Mycobacterium tuberculosis (MTB), the agent of human tuberculosis remains a leading cause of mortality globally. Its resurgence during the last two decades is a reflection of its opportunistic relationship with HIV. The challenges associated with the disease are enormous and often debilitating. The role of clinical and research laboratories is central and significant in this regard as prompt and adequate diagnosis are key factors in the management and control of the disease.

Background : Seasonal variation in hospitalization for cardiovascular disease has been described in the temperate regions of the world as well as in Northern Nigeria. Increase admission rates during the cold seasons have been reported in these areas. No studies have been done in Southern Nigeria. This study is thus aimed at describing the seasonal variation in admissions for heart failure, uncontrolled hypertension and hypertension related-stroke in Southern Nigeria. Methods : Hospital records of patients admitted to the medical wards of the University of Uyo Hospital (UUTH) with heart failure of all causes, uncontrolled hypertension and hypertension&#8211; related stroke (Cerebrovascular accident) between January 1998 and December 2001 were used. Epi-Info 2002 software was used to analyze data. Results : Of the 3500 patients admitted during the study period 542 (15.3%) were on account of heart failure, uncontrolled hypertension and hypertension related cerebrovascular accident (CVA). The mean age of patients was 52±12.8 years. The average monthly admission was eleven (11). More admissions were recorded in the rainy (cold) season than in the dry (hot) season. The observed difference was however statistically significant only for heart failure and uncontrolled hypertension (P<.05). Conclusion : Admissions for heart failure and uncontrolled hypertension are therefore more during the wet (cold) season in southern Nigeria. This may be attributed to the high default rate to follow up visit in this season when agricultural activity is intense and less attention given to medical care. This leads to poor compliance to medications and clinical deterioration. The already bad road network both in rural and urban centers also become worse at this time making access to medical care difficult. Facilities and measures should thus be put in place to provide adequate medical care for these patients during that period of the year.

Background : In recent years commercial motorcyclists (Okada riders) have come to bridge the huge public transport gap in most cities across the country. However, this is not without the dangers they pose to themselves, passengers and to other road users. It is claimed that some of these Okada riders operate under the influence of drugs and other substances. But there are few community-based studies that have investigated the problem in this part of Nigeria. Therefore, this study was conducted to determine the prevalence, health and social consequences of psychoactive substance use among commercial motorcyclists (Okada) in Zaria, northern Nigeria. Method : Multi-stage sampling technique was used to sample commercial motorcyclists registered with commercial motorcyclists union in Zaria city, Kaduna state, Nigeria. Structured, closed ended and interviewer administered questionnaires were used to collect information on socio-demographic characteristics, factors influencing psychoactive substance use, impact on health status, motor cycle riding experience and work performance. Results : Two hundred commercial motor cyclists were interviewed, majority of them were in the age group 21-25 years (55.5%) with a mean age of 25.4±3.9 years. All the motorcyclists were male, (60.5%), had no formal education, (79.5%) are of Hausa extraction and (69%) worked for more than 10 hours per day. A high prevalence of 59.5% of road traffic accident that was associated with the use of psychoactive drugs was found among the motorcyclists. Commonly identified psychoactive substance/drugs used were: marijuana [Indian hemp] 25.8%, solution 24.5%, caffeine (Kola) 15.8%, and coffee 4.8%. Keeping awake, suppression of fatigue, and peer group effect were the identified factors influencing psychoactive substance use. The commonest types of injuries sustained were bruises and lacerations (62.5%) and fractures of upper and lower limbs (10.5%). Conclusion : Road traffic accidents among commercial motorcyclists are a frequent occurrence in this part of the country. There is need for public awareness campaigns on road safety education and health consequences of psychoactive substance use among commercial motorcyclists. It is further recommended that law enforcement agencies (NAFDAC, NDLEA and FRSC) need to work in tandem so as to curb the problem of substance abuse in our society and reduce the rate of accidents on Nigerian roads.

Background : The prevalence of anemia in HIV/ AIDS patients is high, with a multitude of possible etiologies; autoimmune hemolytic anemia (AIHA) in HIV/AIDS patients has been associated with a poor prognosis when treated with red cell transfusion. Our aim was to demonstrate the frequency of AIHA in a cohort of adult Nigerian HIV/AIDS patients and to see if the presence or not of AIHA is related to the severity of the disease with regards to the CD4 counts and the presence or absence of opportunistic infections. Method : Ninety- eight adult patients with HIV infection were screened for the presence of AIHA using the packed cell volume (PCV), direct antiglobulin test (DAT) and reticulocyte count (RC). Results : The frequency of AIHA was 3.06%, 36.74% of our study population were anemic; 11.22% had a positive DAT. Mean RC was 2.22 +/- 0.90 for all the patients. There was no statistically significant difference in the PCV of patients that had positive and negative DAT. There was no correlation between the presence of AIHA, use of ART, presence of opportunistic infections or CD4 counts. Conclusion : We conclude that in spite of the low frequency of AIHA in HIV/AIDS patients, the fact that most patients will respond to standard treatment makes it imperative to screen HIV/AIDS patients with anemia for the presence of AIHA. Again since HIV/AIDS patients with AIHA may have a fatal reaction to red cell transfusion, we suggest that anemic patients with HIV/AIDS in non-emergency situations be screened for the presence of AIHA before receiving red cell transfusions when indicated.

Background : The anatomy of the sella turcica is variable in size and shape. It has been classified into three types: round, oval and flat. It can also be deep or shallow in both children and adults. The floor of the sella turcica which in most cases is concave may be, flat or even convex. In both anatomical and radiological practice in Nigeria, normal data in relation to the description of the normal variants of the anatomical shapes of the sella turcica are based on Caucasian studies. Methods : All available lateral skull radiographs of subjects over a 3-year period, from 2002 to 2004, were retrieved from the Radiology Department of the Usmanu Danfodiyo University Teaching Hospital, Sokoto for the study. Radiographs were mounted on the viewing boxes and sellae turcicae were studied and classified. Results : A total of 228 subjects were involved in this study. Of this figure, 171 (75%) were males, and 57 (25%) were females (m: f ratio=3:1). The predominant shape of sella in the African subjects studied is oval, and the difference in frequency of oval shaped sella and that of round or flat types is highly statistically significant. (P<.001).The commonest type of sella floor in the African subjects studied is concave and the difference in frequency of concave shaped sella floor and that of flat and convex types is highly statistically significant.(P<.001). In both the various anatomical shapes of the sella turcica and the types of floor of the sella turcica in relation to sex of the subjects studied, the difference in frequency of males and females is highly statistically significant. (P<.001). Conclusion : It is concluded that the prevalence and the relative frequencies of the normal variants of the anatomical shapes of the sella turcica reported in this study on Nigerian subjects is similar to those reported in Caucasians. Further studies on a larger scale are needed to corroborate our findings.

Objective : To evaluate patterns of morbidity and mortality among bike riders and pillion seat passengers involved in road traffic accidents in Benin-City Nigeria between August 2003-July 2004. Methods : A total of Fifty-one bike riders and pillion seat passengers, who participated in this study were part of a larger study, involved in a road traffic accident and were brought to the accident and emergency unit of either the University of Benin Teaching Hospital (UBTH) or the State Specialist Hospital between August 2002-July2003.The injured ones were examined and dead patients had an autopsy done on them Results : A total of 51 cases of bikes riders/pillion seat passenger accidents were recorded representing 18% of total accidents. 35 motorbike riders/pillion seat passengers were struck down by cars (68.6%). Seven bike riders/pillion seat passengers (13.5%) were struck by articulated vehicles. 7 bike riders/pillion seat passengers representing 13.5% of cases were stuck by buses, 2 (3.9%) pillion seat passengers fell of bikes from epilepsies and sustained secondary injuries. Males were more in number with a ratio of 2.5; 1. One hundred percent (100%) or all motorcyclist and their passengers did not use helmets. Conclusion : Cars struck down most bike riders and their pillion seat passengers. Males were more than females in number. The commonest autopsy findings as cause of death was intra-cranial hemorrhage preventable by the use of crash helmets.

Broad ligament pregnancy is a rare event and diagnosis is often late in our setting. Two multiparous women in early thirties presented for routine antenatal care. Routine ultrasonography revealed midtrimester abdominal pregnancies. Broad ligament pregnancy was diagnosed in both cases at laparotomy and both had excision of pregnancy and salpingo-ophorectomy with satisfactory recovery. Ultrasonography is a useful tool in the early diagnosis of abdominal pregnancy in our environment. Routine ultrasonography in pregnancy is advocated in our setting.

Myasthenia gravis (MG) is an acquired autoimmune disorder causing skeletal muscle fatigue and weakness. This is a report of one woman and her daughter presenting with myasthenia and gravis and Grave's disease. It highlights possible hereditary component of this condition which has not been commonly reported in our setting.

Oncocytic Schneiderian papilloma is one of the three morphologically separate tumors that arise from the Schneiderian membrane (the others are fungi form papilloma and inverted papilloma). It is quite rare in our environment. We report a case of Oncocytic Schneiderian papilloma arising from the right maxillary sinus and extending to the ipsilateral nasal region in a 26year old Nigerian male. The growth was present for a period of 5 months before his presentation on 18-10-2005 and recurred again nine months later after excision. Both excised tissues were confirmed by histology to be Oncocytic Schneiderian papilloma, with no evidence of malignancy after a rigorous search.