Background and Purpose:An initiative was undertaken by the Netherlands Leprosy Relief (NLR) to formulate guidelines for conducting a study to assess `quality of leprosy services for the patients' perspective'. These new guidelines were used in the end evaluation of leprosy programmes of three States (Jigawa, Kaduna and Plateau) in Nigeria. Methodology:Qualitative methods of data collection (semi­structured interview, focus group discussion (FGD) and priority cards) were used. A total of 24 patients were interviewed (Jigawa (6), Kaduna (6) and Plateau (12) and 7 FGDs were conducted; Jigawa (2), Kaduna (2) and Plateau (3). In addition, 17 community members were interviewed. Results:The results show that most patients were satisfied with the quality of leprosy services offered to them, but more in Jigawa and Kaduna, than in Plateau State. However the need to educate communities on symptoms of leprosy and the availability of MDT services in the health services came out as universal recommendations from all the studies. Poor knowledge regarding leprosy caused patients to continue to use a traditional healer, which is a major source of delay in reporting for treatment, with development of disability as a consequence.

Background: Utero-vaginal (u-v) prolapse is primarily a disease of the parous and often elderly post-menopausal women. The number of ageing women appears to be increasing in proportion due to the increasing life expectancy. Methods:This was a retrospective review of the service delivery records (case notes, ward and Theater records) of 21 women who presented with u-v prolapse at the gynaecological unit of University of Port Harcourt Teaching Hospital over a 5-year period. Results: The incidence of u-v prolapse is 1.6% per total number of patients who underwent major gynecological surgeries. The leading determinants of u-v prolapse were - multiparity difficult delivery, menopause, ageing and physically exerting occupations. Others were no formal education or low levels of education and diet. Conclusion:We recommend that there is a need for public health education geared towards enlightening the populace on the need for antenatal care and supervised hospital delivery, reduced family size, improved nutrition, and the need for hormone replacement therapy for post-menopausal women particularly high parity individuals. Finally, female education should be given priority attention.

Objective: To determine the prevalence of iron deficiency and megaloblastic anaemia at booking in the Specialist Hospital Gombe. Patients and methods:This was a cross sectional study of 461 women attending the antenatal clinic for their booking visit. The capillary technique was used for the estimation of the packed cell volume (PM/) while the morphologic type of anaemia was determined by the blood film appearance. The age, parity social class and gestational age at booking were obtained and analyzed. Results:Among the 461 women studied, 239 were anaemic thus making the prevalence of anaemia at booking to be 51.8%. Most, 67.4% were mildly anaemic, 30.5% were moderately anaemic while 2.1 % were severely anaemic. Three hundred and sixteen, (68.5%) of the women booked in the second trimester while only 3.0% booked in the first trimester. The majority of the women, 293 (63.5%) were in lower social class. Of the 239 anaemic women, 155 (64.9%) had features of pure iron deficiency anaemia while only 1(0.4%) had features of pure megaloblastic anaemia. Eighty three (34.7%) had dim orphic blood picture while 238 (99.6%) in total had features of iron deficiency anaemia. Although not anaemic by PCV the blood film of 26(5.6%) showed features of pure iron deficiency. Conclusion: The contribution of iron deficiency to anaemia in pregnancy is exceedingly high. This further supports the continued use of iron supplements for all pregnant women preferably at no cost in the short run and economic empowerment of the women folk in the long run.

Background:Blindness from diabetic retinopathy is a preventable complication of diabetes if the retinopathy is detected early. Among other approaches, strong awareness of retinopathy by diabetic patients could help in the early detection, management and prevention of this complication. This study sets out to determine the general awareness of diabetic retinopathy amongst diabetic patients attending the outpatient diabetes clinic of the Murtala Muhammad hospital, Kano. This is the central reference general hospital within the ancient and historic walls of the traditional city of Kano. The hospital has an eye unit but with a paucity of manpower and equipment. Most diabetic patients often on self-referral usually present to the eye clinic only when they experience a marked reduction in vision. In the case of diabetic retinopathy, this is unfortunately late for any meaningful intervention. Although primary diabetic caregivers are usually aware of the possibility of eye complications from diabetes, they tend to wait until patients make visual complaints before screening them or inviting eye care personnel to join in the management. Diabetic retinopathy screening protocols are in most cases either not available, or not strictly followed. Patient awareness of diabetic retinopathy and its associated risk factors should aid compliance with risk control measures, and help drive patient demand for retinopathy screening. Method:This is a cross sectional study conducted using an interviewer-administered questionnaire. All consenting adult patients seen at the diabetes clinic over a one-month period were recruited for the study. Results:A total of 185 patients were involved with a mean age of 55.4 years. The majority of the patients (78.4%) had no formal western education and were mainly traders, farmers or housewives. 84.3% of the patients were generally aware of diabetic retinopathy with their main source of information being hospital staff and fellow patients. 80.5% knew diabetic retinopathy could lead to blindness but only 15.7% have ever had retinopathy screening. There was little or no knowledge of retinopathy risk factors or the need for early detection through Conclusion:Although there is general awareness of diabetic retinopathy amongst a majority of the patients, there is however little or no knowledge of its risk factors and prevention. There is therefore a need for increasing this awareness, and the provision of access to retinopathy screening services to the patients.

Background:Stillbirth rate is an important indicator of access to and quality of antenatal and delivery care. Data on birth outcomes are Important for planning maternal and child health care services in developing countries. There is little or no literature on the stillbirth rate in north-eastern Nigeria. This may be the first study to serve as the baseline data in Maiduguri. Objective:This study aimed at determining the prevalence and identifying the risk factors contributing to foetal demise. Study design:A cross-sectional retrospective analysis of stillbirth among women delivering in UMTH over a-4 year period, from January 2001 to December 2004. Method:The Case records of 7996 women that delivered in UMTH over the study period were retrieved and the trend of the stillbirth experiences followed up retrospectively, and relevant information with special reference to socio-demographic characteristics, clinical risk factors for stillbirth and type of stillbirth obtained and analyzed. Results:There was a total of 179 stillbirths among the 7996 deliveries giving the institutional prevalence of 22/1000 deliveries. Macerated stillbirths with no obvious congenital malformation predominated (OR: 10.89; CI: 6.51-31.80), accounting for 52.5%, while fresh stillbirths (OR: 5.81; CI: 3.77­11.87), accounted for 47.5%. Most of the risk factors (63.7%) for stillbirths were present ante partum such as multiparity (OR: 2.88; CI: 1.47-6.09), lack of antenatal care (OR: 1.91; CI: 0.92­2.05), maternal literacy level (OR: 2.82; Cl: 1.44-5.41), hypertension, pre-eclampsia and eclarnpsia disease complex (χ ² =15.12; P-value =0.006); while intra partum risk factors contributed 36.3% with SVD as a mode of delivery, the leading risk factor (χ ² = 23.79; & P-value 0.000). Conclusion:The prevalence of stillbirth is high and is predominantly associated with ante partum risk factors. In our setting, antenatal care should be considered as the cornerstone in the prevention of stillbirth. With adequate antenatal care and good understanding of the determinants of stillbirth, women with clinical risk factors to stillbirth could be identified and measures to avoid or substantially decrease the occurrence of stillbirth instituted.

Background:Ameloblastoma is a benign but locally aggressive odontogenic tumour. Worldwide, maxillary ameloblastoma is rare but its late detection renders adequate treatment difficult. Majority occur in the mandible with about 5-20% occurring in the maxillary bone. Objective: The purpose of this study was to analyze 21 cases of maxillary ameloblastoma seen and managed at the Oral and Maxillofacial Unit of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria and Alba Clinic and Medical Centre, Kaduna, Nigeria. Study Design:A retrospective study of cases of maxillary ameloblastoma from all cases of ameloblastoma seen from January 1993 to August 2008. Data with respect to patient's sex, age, tumour location, clinical presentation, radiologic features, biological and histopathologic type, surgical treatment and recurrences were analyzed. Results:Out of 350 cases of ameloblastoma seen within the period, 21(6%) Patients were with maxillary am eloblastoma. Of the 21 cases, there were 13 males and 8 females, a male female ratio of 1.6 to 1, with an age range of 17-55 years (mean = 38.14), peaking at the 4 ^th and 5 ^th decades of life (61.9%). Tumour duration was from 3 months to 14 years. There were 18 unilateral and 3 bilateral swellings. Clinically, maxillary ameloblastoma presented with grotesque swellings, with antral involvement in 19 cases, teeth mobility/exfoliation. Radiologically, there were 20 multilocular and 1 unilocular radiolucent lesions. The most common histopathologic type was follicular (11, 52.4%).there were 22 procedures done on 21 patients; 21 maxillectomies and 1 enucleation. Follow up period of 18 patients was between 3 months and 10 years from which 3(16.7%) recurrences were observed. Conclusion:Ameloblastum a is uncommon in the maxilla. While maxillary ameloblastoma is indistinguishable histologically from its mandibular counterpart, it is very lethal. An excellent result achieved in this study was due to the radical mode of treatment of the multilocular variety. Rehabilitation postoperatively remains a challenge. Periodic life-long follow-up is recommended.

Superfetation is not usually a human phenomenon, except in rare cases of double uterus and continuous menstruation during pregnancy. This report describes the condition in the presence of a double uterus.