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Background: Since 1974 when the first Nigerian female surgeon was produced, an increasing number of Nigerian females have qualified as surgeons and more are in the various residency training programmes in Nigeria to become surgeons., Aim: To document the evolving trend of Nigerian females training as surgeons and their contribution to the surgical workforce., Methodology: A questionnaire based survey of Nigerian females who are qualified surgeons and those in the surgical training programmes from June 2016 - September 2017., Results: Sixty questionnaires were sent out, and 54(90%) responded, with 49(91%) completely answering the questionnaire. The age range of the respondents was between 29 -72 years, with a mean age of 37.5 ± 6.2 years. Twelve (22.2%) were registrars, 18(33.3%) were senior registrars, and 24(44.4%) were specialists. One respondent (1.85%) had an academic professorial chair. The reasons for the preferred choice of subspecialty included: genuine interest 44(89.8%), availability of mentors 20(40.8%), the availability of a structured programme 14(28.62%), lifestyle friendly programmes 7(14.3%), remuneration 6(12.2%), and the duration of the training 1(2.2%). Thirty three (67.4%) were married, 11(22.5%) were single and 5(10.2%) were divorced. Twenty six (78.8%) gave birth to children during their surgical training programmes, while 12(36.4%) and 5(15.2%) gave birth to children before and after their programmes respectively. Twelve (37.5%) of the respondents who gave birth during training, had disruption in their training. Four (8.2%) of the respondents, made a career switch from Surgery., Conclusion: The evolving interest of female doctors in Surgery in Nigeria as highlighted in this study is a welcome development and should be encouraged and sustained by mentoring of aspiring female surgeons even from the medical schools.

Objective: To evaluate the relevance of Electroencephalography (EEG) in the management of various neuropsychiatric conditions in University of Ilorin Teaching Hospital (UITH), Ilorin., Background: EEG is still relevant in the diagnosis and management of patients with seizure disorders and extends to other neuropsychiatric conditions. However, very few studies have examined the use of EEG in developing countries, including Nigeria., Methods: The EEG records of 154 patients between January 2012 and December 2012 were reviewed. EEG unit's records, including EEG request forms and EEG reports were examined. Socio demographic data, clinical data and the neurologist's comments on the EEG recordings were extracted and recorded on the proforma form., Results: A total of 142(92.2%) of the patients out of 154 had complete records and were studied. Majority (84.5%) of the patients were below the age of 30 years. Various types of seizure disorders accounted for 80% of the provisional diagnosis. The EEG diagnosis based on the interpretation of the EEG records showed that 96 (67.6%) of the patients had normal records., Conclusion: EEG still plays a very important role in the investigation of neuropsychiatric conditions especially epilepsy in developing countries. EEG facilities should be readily available.

Objectives: The objectives of this study were to determine the prevalence of obsessive-compulsive symptoms (OCS) among subjects with schizophrenia and also to determine their associated factors., Methods: A cross-sectional study involving 232 patients with schizophrenia were recruited from a teaching hospital in Nigeria. Socio-demographic questionnaire, Obsessive-Compulsive Inventory, Positive and Negative Syndrome Scale and Suicidality module of the MINI International Neuropsychiatric Inventory were administered., Results: The prevalence of OCS was 54.3% among patients with schizophrenia, and washing symptom was the most common (51.7%). Patients with schizophrenia that had OCS had more severe psychopathologies and higher levels of suicidality. OCS among patients with schizophrenia were also associated with the use of second-generation antipsychotic medications., Conclusions: OCS are common in schizophrenia. Hence, there is a need for routine screening of patients with schizophrenia for OCS and then, manage them appropriately.

Background: The reported health and socioeconomic consequences of ear piercing, especially in modern day society, underscore the need to further research into this subject. In this study, we determine the trends and complications of ear piercing among selected Nigerian population., Aim and Objectives: The aim and objective of this study was to draw attention to the trends and complications of ear piercing with a view to prevent its associated complications., Methodology: It is a descriptive cross-sectional study carried out between February and May 2015 among selected Nigerian population from two of its six geo-political zones. A self-administered semi-structured questionnaire which had been pretested was used to collect data from 458 respondents who consented using multistage sampling technique., Results: Of 480 respondents enumerated, 458 completed the questionnaires and gave their biodata. The male:female ratio was 1:6.2. Their ages ranged from 18 to 75 years with a mean of 35.56 ± 10.16. About 35.4% of the respondents were within the age group of 31-40 years. Majority of the respondents, i.e.,79.3% practiced ear piercing on their children. Most of them (86.8%) preferred single piercing. Ear piercing was performed within the 1 st week of birth in 37.2% of the respondents. Large percentage (93.2%) of the respondents will not encourage ear piercing in male children. Nearly 20.5% of the respondents observed complications., Conclusion: Ear piercing remained a common practice in Nigeria, with respondents preferring it on females. Majority of the piercings are done in childhood and by untrained personnel. Keloid formation was the notable complication observed by the respondents. There is a need to increase awareness about the hazards of ear piercings and to enact laws that regulate ear piercings particularly in children which is hereby stretched., Competing Interests: There are no conflicts of interest.

Background: Biopsies are often essential for definitive diagnosis of oro-facial lesions and are a part of oral diagnostic procedures carried out in histopathology laboratories. At present, there is paucity of literature on the audit of oral histopathology services in Nigeria. The objectives of this study were to determine the prevalence of biopsied oral lesions in a Nigerian tertiary institution. Also to profile the usage of oral pathology service and to identify challenges that may be present in an oral histodiagnostic service., Methods: This was a retrospective study performed at the Oral Pathology Department of the University of Ibadan/ University College Hospital, Ibadan, Nigeria. Reports of all biopsies submitted at the Oral Pathology laboratory, for the period 1990-2014, were reviewed and data extracted. Descriptive analysis was done using SPSS software, version 20., Results: The total number of reports was 1,998; invalid reports constituting 220(11%) were subsequently excluded leaving 1,778(89%) valid reports. The mean age of patients was 36.70±19.79, while the peak age of presentation was in the 3 rd decade. Male to female ratio was 1:1.1, and the mandible was the most common site of lesions 619(34.8%). These services were mainly utilized by oral surgeons (83.9%) and ameloblastoma (11.5%) was the most frequently diagnosed lesion. CD45 (16.7%) was the most frequently requested immuno-diagnostic test., Conclusion: Biopsied oral lesions were more prevalent in females, while oral and maxillofacial surgeons utilized these services the most. Inadequate biopsy specimens or unrepresentative specimens and deficient documentation were challenges identified in this study.

Background: Congenitally missing or aberrant morphology of maxillary lateral incisors may cause aesthetic and functional impairment of the affected individual. There is however paucity of information on its prevalence and pattern of presentation among Nigerians., Aim: To determine the prevalence of agenesis, peg and small maxillary lateral incisors in Nigerian orthodontic patients in Lagos, Nigeria., Study Design: A retrospective study., Setting: Orthodontic Unit, Lagos State University Teaching Hospital, Lagos, Nigeria., Methodology: The hospital folders, dental casts and panoramic radiographs of 611 patients between December 2013 and September 2014 were reviewed. The data obtained included congenital absence, size and shape of maxillary lateral incisors., Results: Out of the 611 patients studied, agenesis of maxillary lateral incisors was found in 14(2.3%) of the patients with 12(2.0%) females being significantly higher than 2(0.3%) males. The prevalence of maxillary peg laterals was 4.6% with no gender difference, while the prevalence of maxillary small lateral incisors was 3.9% also with no gender difference. A total of 20 maxillary lateral incisors were congenitally missing, while 35 peg laterals were recorded and 30 small lateral incisors were found. Unilateral agenesis of maxillary lateral incisor was more prevalent in 8(57%) patients than bilateral agenesis found in 6(43%) with significant preference for the right side 7(50%) than 1(7%) on the left. Unilateral peg maxillary lateral incisor was more prevalent in 21(75%) than bilateral peg 7(25%) with significant preference for the left side 16(57.1%). Unilateral small maxillary lateral incisor 18(75%) was more prevalent than bilateral small lateral incisor 6(25%) with preference for the left side 10(41.7%)., Conclusion: We found that the prevalence rates for lateral incisor agenesis, peg and small lateral incisor among Nigerian orthodontic patients were 2.3%, 4.6% and 3.9% respectively., Competing Interests: Competing Interests: The authors have declared that no competing interests exist.

Objective: This paper addresses price elasticity of demand (PED) in a region where most patients make payments for consultations out of pocket. PED is a measure of the responsiveness of the quantity demanded of goods or services to changes in price. The study was done in the context of an outpatient psychiatric clinic in a sub -Saharan African country., Methods: The study was performed at the University College Hospital (UCH), Ibadan, Nigeria. Aggregate data were collected on weekly clinic attendance over a 24-month period October 2008 - September 2010 representing 12 months before, to 12months after a 67% increase in price of outpatient psychiatric consultation. The average weekly clinic attendance prior to the increase was compared to the average clinic attendance after the price increase. Arc-PED for consultation was also estimated., Results: Clinic attendance dropped immediately and significantly in the weeks following the price increase. There was a 34.4% reduction in average weekly clinic attendance. Arc-PED for psychiatric consultation was -0.85., Conclusion: In comparison to reported PED on health care goods and services, this study finds a relatively high PED in psychiatric consultation following an increase in price of user fees of psychiatric consultation.

Background: Juvenile delinquency has become a significant global problem. Conduct disorder (CD), among other psychiatric disorders, has assumed prominence in its association with juvenile offending as well as criminality in adulthood. Despite this knowledge, little attention is given to this problem especially as it affects adjudicated adolescent offenders in developing countries., Aim: To examine the prevalence and correlates of CD among incarcerated adolescents in a Nigerian Borstal Institution and to investigate its independent predictors., Methods: A cross-sectional descriptive study was conducted among 147 inmates of a Borstal Institution in Abeokuta, South Western Nigeria. A self-administered questionnaire and interviewer administered MINI-KID were used. The associations between conduct disorder and socio demographic as well as forensic variables were investigated using Chi square statistics while logistic regression was used to predict CD., Results: Out of 147 respondents, 83 (56.5 %) met the criteria for CD with a mean age 17.1 ± 1.1. Of the socio-demographic and forensic variables investigated, number of siblings (OR 4. 630; p = 0.010; 95 % CI 1.433-14.964) and previous history of incarceration (OR 4. 99; p = 0.043; 95 % CI 1.048-23.846) emerged as independent predictors of CD., Conclusions: This study recorded a high prevalence of conduct disorder among a sample of incarcerated juvenile offenders. The association of conduct disorder with large family size and recidivism highlights the need for comprehensive early interventions focused on improving parental supervision in large families as well as other re-training programs aimed at reducing juvenile re-offending.

Introduction: Serum prostate specific antigen (PSA) levels increase with age and varies among different races and communities. The study was aimed at defining the age-specific reference ranges of serum PSA in our environment., Methods: We evaluated the relationship between age and serum PSA levels and the age-specific reference ranges of serum PSA among civil servants in Lagos, who underwent routine medical checkups. Criteria for inclusion were men who have no lower urinary tract symptoms, normal digital rectal examination and serum PSA ≤ 20 ng/ml. SPSS Statistic 21 was used for data evaluation and the mean, median, 95(th) percentile PSA levels were estimated. Pearson's correlation was used to examine the relationship, and P < 0.05 was considered significant., Results: 4032 men met the criteria for inclusion in the evaluation. The mean age was 51.6 (range 40-70) years, and there was a strong correlation between serum PSA levels and age (r = 0.097, P < 0.001). PSA ranges of 0-2.5, >2.5-4.0, >4.0-10, and >10 ng/ml were found in 3218 (80%), 481 (12%), 284 (7%), and 52 (1%) men, respectively. The mean, median and the 95(th) percentile PSA for the overall group were 1.84, 1.33, and 5.2 ng/ml respectively. However the 95(th) percentile PSA levels for men aged 40-49, 50-59, and 60-70 years were 4.78, 5.47, and 8.93 ng/ml respectively., Conclusion: The age-specific PSA levels among Nigerian men for each age group is higher than what was described for men in the Western world. These reference ranges of serum PSA should be considered for men aged ≥40 years in our environment.

Background: The epidemiology of fractures of the humeral shaft has received little attention in Nigeria. This study was aimed at investigating the possible risk factors associated with diaphyseal humeral fractures among Nigerians., Methods: The study was carried out retrospectively at the Department of Medical Records, National Orthopaedic Hospital, Igbobi, Lagos State, Nigeria, between 2007 and 2012. Case notes and plain films of X-ray from a total number of 206 patients of ages from birth to one hundred years (0-100 years), comprising of 140 males and 66 females, were used for the study. The analyses were done using Statistical Package for Social Sciences (SPSS) version 16.0 and presented in bar charts. The frequencies were reported as percentages. The differences in frequencies were compared using chi-square test., Results: The results showed that the percentage frequency of diaphyseal humeral fractures was significantly higher (P < 0.05) in males than in females. The main cause (P < 0.05) of diaphyseal humeral fractures was road traffic accident followed by fall., Conclusions: The major causes of diaphyseal humeral fractures are road traffic accidents and falls. Since diaphyseal humeral fracture is an issue of harsh economic consequences, adequate measures should be taken by all the parties involved, especially government agencies, to address this menace in term of road maintenance and general well-being of the citizens. Furthermore, since it was observed that different regions of the bones of interest present diverse characteristics with respect to associated risk factors, it is recommended that such studies as this should be region-based rather than whole-bone based.

Background: Association between some socio-demographic attributes and tooth wear among adult male population in a rural community of Igbo-ora, Southwestern Nigeria was investigated in this cross-sectional study., Methods: Cross-sectional study among 200 consenting adult males in Igbo-ora was carried out using a 10-item semi-structured questionnaire to obtain data on socio-demographics. Oral examination to establish the presence of tooth wear lesions was carried out by two examiners. Frequencies and percentages of relevant variables were generated. Multivariate analysis was used to test associations between categorical variables at P<0.05., Results: The mean age of participants was 35.6±11.7 years. One hundred and six (53.0%) subjects had one form of tooth wear lesion. Sixty eight (34.0%) of the subjects had attrition only and 96 (48.0%) had multiple tooth wear lesions. There was an association between age group, marital status, level of education and tooth wear (p<0.05). However, the association between occupation and tooth wear was not statistically significant (p>0.05). After adjusting for marital status, occupation and level of education, the association between age group and tooth wear was still significant. Though marital status was found to be associated with tooth wear, this association was not significant after adjusting for age, occupation and level of education. The association between some of the socio-demographic factors studied and the types of tooth wear was statistically significant (p<0.05)., Conclusion: Age group was the only independent predictor of tooth wear.

Background: Chronic psychosocial stress and serum uric acid (SUA) level have been implicated in the etiology and cardiovascular events risk factors in hypertension. Studies have reported significant benefit of exercise in the overall management of hypertension. However, studies on the effect of exercise on psychosocial stress and SUA in the management of hypertension seem scanty., Aim: The aim of this study was to determine the effect of continuous training program on SUA and psychosocial status of black African (Nigerian) population with hypertension., Subjects and Methods: Age-matched randomized controlled trial was used; subjects with diagnosis of hypertension attending the hypertensive clinic of Murtala Muhammed Specialist Hospital (MMSH), Kano, Nigeria form the population for the study. Two hundred and seventeen subjects with mild to moderate (systolic blood pressure (SBP) between 140 and180 and diastolic blood pressure (DBP) between 90 and 109 mmHg) essential hypertension were grouped into continuous (112) and control groups (105). The continuous group involved in an 8 weeks continuous training (60%-79% HR max) of between 45 and 60 min, 3 times per week, while the controls group remain sedentary. SBP, DBP, SUA, VO(2) max and psychosocial status were assessed. Student t-test and Pearson correlation test were used in data analysis., Results: The study revealed significant beneficial effect of continuous training programs on VO(2) max, SBP, DBP, SUA, and psychosocial status (P < 0.05). Psychosocial status and SUA was significantly and positively and negatively correlated respectively with VO(2) max at P < 0.01., Conclusions: This study concludes and supports the recommendations of moderate intensity (continuous) training program in blood pressure reduction, SUA and psychosocial stress management in hypertension.

Background: Type 2 diabetes mellitus initially said to be an adult disease is now reported in children and adolescents in the developed countries because of increased incidence of obesity and sedentary habits associated with westernization and lifestyle changes. There is a paucity of reports from Africa., Method: A 9 year old overweight female with a BMI of 28 kg/m(2) and a strong family history of DM in at least two generations presented with polyuria and weight loss. The mother had gestational diabetes and is on oral hypoglycaemics. Fasting blood sugar was 11.9 mmol/l. Urinalysis had +1 of glucose, no ketones. She was managed with diet control and exercise., Result: The patient has remained euglycaemic in the past two months without drugs and is losing weight., Conclusion: Type 2 diabetes mellitus is being reported in an obese Nigerian child with a family history of DM and high socio-economic class. Routine screening of overweight children with a family history of DM is recommended.

Objective: Human immunodeficiency virus (HIV)-infected patients, especially those on antiretrovirals are at risk of cardiovascular disease (CVD). The haemorheologic and fibrinolgtic activity of treatment naïve Nigerian HIV-infected patients were investigated., Methods: Blood was collected from 50 newly diagnosed treatment naïve HIV-infected patients and 50 apparently healthy HIV seronegative individuals that served as controls. Haematocrit values, plasma and serum viscosity, plasma fibrinogen concentration and euglobin lysis time were determined., Result: The mean +/- standard deviation of haematocrit value of HIV infected patients (31.70 +/- 6.33%) was significantly lower (p<0.0001) than those of controls (39.50 +/- 2.43%). The plasma serum viscosity, plasma fibrinogen concentration and euglobin lysis time of HIV-infected patients were significantly higher compared with those of controls (p<0.0001)., Conclusion: Treatment naive Nigerian HIV-infected patients have a defective blood flow and fibrinolytic system, which may predispose them to CVD.

Background: Some studies have suggested that breast cancer in black women is more aggressive than in white women. This study's aim was to look for evidence of differences in tumour biology between the two cohorts., Methods: This study compared the stage, grade and pathological expression of five immunohistochemical markers (oestrogen receptor [ER], progesterone receptor [PR], ERBB2, P53 and cyclin D1 [CCND1]) in tumour biopsies from age-matched cohorts of patients from Nigeria and England. Sixty-eight suitable samples from Nigerian (n = 34) and British (n = 34) breast cancer patients were retrieved from histology tissue banks., Results: There were significant differences between the two cohorts in the expression of ER and CCND1; and stark differences in the clinical stage at presentation. But no significant differences were observed for tumour grade., Conclusion: There was a significantly, low ER expression in the Nigerian cases which also predicts a poor response to hormonal therapy as well as a poorer prognosis. Differences in clinical stage at presentation will most likely influence prognosis between Nigerian and British women with breast cancer.

A total of 36 patients were seen and managed at the Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, Nigeria, over a period of five years (2000 to 2004). There were 28 males and 8 females (male to female ratio, 3.5:1). The ages ranged from 1 to 46 yr (mean, 14.5 yr). The burn surface area percentage ranged between 2.5 and 70% (mean, 22.9%). Flame constituted the commonest source of injury (66.7%). Other agents were scalding (9 patients = 25%) and electrical burns (3 patients = 8.3%). The sources of flame burns were kerosene lantern/stove explosion (7 patients = 29.2%); petrol explosion (7 patients = 29.2%); road accidents followed by an explosion (3 patients = 12.5%); one case each (4.2%%) involving ethanol explosion, gun powder explosion, firewood, a lighted candle that ignited furniture and then a whole house; and other unexplained sources (3 patients = 12.5%). Mortality in this study was 7 cases (19.4%). Death was due to acute respiratory distress syndrome in one patient, sepsis in five, and tetanus infection in one. We conclude that most of the injuries were preventable. Education regarding refuelling a lighted lantern/stove, discouraging the storing of petrol in the house, and driving with care will reduce the number of accidents and subsequent possible burn injuries. Children should be monitored carefully to prevent scalding from hot water and food.