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Background: The use of urethral catheter is common in medical practice with up to 25% of hospitalized adults having an indwelling Foley catheter at some point during hospital stay. Its use however, is not without complications. We sought to find out the knowledge and practice patterns of physicians regarding urethral catheterization. Methodology: Self-administered questionnaires aimed at elucidating knowledge of the indications of urethral catheterization and precautionary measures effective against catheter-associated urinary tract infection (CAUTI) were distributed to physicians in a teaching hospital. Results: The majority of respondents correctly identified hemodynamic instability necessitating fluid administration (94.9%), lower urinary tract obstruction (92.1%), and assisting the healing of perineal wounds (84.3%) as appropriate indications for urethral catheter use. Incontinence (89.1%), preoperative use (88.3%), and epidural anesthesia (66.9%) were also identified as indications for catheterization. Early catheter removal (94.9%), use of condom catheter (91%), use of antibiotic coated Foley catheter (79.6%), intermittent catheterization (76.2%) and the use of automated reminders (67.6%) were correctly identified as measures that can prevent CAUTI by the majority of the respondents. Routine change of catheter was identified as an effective measure by 84% of the respondents. Conclusion: Physicians in a teaching hospital in Jos, Nigeria have adequate knowledge of indications for urethral catheter use and effective measures aimed at preventing CAUTI. More surgeons identified epidural anesthesia as an appropriate indication for urethral catheter use when compared to those of the medical specialties. Key Words Foley Catheter, Indications, Physicians, Urethral catheterization

Background: The introduction of highly active antiretroviral therapy (HAART) has significantly reduced the morbidity and mortality associated with HIV/AIDS. This benefit that HAART confers can only be maximized if patients present early. This study was embarked upon to describe the characteristics of patients presenting late at a teaching hospital in north central Nigeria. Methodology: This was a cross sectional study of patients who presented late with HIV/AIDS admitted into the medical wards of the Jos University Teaching Hospital over a one year period. Late presentation was defined as patients presenting in CDC class B or C Results: 56.7% of patients who were admitted with HIV /AIDS presented late with the majority (79%) being in CDC class C. The median CD4+ cell count was 88 cells/mm3 with a range of 12 -552 cells/mm3. Reasons for late presentation included fear of stigma 35 (46.7%), financial constraints 23 (30.7%), faith in herbal / spiritual healing 8 (10.7%) and not believing in HIV treatment 5 (6.7%). No one came to hospital in late stage because of distance from hospital. Similarly HCT services were not accessed early because of fear of stigma 37 (50.7 %), not wanting to know about status 29 (39.2 %), absence of symptoms 51(68%) and seeing partner as faithful 28 (38.9%). Tuberculosis was the commonest reason for hospitalization Conclusions: Stigma was the major reason for delayed HIV testing and late presentation.. Public education and enlightenment on the need for routine HCT and early presentation for care and treatment is advocated.Key Words HIV/AIDS, Late presentation, Stigma, Tuberculosis

Background : Chronic hepatitis B virus (HBV) infection affects 350 million persons worldwide with its attendant consequences of liver cirrhosis and liver cancer. The degree of liver damage in asymptomatic hepatitis B surface antigen positive native Africans is unknown. We report hepatic histological findings in apparently healthy Nigerians infected with HBV. Methods : This was a retrospective study of apparently healthy Nigerians (61 males and 30 females) chronically infected with HBV aged 33±10 years who had liver biopsies done at the Jos University Teaching Hospital. Results : A lanine transferase (ALT) was elevated in 36.5% and serum albumin was low in 9.9% of the subjects respectively. Fifty nine subjects (64.8%) had evidence of chronic hepatitis, with 29 (49.2%) having histologic activity index (HAI) > 7. Normal histology was present in 27 (29.6%) subjects, three (4.6%) had frank cirrhosis and two (2.3%) had hepatocellular carcinoma with one on the background of cirrhosis. Similar proportions of subjects with 2 normal and elevated ALT levels (50% vs. 51% respectively) had HAI scores > 7; X = 0.1, p =0.92. Conclusion : Our study shows that the vast majority of incidentally detected asymptomatic individuals infected with HBV have significant liver disease. Policies aimed at screening, evaluation, treatment and prevention is mandatory in our communities.

Background : Liver cirrhosis is a chronic inflammatory condition associated lipid abnormalities. There are no studies documenting lipid levels among patients with liver cirrhosis in northern Nigeria. Methodology : Seventy four consecutive patients with liver cirrhosis seen at the Jos University Teaching Hospital and 88 apparently healthy controls had lipid levels estimated in the fasting state. Results : The median serum triglyceride levels were similar in both patients and controls (2.6 mmol/L versus 2.6 mmol/L, ÷2 0.09, P=0.7). The median LDL were also similar being 2.3 mmol/L and 1.9 mmol/L respectively, ÷2 =2.75 p= 0.09. However, the median total cholesterol and HDL cholesterol levels were significantly higher in the controls compared to the 2 study subjects (4.2 mmol/L vs. 3.6 mmol/L; X = 10.1; P=0.0001, and 1.1 mmol/L vs. 0.9 mmol/L; ÷2 = 21.7l, P Conclusion : Lipid abnormalities exist in patients with liver cirrhosis. HDL-C levels are significantly reduced in these subjects. Patients with liver cirrhosis thus, should be routinely screened for such abnormalities.