Background: Cervical cancer is the most common genital tract malignancy among women in developing countries. Objective: To assess the awareness of cervical cancer among Igbo women in a rural population of Southeastern Nigerian and determine their uptake of cervical screening services. Materials and Methods: A questionnaire-based descriptive cross-sectional study. Structured questionnaires were administered to female attendees to the antenatal and gynecological clinics of a secondary hospital in the outskirts of Afikpo, Southeast Nigeria over a six-month period (1 ^st July to 31 ^st December 2007). Data analysis was by SPSS. Results: Five hundred questionnaires were given out. Three hundred and sixty were correctly filled (72%) and analyzed. The mean age of respondents was 36.2 years, 25.0% had tertiary education and 40.3% were self employed. All the respondents were sexually active. There were high incidences of premarital sex, multiple sexual partners and abnormal vaginal discharge and low condom use. Awareness of cervical cancer (37.5%), its preventable nature (31.9%), cervical screening (25%) and screening centers (20.8%) were generally low and screening uptake (0.6%) was abysmally low. Lack of awareness, non-availability of screening centers locally, cost and time were the main reasons adduced by respondents for not being screened. Overall, 62.5% of all the respondents indicated willingness to be screened. Conclusion: The exposure to conditions that predispose women to cervical cancer was high, and the levels of awareness of cervical cancer and cervical screening uptake were low. Continued awareness creation, local provision of cheap and affordable services and poverty alleviation are needed to improve cervical screening uptake with the hope of reducing the incidence of cervical cancer in the long term.

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Background: Diarrhea is widely recognized as a major cause of childhood morbidity and mortality in many developing countries, particularly in sub-Saharan Africa. According to World Health Organization (WHO) report in the African region, diarrheal diseases are still leading causes of mortality and morbidity in children under five years of age. This same report indicates that each child in the said region has five episodes of diarrhea per year and that 800,000 die each year from diarrhea and dehydration. Materials and Methods: This study examined diarrheal morbidity and associated risk factors in children under five years in Jos. A total of 340 children were seen in the Diarrhea Training Unit (DTU) of the Jos University Teaching Hospital (JUTH), Jos, over a period of 24 months (Jan 2008-Dec 2009). A semi-structured interviewer administered questionnaire was used to generate the data. All women whose children presented with diarrhea were interviewed and data generated analyzed using Epi info version 3.5.1 statistical software. Results: During the study period, 13,076 children were seen in our facility, of which 340 were suffering from diarrhea, thus giving a diarrhea prevalence of 2.7%. There were 183 (54%) male and 157 (40%) female children seen with diarrhea. The mean age was 11 ± 8.5 months. The mean duration of diarrhea was found to be 4 ± 3.6 days. A majority of children were aged less than 6 months, consisting of 235 infants, 95 toddlers, and 10 pre-schoolers. Of the number of women seen, 242 (61%) had at least primary education, while 98 (29%) had no formal education. Diarrheal episodes were found to have a bivariate association with mothers' educational status, family type, family size, breastfeeding, and sex of child. However, only mother's educational status, diarrhea in other sibling, and breast feeding were significantly associated with the occurrence of diarrhea. Although there were more male children with diarrhea, the odds of having diarrhea was not significantly related to sex. Conclusion: Our study demonstrated an important relationship between diarrheal morbidity and low maternal education, nonexclusively breastfed infant, and previous diarrheal episode in a sibling. It thus meant that diarrhea morbidity is still an important problem for infants in our environment. Moreover, maternal education and exclusive breastfeeding are still relevant viable measures in curbing diarrhea in infants.

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Background: Dyslipidemia is a major risk factor for cardiovascular disease. Data are scanty on the prevalence and pattern of dyslipidemia in Nigeria. However, some studies on the subject are now becoming available. This article reviews these studies on the prevalence and pattern of this important risk factor for cardiovascular disease in Nigeria. Materials and Methods: Intensive internet search on studies done in different parts of Nigeria showing the prevalence and pattern of dyslipidemia in various focal groups that include apparently healthy individuals, the elderly, diabetics, hypertensives, and diabetic hypertensives was carried out . Results: Dyslipidemia was highly prevalent in all the geopolitical zones of Nigeria with the consistent pattern being low HDL-Cholesterol and high LDL-C. Overall, the prevalence of dyslipidemia ranged from 60% among apparently healthy Nigerians to 89% among diabetic Nigerians. Conclusion: Dyslipidemia is highly prevalent in Nigeria and health education to increase awareness of the need for and to actually screen for dyslipidemia will facilitate early detection and treatment.

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Bilateral calcification involving the basal ganglia (Fahr's disease) is a rare disease. A high index of suspicion is required to make clinical diagnosis; more so that the calcinosis may remain asymptomatic in a vast majority of cases. Movement disorder is by far the most common manifestation in symptomatic individuals. Fahr's disease is by no means absent in our environment, and increasing availability of a computed tomography-scan machine in Nigeria may enhance the case identification of Fahr's disease. This review presents a case of bilateral strio-pallido-dentate calcification; it also affirms the fact that Fahr's disease could present with hyperkinetic movement disorder (chorea) in our setting.

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Introduction: Neurocognitive dysfunction is common in patients with liver cirrhosis who have no evidence of overt hepatic encephalopathy and is usually associated with impairment of activities of daily living in the patients. Materials and Methods: Forty patients with liver cirrhosis without overt hepatic encephalopathy were studied along with forty-one healthy controls. Blood samples were taken from the patients for liver function tests and Hepatitis B and C screening. Liver disease severity was graded using the Child-Pugh scoring system. Community Screening Interview for the Dementia (CSID) questionnaire was administered to all subjects. The CSID questionnaire assesses the cognitive functions of the subjects in the domains of language, memory, orientation, attention/calculation, and praxis. The data were collated and analyzed with the aid of SPSS 15.0 software for frequency, means, and comparison of means using Student's t-test and one-way ANOVA. Significant level was put at P< 0.05. Results: The mean age ± SD of the patients was 46.15±15.31 years and the controls was 45.66±11.54 years. There were 30 males and 10 females in the patients group while the control had has 26 males and 15 females. Majority of the patients had secondary level of education. Nine out of 40 patients (23%) had abnormally low total CSID score. The patients with liver cirrhosis performed poorly in the domains of language, memory, attention/calculation, and praxis. There was no difference in the orientation scores between the patients and the normal controls. The type of Hepatitis virus infection, serum liver enzyme, serum albumin, serum bilirubin, prothrombin time and Child Pugh class of the patients did not influence cognitive performance in the patients. Conclusion: Patients with liver cirrhosis have significant cognitive impairment compared with controls and liver function tests/ clinical parameters in the patients did not correlate with their cognitive functions.

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Background: Previous studies have suggested that a high body mass index (BMI) was associated with improved outcome in congestive heart failure (CHF). The aim of this study was to examine the relationship between BMI and echocardiographic variables of cardiac function in stable outpatients with heart failure. Methods and Materials: This is a cross-sectional study in which the cardiology clinic out-patients of Obafemi Awolowo University Teaching Hospital with heart failure were recruited. Patients were categorized using baseline BMI as normal weight BMI = 18.5-24.9 kg/m ² and overweight/obese (BMI > 25.0 kg/m ² ). Risks associated with BMI groups were evaluated and the data were analyzed with the aid of SPSS 15.0 software. Results: Patients with higher BMI have higher left ventricular ejection fraction and fractional shortening and lesser tendency to have an abnormal left ventricular geometry and better functional (New York Heart Association) class of heart failure at presentation. Conclusion: Overweight and obese patients had less severe degree of heart failure than normal weight patients and efforts should be made to prevent excessive weight loss in patients with heart failure.

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Renal metastasis from prostatic origin is an uncommon event. Advanced prostate cancer locally invades the seminal vesicles, bladder and regional lymph nodes. Other metastatic sites are the lung, bone and other visceral organs. We present a 55-year old, Hausa man from Northern Nigeria who was managed as a case of infected renal cyst which later turned out to be a metastatic prostatic adenocarcinoma with a rare pattern of widespread bony metastases.Renal metastasis from prostate adenocarcinoma is a rare occurrence, however, high level of suspicion is needed in order to avoid potential diagnostic pitfall.

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Background: To improve poor attendance and underutilization of the child and adolescent psychiatric service in the University of Ilorin Teaching Hospital, Ilorin, Nigeria, we compared a child behavior questionnaire (CBQ) with reporting questionnaire for children (RQC) for use in our primary care unit where the bulk of referrals come from to determine which is more applicable. Methods: This was a cross-sectional two-stage study on the prevalence and pattern of psychiatric disorders in children attending the primary care unit of University of Ilorin Teaching Hospital, over a 6-month period. CBQ and RQC were completed by the mothers of 350 children aged 7-14 years in the first stage; in the second, a stratified subsample of 157 children based on scores on CBQ were interviewed using the children's version of the schedule for affective disorders and schizophrenia (Kiddie-SADS-PL). The receiver operating characteristics (ROC) analysis was carried out to determine the screening properties of CBQ and RQC. Results: The optimal cutoff score for CBQ and RQC were 7 and 1, respectively. Sensitivity, specificity, and misclassification rates at the cutoff for CBQ was 0.8 (80%); 0 96 (96%); 0.083 (8.3%), and RQC was 0.90 (90%); 0.78 (78%); 0.19 (19%). The discriminating ability of CBQ indicated by the area under the curve (AUC) in the ROC was 0.93 while RQC was 0.88. Conclusion: Even with the evident marginal superior discriminating ability of CBQ in our study in primary care, RQC has the advantage of brevity and ease of application for workers at this level. In the child and adolescent clinic CBQ may still be preferred.

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