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- The clinicopathological features of 103 tumours of the urinary bladder are reported; 56.3% were transitional cell and 38.8% were squamous cell carcinoma. The results support a strong association between schistosomiasis and bladder cancer. [ABSTRACT FROM AUTHOR]

The Food and Drug Administration's menu labeling rule requires chain restaurants to prominently display calories, while leaving other nutritional information (e.g., fat, sodium, sugar) to the request of consumers. We use rich micronutrient data from 257 large chain brands and 24,076 menu items to examine whether calories are correlated with widely used "nutrient profile" scores that measure healthfulness based on nutrient density. We show that calories are indeed statistically significant predictors of nutrient density. However, as a substantive matter, the correlation is highly attenuated (partial R2 < 0.01). Our findings (a) suggest that the promise of calorie labeling to improve nutrient intake quality at restaurants is limited and (b) clarify the basis for transparency of nutrient composition beyond calories to promote healthy menu choices., Competing Interests: The authors have declared that no competing interests exist.

Background: Missile injuries occupy a large segment of injuries treated in Southeast Nigeria, accounting for a significant proportion of morbidity and mortality. However, blast injuries are uncommon in this region. This study became necessary as a result of the rising spate of violence in various parts of Nigeria, particularly in the Northeast and in the Niger Delta regions, as well as the ever-present fear of kidnappers, armed robbers and occasionally, trigger-happy security agents., Aim: To determine the types of missile and blast injuries in Southeast region, the circumstances that led to them, the management of the patients, and the outcome., Design of This Study: This is a collaborative, retrospective multi-centre study. Setting: 1. Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State. 2. Imo State University Teaching Hospital, Orlu, Imo State 3. Abia State University Teaching Hospital Aba, Abia State. 4. Federal Medical Centre, Owerri, Imo State. 5. University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, all in the Southeast of Nigeria., Methodology: Patients who were treated for missile or blast injuries in the last five years in each of the collaborating institutions were studied to determine the pattern of such injuries, causes, management options and outcome., Results: Four thousand, two hundred and sixteen (4,216) patients were admitted with missile and blast injuries in the collaborating Institutions in a period of five years. Majority of the injuries (4,177{99.1%}) were from gunshots, mainly to the limbs. The 39 (0.9%) cases of blast injuries were from land mines, hand grenades, and the Biafran type of improvised explosive device, popularly known as "Ogbunigwe". Seven hundred and seventy-two (18.3%) of the patients signed against medical advice and went to traditional bone-setters. Of the remaining 3,444 patients, 3,432 (99.7%) had good outcome. However, there were a total of 12 (0.4%) deaths, four from fulminant sepsis; eight from unknown causes., Conclusion: Missile injuries account for a significant proportion of injuries treated in the Southeast of Nigeria; only a few were blast injuries. The outcome of management of the affected patients was satisfactory.

A thirty-year old married nulliparous lady had a difficult myomectomy done by a general practitioner one year prior to presentation. Two months after the operation, she had her menstruation, but with a concurrent total, painless haematuria. This combination continued for nine months before her family physician referred her to the urological clinic. Full urological work-up revealed an iatrogenic vesico-uterine fistula, but the features were not consistent with those of the classical vesico-uterine fistula syndrome. Transabdominal fistulectomy not only controlled the haematuria but also helped the patient to achieve a viable pregnancy.

Eight cases of 'fracture' of the penis in a Negro population over a 5-year period are presented. The majority of the cases occurred on the right side in association with sexual activity. All gave a positive history of sexually transmitted disease. We recommend prompt operative treatment that is aimed at full functional and cosmetic recovery.

A 13-year retrospective study of ureteric tumours in an African Negro population is reviewed. The tumour is rare. Seven cases were reported, six of them admitting to smoking over 50 packets of cigarettes per year. All the tumours were of the transitional cell type and prognosis is related to grade and staging. Nephroureterectomy with excision of a cuff of bladder was the treatment given. Follow-up was poor owing to illiteracy.

A review of 150 patients with urethral strictures treated over a period of seven years at the University of Nigeria Teaching Hospital, Enugu, showed that 83 per cent of the patients were treated with a form of bouginage. Recurrence rate among this group was 65 per cent as opposed to 44 per cent among the group treated with urethroplasty. About 40 per cent of the patients obtained good to excellent results, 26 per cent rather poor results, and the rest achieved fair results. Even though urethroplasty afforded the best results, bouginage, in spite of the high recurrence rate, should be encouraged in centers with limited facilities for urethroplasty.

Synergistic bacterial gangrene is a distressing and destructive mixed infection where early recognition is essential. It is suggested that synergistic bacterial gangrene with its allied states may be manifestations of the same process with a wide spectrum. Prompt and appropriate bactericidal therapy may arrest spread before tissue destruction makes radical and immediate surgical intervention, with its attendant high mortality, inevitable.

A plea is made for diversion of urine by suprapubic cystostomy as initial treatment in clinically established urethral injury. When early retrograde urethrography is not possible this study should be done between 3 and 6 weeks after injury, when infection or extravasation of urine at the injured site might have cleared. The quality of x-ray at this time is good and helps to determine the definitive treatment of the resultant stricture, if any. Good results were achieved in 32 patients treated along these guidelines. Poor results were achieved in 13 additional patients treated initially with interlocking sounds, even though the nature of the injury could have contributed partly to the bad result.

Pulmonary radiological features of 27 patients with a diagnosis of hepatoma were reviewed and compared with 64 controls. Coin shadows, nodular, lymphangitic or hilar node metastases were observed in 50% of the hepatoma cases. Other radiological pulmonary findings in hepatoma included statistically significant elevation of the right hemidiaphragm, double contour of the diaphragmatic silhouette and discoid atelectasis. Left hemidiaphragm changes may occur with left lobe involvement. Double contour of the crest of the diaphragm appeared to be specific and common in hepatoma in this African population. Doming of the diaphragm was not specific to hepatoma.