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Organ shortage is a major public health challenge for transplant programs globally. The sustenance of such programs as an effective therapy for end-stage organ failure (ESOF) requires an exploration of public awareness and willingness to donate organs. This is imperative, especially in developing countries where ESOF is highly prevalent. We studied the awareness and predictors of public attitude toward organ donation in Kano city in northern Nigeria. Using interviewer-administered questionnaires, we assessed the awareness and willingness to donate solid organs among 400 adults in the Kano metropolis. Three hundred and five of the 383 respondents (79.6%) reported that they had heard about organ donation. There was a significant variation of awareness by education and ethnicity (P <0.05). Most respondents, 303 (79.1%), were willing to donate an organ. Gender [adjusted odds ratio (AOR) = 2.13; 95% confidence interval (CI): 1.40-4.95], educational attainment (AOR = 2.55; 95% CI: 1.35-5.88), marital status (AOR = 4.5; 95% CI: 2.97-9.1), religion (AOR = 3.40; 95% CI: 1.43-8.10) and ethnicity (AOR = 2.36; 95% CI 1.04-5.35) were significant predictors of willingness to donate an organ. Preferred organ recipients were parents (48.9%), children (21.3%), spouses (14.6%) and other relatives (13.4%). Reasons for willingness to donate organs included religion (51.2%), moral obligation (21.4%) and compassion (11.9%), among others. However, there was widespread ignorance of religious precepts concerning organ donation. The high level of awareness and willingness to donate organs in this society could be further enhanced by intensive information, education and communication strategies providing clear messages on societal benefits, religious aspects and bioethical guidance regarding organ donation.

Background: Fistula-in-ano when complicated by Fournier's gangrene is an unusual finding and always carries high morbidity. This study details our experience in managing 10 cases., Methods of Study: Case files of all patients managed in University of Maiduguri Teaching Hospital and Federal Medical Center of Yola and Gombe from January, 2007 to December, 2011 were retrieved from Medical Record Departments and other Hospital Records. These were analyzed for demographic, clinical and pathological variables, the type of treatment and follow-up., Results: A total of 10 men with a mean age of 50.5 years (35-60) were managed in the period of study. Nearly, 50% of the patients were farmers, 30% businessmen and 20% were civil servant. 7 (70%) of these patients presented with Fournier's gangrene within 4 weeks of development of fistula-in-ano and the rest within 8 weeks. 4 (40%) of these patients had inadequate drainage of their perianal abscess and 2 (20%) had incision and drainage. Another 4 (40%) had spontaneously rupture of the perianal abscess. 6 (60%) of the fistula-in-ano was submuscular, 30% subcutaneous and 10% were complex or recurrent. Nearly, 20% of patients had fistulotomy and seton application for adequate drainage. Mucosal advancement flap was performed in 5 (50%) and fistulotomy in 3 (30%) patients. Another 30% had fistulotomy and continuing sitz bath., Conclusion: Cryptoglandular infection is an important cause of perianal abscesses and fistula-in-ano and if poorly managed results in Fournier's gangrene. Early broad spectrum parenteral antibiotic therapy and primary surgical treatment can prevent Fournier's gangrene.

The major long-term complications of renal transplantation (RT) include cardio-vascular disease, opportunistic infections, malignancies, and chronic allograft nephropathy. Long-term complications are generally considered as those occurring more than 1 year post trans-plantation; however, some of the complications can occur earlier. We present a 58-year-old man who presented with multiple complications of RT concurrently and relatively early post trans-plantation including Kaposi's sarcoma, tuberculosis and allograft dysfunction.

Amyloidosis is a rare systemic disorder of protein metabolism with progressive extra-cellular deposition of insoluble fibrillary protein, disorganization of tissue architecture, and subsequent organ dysfunction. Primary amyloidosis is the most common form of this disorder, however, it can develop secondary to plasma cell dyscrasias such as multiple myeloma (MM); 10-15% of MM patients may develop amyloidosis of vital organs. Amyloidosis is usually associated with bleeding, but less commonly with thrombosis. We present a 52-year-old Saudi female with amyloidosis secondary to multiple myeloma. She presented with both venous and extensive arterial thrombosis. Although relatively rare, plasma cell dyscrasias such as amyloidosis and multiple myeloma could present with thrombotic rather than hemorrhagic complications.