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The biotolerance of water spinach (Ipomoea aquatica) to heavy metals was investigated in the Agodi Reservoir and its supplying source, the Ogunpa River, to examine the impact of aquatic pollution. I. aquatica was collected monthly from the Ogunpa River and the Agodi Reservoir. Atomic absorption spectrophotometry was used to analyse the concentration of heavy metals in the samples. A box plot was used to evaluate the tolerance of the plants to heavy metals and ecological risk quotients (ERQ) were calculated to indicate the threat to human health and environment. The concentrations of cobalt (Co), chromium (Cr), copper (Cu), nickel (Ni) and zinc (Zn) in the plants were below standard thresholds, but cadmium (Cd), iron (Fe), manganese (Mn) and lead (Pb) were present in higher than permissible levels. The ERQ of Cd in I. aquatica in the Ogunpa River was at an elevated ecological risk level in January (3.450), May (3.125), June (8.175), August (1.900) and September (2.025). The ERQ of Co, Cr, Cu and Ni in plants from both the reservoir and the river were less than one. The ERQ and biotolerance of heavy metals in this study indicated that I. aquatica is effective in binding heavy metals. [ABSTRACT FROM AUTHOR]

This study assessed the performance of SD Bioline MPT64 immunochromatographic test for the identification of Mycobacterium tuberculosis complex (MTBC) in Nigeria. A total of 157 mycobacterial isolates, comprising 120 (76.4%) MTBC (M. tuberculosis, 112; M. africanum, 5; M. bovis, 3) and 37 (23.6%) non-tuberculous mycobacteria (NTM) isolates from patients attending six DOTS centers in Lagos between June 2012 and July 2014 were analyzed. All the isolates were grown on Bactec MGIT960 liquid media and identified in parallel by the conventional method and MPT64 immunochromatographic test. Discrepant results were resolved using the line probe assay. The comorbid disease rates for HIV and type 2 diabetes were 20.9% and 8.2%, respectively. Compared to the conventional method, SD Bioline MPT64 identified 117 MTBC isolates correctly, producing a sensitivity of 97.5% (95% CI, 92.9–99.2) at a shorter growing median time of 11 days compared to 26 days by the conventional method. The three undetected MTBC were confirmed by the line probe assay to be M. tuberculosis strains. The test also identified all the NTM correctly producing a specificity of 100% (95% CI, 90.7–100). This study supports the integration of SD Bioline TB MPT64 antigen test into diagnostic workflow for rapid MTBC case identification in Nigeria. [ABSTRACT FROM AUTHOR]

Objective: The aim was to determine the breastfeeding practices of mothers of children two years and below in Egor Local Government Area (LGA) of Edo State. Design: This is a community-based descriptive cross-sectional study. Subjects were recruited consecutively by multi-staged sampling technique. A semi-structured researcher-administered questionnaire was used to obtain information from the respondents. Setting: Subjects were from the Edaiken community in Egor LGA State, Nigeria. Subjects: Mother and child pairs were recruited. Outcome measures: The early initiation of breastfeeding rate, prevalence of exclusive breastfeeding and the duration of breastfeeding were calculated from the information obtained from the mothers. Factors associated with the practice of early initiation of breastfeeding and exclusive breastfeeding were also determined. Results: A total of 186 mothers (44.5%) of the 418 recruited initiated breastfeeding (early) within one hour of delivery. The prevalence of exclusive breastfeeding (EBF) was 36.6%. Maternal education was significantly associated with the practice of EBF while maternal age and delivery facility were significantly associated with early initiation of breastfeeding. The median duration of breastfeeding was 15.1 ± 2.3 months. Conclusion: Less than half of the mothers of children aged 1–24 months in Egor LGA practised early initiation of breastfeeding and exclusive breastfeeding. Nutritional education at the community level should be embarked upon by the Local Health Authority of Egor LGA to improve these practices. [ABSTRACT FROM AUTHOR]

Background: Postgraduate training in Family Medicine in Nigeria began over three decades ago, but it was not until recently that the National University Commission (NUC) made it a policy for all Nigerian universities to include undergraduate Family Medicine training in their curriculum. This study aimed to assess the awareness and perception of Family Medicine among medical students at the University College Hospital (UCH), Ibadan. Method: A descriptive cross-sectional study was conducted over a period of four weeks (June 11–July 6, 2018) among 131 fourth-year, 118 fifth-year and 163 sixth-year medical students at UCH, Ibadan. Data were obtained using a self-administered questionnaire. Results: Data were collected from 309 (75% of the target population). The mean age of the respondents was 22.3 ± 2.3 years. The majority (74.4%) did not have a family member who was a doctor and only 2.3% had a family member who was specialising in Family Medicine. Most of the participants (68.9%) had good knowledge of Family Medicine, while 57.3% had good perception of Family Medicine as a specialty. Importantly, an increase in year of clerkship was associated with an increase in the knowledge of Family Medicine among the respondents. Conclusion: It was observed that with increase in length of exposure to Family Medicine as a specialty, knowledge and perception of the specialty improved among the medical students. It is imperative that all the medical schools in Nigeria implement the NUC directive and start undergraduate Family Medicine training. [ABSTRACT FROM AUTHOR]

Background: The Nigerian literature on the preference for specialties under the West African College of Physicians (WACP) among medical graduates reported a preference for core specialties (Internal Medicine and Paediatrics). This finding is at variance with the number of certified new fellows produced by different faculties under the WACP (reality). The aim was to compare the preference for specialties under the WACP by medical graduates in the published literature (2006–2017) with the number of new fellows produced by the faculties under the WACP (2006–2015) and provide explanations for any observed disparity. Methods: A systematic review was done on primary studies databases, which were searched electronically. Based on the inclusion criteria, 14 eligible studies were reviewed. The number of certified new fellows produced by the WACP in a 10-year period (2006–2015) was also analysed. Results: The reviewed studies were mainly of cross-sectional design. The majority of the studies (n = 12) reported Internal Medicine and Paediatrics as the preferred specialty choice among the specialties under the WACP. Six of the 14 studies did not list Family Medicine as one of the specialties in their results section. Ironically, the faculty of Family Medicine had the highest number of certified fellows (n = 288 [21.4%]) in the WACP over a 10-year period (2006–2015). Conclusion: There is a disparity between what the literature reports on the preference of Nigerian medical graduates for specialties under the WACP and the reality. This is particularly noted in the Family Medicine specialty. The unpredictable postgraduate medical experiences that may change prior choices of future specialisation makes longitudinal and qualitative study designs appropriate for this theme to reveal new or changed motives. [ABSTRACT FROM AUTHOR]

Background: In spite of the availability of myriads of antihypertensive medications, the control of high blood pressure is still low. Studies on effect of lifestyle behavioural changes through counselling on blood pressure control are scant in Nigeria. Therefore, this study set out to determine the role of lifestyle counselling on behavioural change among hypertensive patients attending the Federal Medical Centre, Ido-Ekiti. Methods: A total of 322 adult hypertensive participants who had been on treatment for at least three consecutive months were randomised into two groups. Relevant data were collected using an interviewer-administered semi-structured questionnaire and clinical parameters were measured pre- and post-intervention. The intervention group was counselled on lifestyle behaviours, namely regular exercise, eating adequate fruits and vegetables, moderate alcohol intake and cessation of smoking. Results: Post-intervention, among the intervention group 22.4%, 71.4% and 100%, as compared with the control group at 6.2%, 41.0% and 87.6%, met recommendations for physical activity, fruit and vegetable consumption and alcohol consumption respectively. The difference in each category was statistically significant (p < 0.001). However, the difference in smoking habits between the two groups (83.9% vs. 79.5%) was not statistically significant (p = 0.313). There was a statistically significant difference (p ≤ 0.001) in the difference in mean arterial pressure (96.4 ± 8.1 vs 106.2 ± 7.6 mmHg) between the intervention and control group post-intervention. Conclusion: Lifestyle modifications form part of an important and effective treatment modality for hypertension. It is desirable that primary care physicians devise and implement clinical and public health strategies that promote and maintain a combination of pharmacologic interventions and lifestyle modifications. [ABSTRACT FROM AUTHOR]

Objective: To investigate life-threatening maternal complications related to hypertensive disorders of pregnancy (HDP) in Nigerian public tertiary hospitals.Design: Secondary analysis of a nationwide cross-sectional study.Setting: Forty-two tertiary hospitals.Population: Women admitted for pregnancy, childbirth or puerperal complications.Method: All cases of severe maternal outcome (SMO: maternal near-miss or maternal death) due to HDP were prospectively identified using the WHO criteria over a 1-year period.Main Outcome Measures: Incidence of SMO, health service events, case fatality rate, and mortality index (% of maternal death/SMO).Results: Out of 100 107 admissions for maternal complications, 6753 (6.8%) women had HDP. Pre-eclampsia (PE) (54.5%) and eclampsia (E) (30.4%) were the most common HDP recorded. SMO occurred in 587 women with HDP: 298 maternal near-misses and 289 maternal deaths. The majority (93%) of the women with SMO due to HDP were admitted in a critical condition. The median diagnosis-definitive intervention interval was over 4 hours in a quarter of women who died from HDP. For PE and E, case fatality rates were 1.9 and 10.4%, respectively, although both conditions had a similar mortality index of 49.3%. Lack of antenatal care and place of residence further than 5 km from the hospital were associated with maternal death.Conclusions: Severe maternal outcomes from HDP were due to late presentations and health system challenges. To reduce maternal deaths from HDP, health system strengthening that would engender early hospital presentation and prompt treatment is recommended.Funding: The original research that generated the data for this secondary analysis was funded by the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a co-sponsored programme executed by the World Health Organization (WHO). We have no other funding issue to declare for our study.Tweetable Abstract: Eclampsia is the leading cause of maternal death in Nigerian hospitals. [ABSTRACT FROM AUTHOR]

Background: Most of the Nigerian studies on the determinants of diabetes self-management have focused on patient-related factors. There is no previous local study that examined the quality of diabetes self-management education provided by primary care physicians to people with diabetes mellitus. Methods: A descriptive cross-sectional study was conducted among 105 primary care physicians during a workshop. The quality of diabetes self-management education provided by the physicians was assessed using a self-designed scale of 39 Likert questions derived from American Association of Diabetes Educators seven domains of diabetes self-management. Cronbach's reliability coefficient of each domain/subscale was ≥ 0.7. The data was analysed using the independent sample t-test and one-way ANOVA. Results: Over half of the physicians provided ‘inadequate quality’ diabetes self-management education in all the domains. Physicians had the highest mean score in the ‘taking medication’ domain (4.35 ± 0.59). The mean scores in the ‘problem-solving domain’ (3.63 ± 0.74) and the ‘being active domain’ (3.57 ± 0.71) were low. The quality of diabetes self-management education provided by the physicians was not associated with any of the physician characteristics. Conclusion: The quality of physicians’ communication of diabetes self-management was suboptimal in this study. The majority of the adequately communicated diabetes self-management behaviours were risk factors reduction related and disease-centred. Thus, training of primary care physicians on diabetes self-management education is recommended because of the key role these physicians play in diabetes management in resource-poor countries. [ABSTRACT FROM AUTHOR]

Introduction: Prelacteal feeding practice contravenes the recommendation of World Health Organisation that breastfeeding be initiated within an hour of childbirth. Consequently, the health, social, emotional and economic benefits of optimal breastfeeding are limited. Therefore, to break this vicious cycle of prelacteal feeding and suboptimal breastfeeding, factors associated with the practice must be identified. Objective: To assess prelacteal feeding practices and its associated factors in a rural community with the view to generate data for community-level interventions that will promote optimal breastfeeding. Methods: Data was collected during a community-based surveillance for maternal, newborn and child health project in Tsibiri, a rural community in north-western Nigeria. The survey questionnaire was uploaded into mobile devices running on an android operating system. Trained female interviewers collected the data over a period of one week in 2011. Results: A total of 270 out of 309 interviewed women had experienced childbirth and were included in the analysis. Majority (85.2%) of respondents utilised prelacteal feeds for their newborns. Plain water was the most common prelacteal feed (44.7%). Prelacteal feeding was associated with births assisted by unskilled birth attendants (AOR 5.322, 95%CI 1.634-17.333); while operative delivery reduced the likelihood of the practice (AOR 0.168, 95%CI 0.060-0.470). No statistically significant association was found between use of prelacteal feed and women’s age, education or access to income. Conclusion: The predominance of prelacteal feeding practices underscores the need for innovative strategies that create awareness among mothers and health care providers, with emphasis on health facility deliveries, advantages of breastfeeding and risks of prelacteal feeding. [ABSTRACT FROM AUTHOR]

Background: The prevalence of metabolic syndrome varies by the definition used and the population studied. In order to make comparison among various studies possible, a new criterion which harmonizes the previous definitions was proposed. This study aims to determine the prevalence of metabolic syndrome with the harmonized criteria, and its concordance with the International Diabetes Federation (IDF), and National Cholesterol Education Programme-Adult Treatment Panel (NCEP-ATP III) criteria. Methods: One hundred and two apparently healthy individuals who participated in health screening were evaluated for metabolic syndrome. The blood pressure and anthropometric parameters were measured according to standard protocol, and fasting plasma glucose and lipid profile were determined. Metabolic syndrome was defined using the Harmonized, IDF and ATP III criteria. The agreement among the three diagnostic criteria was determined with kappa statistics. Results: The prevalence of metabolic syndrome was 4.9%, 3.9% and 4.9% with harmonized, IDF, and NCEP-ATP criteria respectively. Compared to the males, the prevalence was greater in females: Males vs Females (harmonized, 2.2% vs 7.0%; IDF 2.2% vs 5.3%; NCEP-ATP III, 2.2% vs 7.0%). The commonest risk factor in this population was low HDL occurring in 93.0% and 378% of females and males respectively, followed by central obesity (50.9% in females, 13.3% in males with harmonized and IDF criteria; 33.3% in females, 4.4% in males with NCEP-ATP criteria), hypertension (12.5% in females, 18.6% in males) and hyperglycaemia (4.2% in females, 0.0% in males) in that order. None of the participants had elevated Triglyceride. There was a substantial concordance between the harmonized and the IDF (k=0.884) as well as the harmonized and NCEP-ATP III (k=1.000) definitions. Conclusion: The prevalence of metabolic syndrome was low in this population. There was a substantial agreement among the three diagnostic criteria. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is a significant public health problem. Despite being a phenomenon that occurs globally, few studies have reviewed the issue of intimate partner violence among pregnant women as it relates to disclosure of abuse. This study sets out to determine the prevalence and pattern of disclosure of intimate partner violence among pregnant women attending antenatal clinic in Oyo East Local Government of Oyo State. Methods: A descriptive cross-sectional study among pregnant women aged 18-49 years. A total of 350 pregnant women in the sole secondary health care facility and 3 out of the 18 primary health care facilities randomly selected by balloting were consecutively recruited. A pre-tested semi-structured questionnaire adapted from the WHO Multi-Country Study on Women's Health and Domestic Violence was used to collect data. Data were analysed with SPSS® version 16. Results: Of 252 (72.0%) women who had been exposed to violence by their partner in pregnancy, 72 (28.6%) disclosed their IPV experience. The experience was disclosed to relatives, friends and religious leaders. Of the 72 that disclosed their IPV experience, 31 (43.1%) reported for the purpose of seeking redress through religious or local leaders, healthcare professionals and law enforcement agencies. Conclusion: Intimate partner violence is common among pregnant women, but a culture of silence still persists, making identification of the exposed difficult. These data may encourage healthcare providers to include screening for IPV in the curriculum of the antenatal care. [ABSTRACT FROM AUTHOR]

Background: It has been proposed that the overexpression of the human epidermal growth factor receptor 2 (HER2/neuproto-oncogene) could be a possible therapeutic target in epithelial ovarian cancer, as has been the case in breast carcinomas. However, there is lack of knowledge on the status of the gene in neoplasms which occur in black women. The objective of this study was to determine HER2/neuexpression status in EOC in black women. Method: Ninety cases of EOC were evaluated for HER2/neuprotein expression using immunohistochemistry. Results: HER-2/neuexpression was observed in 33 of the 90 cases (37%), of which 15 EOC cases (17%) were weakly or moderately positive, and 18 (20%) strongly positive. A significant association was not found between HER-2/neuexpression and age, International Federation of Gynecologists and Obstetrics (FIGO) stage, grading and histological subtypes (p-values of 0.463, 0.360, 0.975 and 0.168, respectively). However, there were more cases of advanced-stage disease (III/IV) with HER-2 expression than early-stage EOC (I/II). In this study, 21%, 36% and 42% of HER2/neu-positive tumours were grades 1, 2 and 3, respectively. A higher proportion of serous carcinomas (as opposed to mucinous carcinomas) was also observed to be HER2/neupositive. Conclusion: HER2/neuexpression was observed to increase with advanced stages of cancer, and was more commonly seen in serous, rather than in mucinous, carcinomas. [ABSTRACT FROM PUBLISHER]

The article discusses a study that aims to examine the effect of an educational programme on the attitude of community volunteers towards mental illness in Nigeria. The study was part of the evaluation of a mental health education programme in Pakoto, Nigeria. It was done according to the guidelines in the current version of the Declaration of Helsinki. It is said that the study's limitations include its small, non-random sample, and lack of control group.

Purpose: The aims of this study were to determine the QoL of Nigerians with lower limb amputation and to investigate the influence of some clinical and socio-demographic variables on it. Method: Forty-seven individuals with lower limb amputation participated in this study. Participants' age, gender, marital status, occupation, time since amputation, level of amputation, affected limb and use of prosthesis were recorded. Quality of life was then measured using the WHO QOL-BREF. Data were analysed using mean and standard deviation, Mann-Whitney U test and Kruskal-Wallis test at 0.05 alpha levels. Results: Participants' overall health and QoL scores were 3.6(SD 0.9) and 3.9 (SD 0.7) respectively. Male subjects had significantly higher scores than females in the domains of physical health (p = 0.007), social relationships (p = 0.024) and overall health (p = 0.012). Prosthesis-wearing subjects scored significantly higher in the domains of physical health (p = 0.015), psychological health (p = 0.008) and environment (p = 0.011) and overall health (0.033), than those not wearing prosthesis. Level of amputation, leg dominance and pre-amputation occupational category had no significant influence on participants' QoL. Conclusion: The findings of this study suggest that the QoL of individuals with lower limb amputation in Nigeria is moderate. The only factors which have significant influence on some QoL domains are gender and use of prosthesis.Implications: Individuals with lower limb amputation, particularly females and those not wearing prosthesis, require special attention. Clinicians should identify barriers to the use of prosthesis so as to enhance their quality of life. [ABSTRACT FROM AUTHOR]

In Africa, epidemiological data on the effect of the HIV epidemic on the occurrence of lymphomas are scanty. The 1990s witnessed the alarming rates of HIV/AIDS in Nigeria. The prevalence of HIV/AIDS in Nigeria increased from 1.8% in 1991 to 4.4% in 2005. The aim of this study was to determine whether there have been any changes in the frequency and pattern of lymphomas in view of the HIV/AIDS epidemic in the country. This is a retrospective study of all lymphoma cases diagnosed during 1991-2005. The prevalence of lymphomas declined from 1.4% to 0.7% of surgical biopsies during 1991-2005. There was a decline in the proportion of high-grade non-Hodgkin lymphoma and Burkitt's lymphoma from 79.1% and 45.8% respectively to 21.1% and 13.6% respectively. There is a suggestion that the HIV/AIDS epidemic in the country may not have influenced the pattern of occurrence of both major histomorphological types of lymphoma in Ibadan. [ABSTRACT FROM AUTHOR]

Oduwole AO, Uko RI, Tade T, Doherty OK, Nwodo R, Imafidon EO. The effect of home visits on the quality of life of children and adolescents with type 1 diabetes mellitus. Objective: The aim of the study was to analyze the impact of home and school visits and to strengthen the knowledge on diabetes education on the quality of care and life of children and adolescents with diabetes. Methodology and results: This was a descriptive cross-sectional study of all children and adolescents (n = 16, seven males and nine females), attending a pediatric diabetes center (mean age: 11.25 yr ± 4.82, range: 5-17 yr), mean duration of diabetes being 4.6 ± 3.9 yr, range 0.5-8.4 yr. Ten patients were visited by the medical social worker at home and school, their knowledge ondiabetes education was strengthened, and intervention effect was evaluated 4 months later. Positive effects observed were that clinic visits became regular, there was notification by school of clinical status, a reduction in number of hypoglycemic episodes at school, increased acquisition of glucometers, and daily and regular (100%) self home blood glucose (BG) monitoring. The mean center HbA1c was reduced from 12.86 ± 2.5% to 9.41 ± 1.56%, the change from previsit was 3.45%. The mean center morning BG dropped from 181.60 ± 71.96 to 127.54 ± 27.54 mg/dL reflecting change from previsit BG of 54.19 mg/dL. However, these visitations had little effect on checking of BG at school. Conclusion: This study stressed the importance of home and school visits and diabetes education on the quality of care and life of the children and adolescents with diabetes in our region. [ABSTRACT FROM AUTHOR]

To address the needs of young people in Lagos State, Nigeria, for information about family life and HIV, the Lagos State Ministry of Education, in collaboration with Action Health Incorporated, began to offer the Family Life and HIV Education Curriculum in government junior secondary schools in 2003. Knowledge and attitudes were measured in a sample of 1,366 students in Lagos State, Nigeria, in November 2004, at the beginning of the school year, and again in July 2005 after receiving a year of the Family Life and HIV Education Curriculum. Students exposed to the curriculum significantly increased knowledge of sexuality and HIV, support for abstinence, and gender role equality. [ABSTRACT FROM AUTHOR]

This study was a crossectional survey conducted among 716 senior secondary school adolescents in Ibadan from March to August 2005. The result of 695 that was analyzed revealed that the mean age of 15±2.6years. 28.3% of the respondents had previous sexual exposure with higher proportions being male (p=0.00043). Majorities' first sexual exposure was unplanned. Family settings and educational level do not have significant influence on the previous sexual exposure. The methods of sexual activity were mainly through vagina route while some had also practiced oral and anal sex. Most of those that are sexually exposed had more than one partner. About half of the respondents learn about sex from their friends while others through their parents and media. We conclude that in-school adolescents practiced unsafe sexual activity and they are therefore predisposed to STI/HIV and other reproductive health risks. [ABSTRACT FROM AUTHOR]

Eclampsia is a well-recognised major cause of maternal death and perinatal morbidity and mortality. The incidence of eclampsia, its presentation patterns, maternal and perinatal outcomes were investigated in a retrospective study conducted at the University of Benin Teaching Hospital, Nigeria over an 8-year period, 1995 - 2002. There were 103 cases of eclampsia of 7835 deliveries, giving an incidence of one in 76 (1.32%). The mean age of the women was 27.1 ± 5.6 years. Eclampsia significantly ( P  < 0.001) occurred in nulliparous and unbooked mothers. Eighty-nine (86.4%) of the patients developed fits in the predelivery stage; 85 (83%) of the patients had at least one premonitory symptom including headache (82.4%) visual disturbance (10.6%) and epigastric pain (7%). There were nine stillbirths and 16 early neonatal deaths for a perinatal mortality rate of 214/1000. The major causes of perinatal mortality were prematurity and birth asphyxia. Eleven maternal deaths occurred with a maternal case fatality rate of 10.7% and a maternal mortality ratio from eclampsia of 140/100 000. The clinical causes of deaths were cardiopulmonary failure, acute renal failure, haemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome and cerebrovascular accident. Timely referral of high-risk patients coupled with availability of emergency obstetric and neonatal care services would reduce the incidence eclampsia associated mortality and morbidity in our facility. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate the socio-economics and medicinal utilization of Spondia monbin, commonly known as plum in English and iyeye in Yoruba. Methods: Three communities were selected in Abeokuta which was Itoku, Kuto, and Omida using purposive random sampling technique because of the concentration of users in the area. Structured questionnaire was administered to randomly selected marketers, consumers and herbalists from the three communities. Utilization and marketing margin were descriptively analyzed. Results: The results showed that the leaves were being used for child birth aid, cough, sore throat, efu dudu, antiseptic soap, malaria and stomachic. The bark uses included child birth aid, inflammation concoction, fever, stomachic, malaria, and efu dudu. The uses of the fruit included cure for dizziness, stomachic, eaten as food, and fibroid. The seed were also being used for child birth aid, fibroid, and stomachic. The marketing margin analyses revealed that trading on the plants was profitable with the bark having the highest margin which showed the level of its profitability. Conclusions: The study reveals the medicinal potentials and the socioeconomic importance of Spondia mombin hence the need to conserve the species from unsustainable exploitation to ensure its availability. [Copyright &y& Elsevier]

Background: HIV exposed children could require surgical procedures when ill. This study assessed how paediatric HIV/AIDS affected surgical practice among Nigerian paediatric surgeons., Methods: Descriptive cross-sectional study among consenting paediatric surgeons completing a self-administered questionnaire on the current practices and perception on HIV/AIDS in relation to their surgical practice. Data were analyzed using descriptive and inferential statistics., Results: Thirty eight out of forty two copies of questionnaire distributed were completed and included in analysis giving a response rate of 92.5%. Most of the respondents (73.7%) were Consultants and had practised more than 10 years. Mean (SD) age was 42.4 (7.5) years ranging from 31 to 63 years. Nearly all the 35 (92.1%) respondents were males while 3 (7.9%) were females. All of them had operated on known HIV positive children. Over half (57.9%) were in support of pre-operative HIV screening with most (76.3%) worried about getting infected during surgery. Most paediatric surgeons knew their HIV status (81.6%) and would undergo HIV screening preoperatively (84.2%) when requested by their patients or their caregivers. Only 5 (22.7%) out of 22 surgeons were screened previously because of needle stick or sharp instrument injury during surgical procedure. Only 6 (15.8%) surgeons rated their cross infection control practices as excellent., Conclusion: Increasing number of HIV positive children are presenting to pediatric surgeons for surgical treatment in Nigeria in which at present surgical practices are inadequate in terms of cross infection control practices. There is need to optimize cross infection control practices through adequate provision of safe surgical devices.

The present study was performed to compare the incidence of endodontic flare ups in single with multiple visits treatment procedures, to establish the relationship between pre-operative and post obturation pain in patients attending for endodontic therapy in a Nigerian teaching Hospital. Patients were randomly assigned to either single visit or multiple visits group. Data collected at root canal treatment appointment and recall visits (1st, 7th and 30th day post obturation) include pulp vitality status, the presence or absence of pre-operative pain, presence and degree of post obturation pain. Presence of endodontic flare-ups (defined as either patient's report of pain not controlled with over the counter medication and or increasing swelling). The compiled data were analyzed using chi-square where applicable. P level < 0.05 was taken as significant. Ten endodontic flare-ups (8.1 %) were recorded in the multiple visits group compared to 19 (18,3%) flare-ups for the single visit group, P = 0.02. For both single and multiple visits procedures, there were statistically significant correlations between pre operative and post obturation pain (P = 0.002 and P = 0.0004 respectively). Teeth with vital pulps reported the lowest frequency of post obturation pain (48.8%), while those with non vital pulps were found to have the highest frequency oh post obturation pain (50,3%), P = 0.9. Although the present study reported higher incidences for post obturation pain and flare-ups following the single visit procedures, single visit endodontic therapy has been shown to be a safe and effective alternative to multiple visits treatment.