion: ASSIST is feasible screening tool among pregnant women. At least, half of the participants report alcohol use in pregnancy and use was significantly associated with psychiatric morbidity.

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Context: Majority of the previous studies on thyroid diseases in Northern Nigeria focussed mainly on neoplastic lesions. The non-neoplastic lesions are more common and constitute more public health burdens. Aim: To determine the histopathological pattern of thyroid diseases in our region and compare our findings with similar studies in Nigeria and elsewhere. Settings and Design: This is a retrospective study carried out at the Department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria, from January 2005 to December 2014 using specified criteria. Subjects and Methods: All cases of thyroid diseases diagnosed histologically within the study period had their histology reports as well as their haematoxylin and eosin-stained slides reviewed and analysed. Statistical Analysis: Statistical package for the social sciences (SPSS) software for windows version 20.0 (IBM SPSS Inc. Chicago, IL) was used. Results: There were 302 thyroid diseases diagnosed during the study period. Only 297 cases fulfilled the study inclusion criteria. There were 255 females and 42 males with a male-to-female ratio 1:6. Ages ranged from 4 months to 80 years, with peak age incidence between 31 and 50 years. Thyroglossal cysts accounted for 17 (5.7%) cases. Non-neoplastic diseases composed of colloid goitre, Graves' disease, Hashimoto thyroiditis and lymphocytic thyroiditis. They accounted for 214 (72.1%), 12 (4.0%), 3 (1.0%) and 1 (0.3%) cases, respectively. The neoplastic diseases comprised 36 (12.1%) adenoma cases and 14 (4.7%) carcinomas, with papillary carcinoma being the most common (71.4%) thyroid cancer. Conclusion: This study showed that thyroid diseases in Zaria had a female predominance with a peak age frequency between 30 and 50 years of age. The most common diseases were colloid goitre, follicular adenoma and papillary carcinoma. These findings are comparable with several studies on thyroid diseases in Nigeria and globally.

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Background: Meningioma in Nigeria has been poorly studied. Its location within the intracranial cavity is associated with significant morbidity and mortality. Even when completely excised, it has a tendency to recur and this is associated with repeat operations and shortened survival. The World Health Organization (WHO) grade, progesterone receptor (PR) expression and Ki-67 index are predictive for recurrence and are, therefore, useful for individualised management. The aim of this study was therefore to determine the PR expression and Ki-67 index of meningiomas received in our institution. Materials and Methods: A retrospective review of the forms, slides and results of meningiomas received at the Department of Anatomic and Molecular Pathology, Lagos University Teaching Hospital, from January 2005 to December 2014, was undertaken. Immunohistochemistry for PR and Ki-67 was performed and correlated with other histologic parameters. Results: Meningioma was the most common primary CNS tumour seen. The male-to-female ratio was 1:3.8; with a peak in the 4^th decade. Most cases were WHO Grade I tumours (86.1%) and transitional histologic subtype (31.8%). PR immunoreactive score and Ki-67 index varied widely within WHO Grade I tumours and overlapped considerably with Grade II tumours. PR expression reduced and Ki-67 index increased with increasing WHO grade (P = 0.000). A moderate inverse correlation was found between Ki-67 index and PR score (R = −0.7371). Conclusion: The peak age of meningioma in our patients is five decades earlier than in western populations. Although PR expression reduces and Ki-67 index increases with increasing grade, there is nevertheless a considerable overlap. Management therefore must be individualised.

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Background: The use of honey as an escharotic agent in the conservative management of omphalocele major has not been widely explored in spite of its proven benefits in chronic wound management. We explored the use of local honey as an escharotic agent by comparing its use with 2.5% formal saline in the conservative management of major omphaloceles at the Lagos University Teaching Hospital, Lagos, Nigeria. Methods: From January 2006 to December 2009, 43 consecutive newborns with intact omphalocele major were alternately assigned into either Honey (H) or formal saline (FS) group. The membrane cover of each omphalocele was painted with the allotted group agent once every 48 h. The occurrence of faecal fistulas, rupture of eschar, intestinal obstruction as well as the mean duration of full wound healing, infection rates and overall mortality rates were compiled for the two groups. Results: Eighteen newborns were assigned to the FS group while 25 others were prospectively enrolled into the H group. The age, sex and weight of newborns in both groups at presentation were comparable. Three omphaloceles (16.7%) ruptured and eviscerated among the FS group during the study while 1 (4%) of these occurred in the H group. Four (22.2%) cases of faecal fistula occurred in the FS group while none was recorded in the H group. One (5.6%) patient in the FS group developed small bowel stricture. This was not recorded in the honey group. Overall, there were 8 (44.4%) complications in the FS group and 1 (4%) in the H group. There was no statistical difference between the two groups concerning the occurrence of fistulae, sac rupture or bowel stricture. However, overall number of complications was statistically more in the FS group when compared to the H group (P < 0.05). Wounds in the H group healed within a mean period of 34.4 ± 4.9 days while those in the FS group healed within a mean period of 45.7 ± 6.8 days P < 0.01). Conclusion: Honey is a good escharotics agent in the conservative management of major omphaloceles. Honey promotes faster healing and unlike 2.5% formal saline, is not significantly associated with faecal fistulas, rupture or bowel stricture.

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Introduction: The debate on the current nosological status of schizophrenia and mood disorders as distinct entities is very active among scholars. There is a paucity of genetic epidemiological data to contribute an African perspective to this debate. Aim: This study aimed to assess the morbid risk of mood disorders in the relatives of schizophrenia probands, in comparison with the families of a sample of healthy controls. Subjects and Methods: This study elicited the information on the morbid risk of mood disorders among 5259 relatives of schizophrenia probands (n = 138) and 6734 relatives of healthy controls (n = 138) through direct interview of patients, available relatives of patients and the comparison group. The family history approach using the Family Interview for Genetic Studies was utilised to obtain information on the morbid risk of all relatives that could be recalled. The diagnosis of available relatives was confirmed using the Diagnostic Interview for Genetic Studies. Morbid risk estimates were calculated using the Weinberg shorter method for age correction. Results: Morbid risk for mood disorders in the first-, second- and third-degree relatives of schizophrenia probands were 1.39% (95% confidence interval [CI] = 1.23–1.55), 0.86% (95% CI = 0.80–0.92) and 0.55% (95% CI = 0.53–0.57), respectively, compared with 0.45% (95% CI = 0.39–0.51), 0.11% (95% CI = 0.07–0.51) and 0.08% (95% CI = 0.06–0.09), respectively, for the healthy comparison group. Conclusion: This result supports the impression that familial risk for mood disorders is significantly higher among relatives of schizophrenia patients, compared with healthy controls and that there could be familial relationship between the predisposition to schizophrenia and mood disorders.

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Branchiootorenal syndrome is a rare autosomal dominant disorder characterised by branchial arch anomaly, hearing loss, renal anomalies and other otologic manifestations. We report a case of apparent de novo mutation that presented with hearing loss, branchial sinus and other manifestations of the disease. It is extremely rare in the West African region, and we suggest a high index of suspicion in a patient presenting with branchial sinus and/or hearing loss.

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Background: Complete and accurate pathology reporting of colorectal carcinoma (CRC) resection specimen is critical to clinical management of individual patients. The study aims to audit colorectal cancer histopathology reporting in Lagos between 2011 and 2015 before the adoption of the Society for Gastroenterology and Hepatology in Nigeria pro forma in 2016. Materials and Methods: All resected CRC cases were identified from the Histopathology record of our Department and that of a private Laboratory in Lagos over a 5-year from 2011 to 2015. The dataset as contained in the pro forma was extracted from the reports and analysed using SPSS version 16 software. Results: A total of 92 colorectal resections were received during the 5-year period consisting of 90 colonic and 2 rectal tumours. Data inclusiveness on tumour differentiation, extent of primary tumour, total lymph node and lymph node involvement were 96.7%, 91.3%, 83.7% and 92.4%, respectively. Tumour perforation, level of venous involvement and distant metastasis were reported in 73.9%, 21.7% and 96.7% respectively. The circumferential resection margin (CRM) in the 2 rectal tumours had 100% inclusiveness. Tumour node metastasis staging was complete in 87% of cases while Dukes staging was documented in 8.7% of the reports. Conclusion: None of the data items was 100% complete except the CRM for rectal carcinoma. Free text reporting results in incomplete data resulting in improper staging, especially the lymph node status. This highlights the need for pro forma reporting to ensure and maintain consistent reporting of important parameters required for proper staging and management of patients with colorectal cancer.

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