Background: The childhood mortality rate in Nigeria continued to remain high. Unfortunately, information on the regional trajectories, progress, and sociodemographic determinants of childhood mortality in Nigeria are not readily available. The objectives of this study are to describe the childhood mortality trajectory in Nigeria, assess progress made toward achieving the 2006 child health policy targets, and determine the peculiar factors associated with childhood mortality in Nigeria regions. Materials and Methods: Birth history data from the Nigeria Demographic and Health Surveys for 1990, 2003, 2008 and 2013 were analysed. Childhood mortality levels were derived using indirect demographic techniques. Locally weighted scatterplot smoothing technique was employed to ascertain the childhood mortality trajectory. Weibull frailty models were fitted to determine the influence of unmeasured variables and factors associated with childhood death in each region. Results: Childhood mortality stagnated at 207/1000 live births until the year 2000, after which there was a linear decline to 137/1000 live births in 2010 at an annual rate of 4.91% (confidence interval: 4.52–5.29). The rate of decline was least in the South West (2.97%) and highest in the North Central (7.40%). Multivariate analysis revealed that unmeasured community factors played significant roles in North East and North West. Birth interval < 24 months, multiple births, and young maternal age were risk factors across all regions. Conclusions: Nigeria child survival dynamics differ between the Northern and Southern regions and rural and urban locations. Only the North Central and South-South regions are on course to achieve the 2006 targets for under-five mortality reduction. Multiple birth, short birth intervals, and young maternal age at child's birth were risk factors for childhood mortality in the six geo-political regions in Nigeria.

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Geriatric medicine as a speciality is just evolving in Africa. There is scanty data on the mortality and associated factors among elderly patients admitted to the hospital medical wards in Africa. The objective of this review was to identify, describe, and analyze systematically the available studies on all-cause mortality and associated factors among elderly patients admitted to the medical wards of a hospital in Africa. Online and hand-based systematic searches were conducted for literature (primary and secondary) describing the mortality in elderly patients admitted to the medical wards of a hospital in Africa. These included original research, review articles, proceedings, and transactions from 1969 to 2014. All identified studies were screened using the Population, Intervention, Comparison, and Outcomes criteria. Five studies describing 3427 hospitalized elderly patients reported 773 deaths giving an unadjusted proportion of admissions which resulted in in-hospital deaths of 22.6% (range: 6.8–44.7%). This was higher among the males (38.8–48.0%) compared with the females (29.4–40.7%). There was no significant association between the age and mortality. Mortality was high among patients who had stroke, meningitis, septicaemia, renal failure, chronic liver disease, chronic obstructive pulmonary disease, severe asthma, and heart failure. High mortality was associated with high serum creatinine and urea, tachycardia, reduced length of stay from admission to death, and low serum protein. In conclusion, the few available data showed high unadjusted all-cause mortality among hospitalized elderly patients in Africa. More studies are needed in Africa to quantify this health burden and identify the major factors causing the high mortality in elderly patients.

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Background: Serum electrolyte disturbances are common in under-five children with acute diarrhea but may remain unrecognized, resulting in morbidity and sometimes mortality. Objective: The objective was to assess the type and prevalence of electrolyte abnormalities in severely dehydrated under-five children with acute diarrhea at the point of hospital admission. Patients and Methods: This was a descriptive, hospital-based cross-sectional study of children aged 1–59 months with severe dehydration due to acute diarrhea. Serum electrolyte profiles were determined. Outcome measures such as death or survival were recorded. The co-morbidities were also recorded. Results: Of the 63 children studied, 50 (79.3%) subjects were aged below 36 months. Vomiting and fever accompanied diarrhea in 33 (52.4%) of the cases. The frequencies of the various types of dehydration were hyponatremic in 41 (65.1%), isonatremic in 17 (27.0%), and hypernatremic in 5 (7.9%) of the children. Of the electrolyte abnormalities observed, hyponatremia and hypokalemia ranked first and second in frequency, respectively. The overall case fatality rate was 6 (9.5%). All the patients that died were aged below 24 months. 5 (83.3%) of the 6 patients that died had a combination of metabolic acidosis in association with one or two other electrolyte abnormalities. 6 (10.5%) of the 57 patients that survived had normal serum electrolyte profiles. Conclusion: Hyponatremia, hypokalemia, and metabolic acidosis were the leading electrolyte abnormalities in acute diarrheal illnesses and were responsible for most diarrhea-related deaths, particularly when measles or bronchopneumonia is a co-morbid condition.

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Background: Obsessive–compulsive symptoms (OCS) may be common, yet, under-recognised and under-reported among medical students. Their presence is associated with other mental disorders which could have negative impacts on the academic functioning of medical students. Objectives: The objective is to assess the prevalence and correlates of OCS in a sample of Nigerian clinical medical students. Methods: This is a cross-sectional descriptive study conducted among 209 Nigerian medical students in their clinical training years. They completed a sociodemographic questionnaire, the Obsessive-Compulsive Inventory-Revised, the Depression and Anxiety Stress Scale – 21 and the Rosenberg Self-Esteem Scale. Results: The prevalence of OCS was 32.1%. Depression, anxiety and stress were present in 13.9%, 27.8% and 35.4% of the respondents, respectively. The presence of OCS was associated with stress, anxiety, depression and low self-esteem among the medical students. Conclusions: OCS is relatively common among clinical medical students. Their presence may worsen the difficulties experienced among medical students in the course of their training. There may be a need to be screening clinical medical students for the presence of OCS.

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Background: In Nigeria, infertility treatment using assisted reproductive technology (ART) is perceived as an inconsequential health issue not demanding any public health intervention. ART is largely carried out by private health-care providers in city centres at an unaffordable cost. Objective: The objective is to determine ways to reduce the cost of in vitro fertilisation (IVF) to increase access to treatment. Materials and Methods: Google, Google Scholar and PubMed searches identified scholarly papers published between 1997 and 2013. The keywords used were combinations of ART, infertility treatment in developing countries, family planning and infertility, increasing ART success rate, male factor in infertility, fertility care financing, health insurance and cost of fertility treatment. Results: Infertility is not perceived as a disease the way malaria or typhoid is treated as such by most Nigerian men, and ART is expensive. Most African culture blame infertility on women who have restricted financial access. The current focus of family planning is female gender centric and favours contraception alone. The Nigerian National Health Insurance Scheme (NHIS) has excluded any ART treatment completely. Conclusion: The high cost of IVF is the greatest barrier to ART access both in the developed and underdeveloped world. This is also the most critical factor in accessing IVF care worldwide. This financial barrier is worse in low-resource settings like Nigeria. Low-cost technological innovation is still far from the country. Recommendations: Renewed advocacy with focus on men to understand that infertility is a disease deserving of utmost attention. Increase in the number of public-funded fertility clinics and partial inclusion of IVF into the Nigerian National Health Insurance Scheme (NHIS) needs to be implemented to bring down cost. Other innovations such as public–private partnerships, where financial institutions like banks can finance IVF treatment by giving loans whose repayment is spread over time to make it convenient, should also be considered.

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Background and Objective: Nigeria was unable to meet the Millennium Development Goal target for child mortality. Progress has been hampered by a host of factors which include poor maternal response to childhood illness and inappropriate health-seeking behaviours. This study was done to assess the health-seeking behaviours for infants by caregivers in Orile Agege Area. Materials and Methods: A community-based, descriptive, cross-sectional study using an interviewer-administered questionnaire was done among the caregivers of infants in Orile Agege Local Council Development Area. Three hundred and two caregivers were recruited using a multistaged sampling method. Analysis was done using SPSS. T-test and Chi-square were used to test for association among variables. Results: About half of the caregivers who said their infants had been sick in the study took the child for treatment within 24 h of the onset of the illness, most (40%) of them sought treatment from a health facility. The barriers to seeking healthcare at health facility that was mostly mentioned in this study were financial constraints (15.1%) and poor service (5.7%). Conclusion: Most of the caregivers in the area sought treatment outside the home for their infants when they were sick and they mostly patronised health facilities and health workers. About half of the respondents promptly sought healthcare for their infants in the case of their illness.

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Background: Osteoarthritis, (OA) the most common of all the types of arthritis, is a significant public health problem which contributes greatly to disability in the elderly. Community-based prevalence studies of OA in South-Western Nigeria were scanty for referencing. Objective: This study investigated the prevalence of symptoms of self-reported knee OA (KOA) in a heterogeneous community of Odo-Ogbe in Ile-Ife, South-Western Nigeria. Methods: All houses in Odo-Ogbe community were numbered, and all odd numbered houses were selected for the study. Every adult individual of aged 35 years and above living in the selected houses were recruited for the study. The total number of participants was 119 individuals and all of them participated in the study by completing Western Ontario and McMaster Universities Osteoarthritis Index Questionnaire. Their anthropometric variables were also measured. Data were analyzed using descriptive and inferential statistics. Results: There were 99 females and 20 males respondents that participated in the study. Forty-seven (39.5%) had knee pain and other KOA symptoms. Among those with KOA symptoms, six of them were males while 41 (87.2%) of them were females. There was a significant negative relationship (P < 0.001) between academic qualification and pain intensity (−0.292), stiffness (−0.336), and difficulty (−0.267) of participants with KOA. Age was also found to be significantly related (P < 0.001) with all symptom of KOA. Conclusion: The prevalence of symptomatic KOA at Odo-Ogbe community is high, more female were affected, and many of those affected had family history of arthritis.

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Background: Air pollution is often perceived as an outdoor public health problem but the air in residential buildings, cars and offices can also be polluted. Indoor air pollution (IAP) is the presence of one or more contaminants in the indoor environment that has a degree of human health risk. IAP is a risk factor for respiratory tract infection and is associated with increased risk morbidity and mortality in developing countries. Objective: The present study determined the relationship between awareness of IAP and prevalence of respiratory symptoms. Methods: This was a descriptive cross-sectional study. Respondents were selected using a multistage sampling technique. Data were collected using structured questionnaires with the aid of interviewers. Results: Two hundred and thirty-nine (95.6%) of 250 who were given questionnaires responded. One hundred and fifty (62.8%) of respondents were aware of IAP. The major source of their information was through the radio in 57 (23.8%). One hundred and four (43.5%) prepare food on the corridor with cooking with a kerosene stove, and 211 (88.3%) were using mosquito coil. Shortness of breath was reported by 49 (20.5%) while 25 (10.5%) expectorated phlegm. Respondents with exposure to tobacco smoke in the indoor environment had a 12-fold likelihood of having phlegm and an 8-fold likelihood of having shortness of breath. Conclusion: The level of awareness of IAP by the respondents was low in this study. Indoor smoking was a major determinant of respiratory symptoms. There is thus, a need for widespread health promotion to raise awareness about IAP and its effects.

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Background: HIV/AIDS Counseling and Testing (HCT) is an effective tool in HIV prevention and control. However, perceived hindrances may limit the utilization of HIV Counseling and Testing (HCT) services, particularly among high-risk groups. Therefore, this study assessed perceived hindrances and factors influencing the acceptability of (HCT) among commercial drivers. Methods: This was a cross-sectional survey of commercial drivers in Ife Central Local Government Area. Data were analyzed using Statistical Package for Social Sciences for Windows version 20. The dependent variable for the multiple regressions was commercial drivers willingness to uptake free HCT services in their motor parks, while independent variables were their age, marital status, and the level of education. Results: Three-hundred commercial drivers were surveyed. 76 (25.3%) of respondents had previously undergone HIV test. 184 (61.3%) of the 300 respondents were willing to uptake HCT services. Perceived possible hindrances to HCT uptake were fear of a positive HCT test by 259 (86.3%), stigmatization by 260 (86.7%), lack of in-depth knowledge about HCT 258 (86.0%), and confidentiality concerns by 267 (89.0%) while 151 (50.3%) perceived poor access to HIV testing services as a hindrance. Multivariate analysis revealed that drivers aged 30–39 years were twice more likely to accept HCT service compared to their 20–29-year-old colleagues. Car drivers were twice more likely to accept HCT compared to bus drivers, whereas drivers with secondary education were four times less likely to accept HCT compared with their colleagues with tertiary education. Conclusion: This study revealed that a high proportion of drivers was willing to uptake HCT services. The introduction of free HCT education and services at motor parks would, therefore, enhance HCT uptake.

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Background: There are evidences to suggest that the World Health Organization (WHO) general cutoff points for body mass index (BMI) may not be the most appropriate for young adults globally irrespective of racial and ethnic considerations. Objective: This study assessed body anthropometric parameters in healthy population of young adult Nigerians with a view to determining race and gender-specific criteria (Ife criteria) for BMI classification. Methods: Four hundred and eighty-four (242 males and 242 females) healthy subjects aged between 18 and 41 years (inclusive) were recruited for the study. The participants were age- and sex-matched (mean age: 22.81 ± 3.83 years). The weight and height of the subjects were obtained using standard techniques while BMI was calculated as derivatives of height and weight. The BMI was classified using 5 ^th , 85 ^th , and 95 ^th percentiles and delineated into underweight (<5 ^th percentile), normal (5-85 ^th percentile), overweight (85-95 ^th percentile), and obese (>95 ^th percentile). Results: The result showed that the general BMI cutoff values for underweight, normal, overweight, and obesity were <17.8, 17.8-24.7, 24.8-27.8, and ≥27.9, respectively. The sex-specific BMI cutoff values for underweight, normal, overweight, and obesity in males and females were < 17.8 and < 17.8; 17.8-23.6 and 17.8-25.6; 23.7-26.8 and 25.7-28.7; and ≥26.9 and ≥28.8, respectively. Conclusions: The cutoff values for the new criteria for BMI classification were lower than the WHO defined values and sex differences were demonstrated in BMI. Therefore, WHO criteria may not be universally applicable.

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Background: Sexual abuse of adolescent girls is a menace that has been reported globally, and it is increasing at an alarming rate. Objectives: The study assessed experiences of sexual harassment (SH), sexual exploitation (SE), and rape among school adolescent girls in Ife/Ijesa Zone of Osun State, Nigeria. It also assessed the perpetrators, settings of the abuse, and reactions of survivors to sexual abuse. Latent variables underlying revictimization during adolescent years were also explored. Methods: Cross sectional design was employed with qualitative and quantitative components. Two hundred twenty four adolescent girls from two public high schools were selected using cluster sampling technique. Quantitative data were collected using a semi structure questionnaire while qualitative data were collected using Focus Group Discussion Guide (FGDG). Institutional Review Board approval was received for the study. Results: Quantitative findings showed that 55.5% experienced SH and 23.7% experienced SE while 20.8% experienced rape. Three factors that were extracted using factor analysis were labeled as "forceful sexual interaction," "romance," and "actual sexual intercourse." Perpetrators of rape and SH were mostly male friends (69% and 50% respectively) while perpetrators of SE were mostly sexual partners (91%) which some of girls referred to as "aristos" in FGD. The mostly reported setting for various acts of sexual abuse was the perpetrators' house (rape 3%; SH 7%; SE 6%) and many of the survivors reported they did nothing about the abuse (rape 1%; SH 1%; SE 1%). However, all those who were sexually abused as children experienced high level of sexual abuse in adolescent stage. The FGD revealed that perpetrators of sexual abuse were mostly teachers, sexual partners, and peers while the bush path was mentioned as setting for rape contrary to data from the questionnaire. Conclusion: Sexual abuse educational intervention should focus more on male friends and sexual partners as perpetrators; the perpetrator's house as the settings for abuse; the necessity to report; and romance and force as elements of sexual abuse.

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Background: Pneumonia remains a leading cause of childhood morbidity and mortality despite the presence of effective preventive and curative management. The factors at presentation that determine prognosis particularly mortality among children with pneumonia have not been fully characterised in resource-poor centres. Objectives: This study set out to determine the hospital prevalence, pattern of presentation, associated risk factors, and determinants of deaths among children admitted with community-acquired pneumonia in Ilesa. Methods: We carried out a retrospective review of 352 children managed for pneumonia at the Wesley Guild Hospital, Ilesa, Nigeria over a three year period (2011 to 2013) by analysing hospital records. History, clinical features and laboratory findings at presentation were compared in children who survived and those who died. Binary logistic regression analysis was used to determine the independent predictors of mortality. Results: Pneumonia accounted for 23.5% of the 1470 total admission among children one month - 15 years during the period with a male preponderance of 1.4:1 and 84.9% of the children being less than two years. Sixty (17.0%) of the children were undernourished with 12 (3.4%) being severely wasted. Radiological pneumonia was observed in 44.0% of the children, 116 (33.3%) presented with heart failure while 18 (5.1%) had underlying cardiac lesions. Thirty-five (9.9%) of the children died. Children with pneumonia who in addition had concurrent measles infection, heart failure, cyanosis, head nodding and severe undernutrition were at increased risk of death. (p < 0.05) Severe wasting independently predicts mortality among the children. (RR = 5.86; 95% CI = 1.34 - 12.11; p = 0.01). Conclusion: Children with pneumonia who in addition had measles, heart failure, cyanosis and severe protein energy malnutrition should be aggressively managed because they are at increased of dying

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Background: Literature on awareness of the harmful effect of noise on the health, hearing, and the quality of life of Nigerians engaged in noisy occupation is scarce. Objective: The objective was to assess the knowledge, attitudes, and practice of sawmill workers and owners to noise pollution; and the need for prevention with the use of hearing protection devices. Subjects and Methods: This was a purposive sampling of sawmills in 6 local government areas in Osun state. The respondents were studied using interviewer-administered questionnaires. The workplace noise levels were assessed. Results: A total of 412 male respondents, consisting of 400 sawmill workers and 12 sawmill owners were studied. The mean age of the respondents was 32 years. Average time of exposure to noise was 10 h/day. The average level of noise at the sawmills was 108 ± 9 dB. 140 (35.0%) sawmill workers could not identify the sources of noise correctly. 140 (85.0%) would endure noise exposure, and 376 (94.0%) did not know that hearing loss could be due to noise exposure. 176 (44.0%) of the workers believed that noise had no impact on health, while 373 (93.3%) did not believe that noise was associated with a change in productivity. None of the sawmill owners was familiar with policy on noise control and none of them provided earmuffs or plugs for their workers. Conclusion: Sawmill workers and their employers in the present study were not aware of the harmful effects of noise on their health. Hearing protection devices were therefore not available or worn by most sawmill workers. The sawmill workers were thus at risk of developing noise-induced hearing loss.

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Background: Evaluation of effectiveness of polio immunization has to be monitored continuously, particularly in endemic countries so that the immunity status can be precisely and effectively established. The aim of the present study was to determine the seroprevalence of poliovirus antibody in Zamfara State, Nigeria. Materials and Methods: This was a cross-sectional study of children aged 0–59 months. The children were randomly selected across the state. Blood samples collected from the children were tested for the presence of antibodies to poliovirus. Results: Blood samples from 63 (78.8%) of the 80 children had antibodies to all the three poliovirus serotypes. Seventy-five (93.8%), 68 (85.0%), and 75 (93.8%) of blood samples had antibodies to poliovirus serotypes 1, 2, and 3 respectively. All (100.0%) blood samples from children in the age group of 48–59 months tested positive for poliovirus. All (100.0%) the females had poliovirus antibody. In general, poliovirus antibody prevalence increased with increase in oral polio vaccine doses received. Urban children had higher poliovirus antibody prevalence of 81.0%, higher than their rural counterpart. Children whose fathers were educated up to tertiary level had 100.0% poliovirus antibody. There was no association among seroprevalence of poliovirus antibody and number of vaccine doses received and location of child's place of residence. Prevalence of poliovirus antibody was statistically significant based on age and father's educational level (χ^[2] = 0.1360, χ^[2] = 0.2923, respectively, P < 0.05). Conclusion: For the state to sustain the gains made in interrupting poliovirus transmission, more work need to be done so as to close the gap observed in the study.

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Background: Abnormal body mass index (BMI) is known to result in serious health consequences. Objective: The present study aimed at determining the pattern and prevalence of underweight, overweight and obesity among market women at Ile-Ife. Methods: The participants had their weight and height recorded by standardised techniques, and BMI was calculated from the weight and height. BMI was classified according to the World Health Organization criteria. The average income per day (AIPD) for each participant was estimated as the average sum of daily profit earned on goods and services. Data were analysed using descriptive and inferential statistics. Results: Nine hundred and three market women participated in the present study. The age range was 18–95 years with 41.7% between 18 and 40 years, 43.0% between 41 and 64 years and 15.3% were 65 years and above. The mean of age and BMI of the participants were 46.3 (15.1) years and 28.5 (5.4) kg/m², respectively. Only 23.3% of the women had normal BMI. The prevalence of underweight, overweight and obesity was 1.7%, 38.5% and 36.5%, respectively. The distribution of overweight and obesity among age groups 18–40 years, 41–64 years and 65 years and above was 40.6% and 30.2%; 38.7% and 41.7% and 32.6% and 39.1%, respectively. There was a significant association (χ² = 7.177, P = 0.028) between AIPD and BMI classes. Conclusion: This study showed a high prevalence of abnormal BMI among market women in Ile-Ife. Overweight and obesity constitute a major health burden among market women.

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Background: Respiratory diseases constitute a large percentage of the medical conditions requiring hospital presentation. The burden of respiratory diseases presenting as emergencies need to be understood. Objective: This study aimed at reviewing the pattern of respiratory diseases in the emergency unit of Federal Medical Centre, Owo. Methods: The records of 914 patients seen with respiratory diseases from January 2007 to December 2012 were reviewed. Data were analyzed using SPSS version 21. Descriptive statistics were done. Chi-square test was used to compare other sociodemographic characteristics and disease-related variables by gender. Level of statistical significant was 5%. Results: The mean age of respondents was 46.5 ± 20 years, 54.9% were 40 years and above. Males were 57.9%, 24% presented as acute conditions, 10.4% were Human immunodeficiency virus, HIV-positive. Death occurred in 7.1% within 24 h of admission. Median length of stay was 1.9 ± 1.4 days. Complicated pulmonary tuberculosis (PTB) was diagnosed in 35.1% of the patients followed by pneumonias (26.9%) and acute severe asthma (18.4%). The mean age of male patient was 48.5 ± 20.4 years while female was 43.8 ± 18.9 years, males are significantly older than females P < 0.001. Patients with HIV were younger with mean age 35.9 ± 10.4 years compared with HIV-negative patients, 47.8 ± 20.3 years P < 0.001. More females (13.8%) were HIV-positive compared to males (7.9%), P = 0.004. Conclusion: Complicated PTB and the pneumonias were the leading causes of respiratory emergency in our environment. Not all respiratory cases seen at the emergency were acute condition. Standard precaution should be ensured as every one out of ten patients seen were HIV-positive. Disparities exist in the pattern of respiratory disease across gender.

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Background: Adolescence marks the beginning of transition between childhood and adulthood. However, inadequate knowledge about this transition remains a challenge among this group. Objective: This study was therefore designed to investigate the knowledge of puberty, sexually transmitted infections (STIs), and sexual behavior among very young female adolescent students aged 10-14 years in Agbor metropolis, Nigeria. Methods: A qualitative and quantitative cross-sectional study was conducted among female adolescent students (10-14 years). The discussants were grouped into ages 10-12 years and 13-14 years. A total of four focus group discussions were conducted among the two groups in two government secondary schools in the study area, while a semi-structured questionnaire which comprised sociodemographic characteristics, knowledge of puberty, STIs, and sexual behavior was used to collect the quantitative data. The qualitative data were analyzed thematically for themes and content, while the quantitative data were analyzed using SPSS Version 15.0. Results: The result shows most of the respondents 96 (97.0%) have heard of puberty and were able to define puberty 82 (85.40%). Furthermore, majority of the respondents have heard of the word human immunodeficiency virus 95 (96.0%) and STI 60 (60.6%), but few 4 (4.0%) have heard of the word contraceptive. In addition, only 12 (12.10%) of the respondents have a boyfriend, out of which only 3 (3.0%) have had sex at the age of 9 and 11 years, respectively. Conclusions: The results shows some of the respondents are already sexually active at that young age, therefore more intervention programs targeting these group of students should be carried out regularly in schools nationwide.

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Background: Threatened abortion usually precedes early pregnancy loss. Affected pregnancy may progress or result in eventual miscarriage. Understanding the risk factors and their management will continue to improve its outcome. Materials and Methods: Records of patients managed for threatened abortion at the OAUTHC, Ile-Ife over a period of 5 years from January 2009 to December 2013 were retrieved. Information about the sociodemographic characteristics, clinical presentation and outcome were collected and analysed using IBM, Armonk, NY, USA-SPSS version 20. Results: One hundred and eight records out of 118 patients admitted for threatened abortion over the period under review were retrieved. There were 2060 gynaecological ward admissions over the period. Threatened abortion accounted for 5.7% of all gynaecological ward admissions. The mean age of women admitted was 29.53 ± 4.47 years and majority (68.5%) had tertiary education. Seventy-five per cent were booked for antenatal care, 53.7% were nulliparous and 42.6% had previous first or second-trimester miscarriage(s). Sixty-two per cent were in the first trimester and the mean gestational age was 12.55 weeks ± 4.78. Malaria fever was the single most common risk factor (47.2%), urinary tract infection and other risk factors were identified in 28.7% and 24.1% had no identifiable risk factor. Half of the patients carried their pregnancy to term, whereas 25.9% had a complete miscarriage and the rest were lost to follow-up. Among those who proceeded to term, 74.1% were booked and 42% were unbooked patients (P value of 0.027). Conclusion: Threatened abortion remains a common complication in early pregnancy. It halves the chances of pregnancy continuation to term. In our environment, malaria fever was the most common risk factor and booking for antenatal care conferred better pregnancy outcome.

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The risk of adverse outcome for the mother and/or baby is high in the setting of uterine rupture and its possibility should be entertained in a pregnant woman with previous uterine surgery and recent onset lower abdominal pain in advanced gestation. In the absence of symptoms, uterine scar dehiscence may occur unnoticed until complications set in. Women with short inter-pregnancy interval, caesarean wound morbidity and classical caesarean section are at increased risk. Each case should be individualised and those at high risk of uterine rupture should be offered appropriate care. We report a case of antepartum scar dehiscence found incidentally at elective repeat caesarean section at term.

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Background and Purpose: Universities and colleges are considered as important sites to implement health educational programme. This study investigated the effect of a structured short message service (SMS)-based educational intervention on physical activity participation and weight loss (measured in terms of weight, body mass index (BMI), waist circumference (WC), hip circumference and waist-hip-ratio among female undergraduates. Materials and Methods: This experimental study recruited 50 consenting female undergraduates with BMI of 25 kg/m² and above from the Obafemi Awolowo University, Ile-Ife, Nigeria. The participants were randomly allocated into either intervention group or control group. The participants in the intervention group received structured-SMS based educational instructions on physical activity and nutritional advice thrice weekly for 8 weeks. The control group were only monitored for assessment but received no intervention. Physical activity was assessed using Pedometer. Measures of body weight status were assessed following the standard procedure. Outcomes of interventions were assessed at the end of the 4^th and 8^th weeks. Alpha level was set at P < 0.05. Results: The mean ages of the intervention and control groups were 22.0 ± 1.24 years and 21.9 ± 1.32 years, respectively. There was a significant increase in weight (−0.92 ± 2.15 kg vs. 1.52 ± 2.10 kg P = 0.001), BMI (−0.35 ± 0.84 kg/m² vs. 0.58 ± 0.81 kg/m²) and WC (−1.72 ± 4.07 cm vs. 0.84 ± 3.23 cm P = 0.002) at week four between the experimental and control group. There was a significant increase in weight (−1.40 ± 2.15 kg vs. 1.92 ± 2.61 kg P = 0.001), BMI (−0.52 ± 1.18 kg/m² vs. 0.75 ± 1.01 kg/m² P = 0.001) and WC (−1.90 ± 4.94 cm vs. 0.86 ± 3.54 cm P = 0.003) at week eight between the experimental and control group. Conclusion: A structured SMS on physical activity and nutritional advice can help to achieve weight reduction and improve physical activity participation among female university students.

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Background: Dialysis remains the most common modality of renal replacement therapy for managing end-stage kidney disease. Optimisation of various measures is needed for its efficient delivery. Inadequate dialysis is common in many low-income nations, and there could be inter-centre differences in the delivered dose. Aim: We assessed the dialysis adequacy and factors associated with inter-centre variation. Materials and Methods: This was a two-centre comparative study. Participants' sociodemographic and examination findings were documented and dialysis was prescribed. Pre- and post-dialysis blood for electrolytes, urea and creatinine were taken, and urea reduction ratio and fractional urea clearance as a function of its distribution volume (Kt/V) were calculated. Results: Two hundred and thirty-two participants had 1248 dialysis sessions. Participants' mean age was 49.9 ± 4.6 years. More males participated in the study, and males also received more sessions per participant. A greater proportion of the participants had tertiary education and had hypertensive nephropathy as the cause of kidney disease. The internal jugular access was used for dialysis in majority (60.6%) of the dialysis sessions. Dialysis dose (DD) was adequate in only 115 (9.2%) sessions. The mean DD was 1.02 ± 0.4; in the two centres, it was 0.86 ± 0.2 and 1.11 ± 0.5. Conclusion: DD is low in many low-income nations including Nigeria. The DD was directly related to the blood flow rate, dialysis duration and frequency of erythropoietin use. In addition to other factors, inability to afford prescribed dialysis regimen is a major contributor to the low DD in low-income settings.

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Background: Current discourses on healthcare environments' design suggest that qualitative healthcare is directly linked with the state and quality of the environment, making reference not only to the physical but also to the ambient and social environments. These conclude that in giving qualitative care to patients, who are the primary targets of these facilities, it is advocated that the healthcare environments are consciously humanised. Methods: The study is a literature review citing the Nigerian scenario as a case study among developing countries. Results: This review reveals that even though humanisation is crucial, as a driver for change in healthcare environments, its definition varies contextually. The paper further maintains that culture is central to whatever the definitions given to the concept of humanisation and attempts to initiate a discussion on the definition for 'Humanisation' in healthcare environments in Nigeria. It also emphasises the need for and the benefits of evidence-based designs in ensuring the design of well-humanised healthcare environments. In addition, the study finds that there is a dearth of the literature on healthcare environments' design in Nigeria. Conclusion: Currently, there are no commonly identifiable definitions for humanistic designs in healthcare environments in Nigeria. Recommendations are that more healthcare design research should be conducted to support these observations with empirical evidence and uncover how humanisation is defined in the country.

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