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: Controversies exist about the ideal sitting position. Objective: The present study compared sitting load and feet weight in ischial, sacroischial and ischiofemoral support sitting postures. Methods: Apparently healthy individuals who were asymptomatic of low-back pain for at least 6 months were recruited in the present study. Ischial, sacroischial and ischiofemoral support sitting postures were described based on literature. Assessment of sitting weight was carried out with a standard weighing chair, whereas a bathroom weighing scale was used to assess feet weight. Anthropometric variables were assessed following standard procedures. Data were analysed using descriptive and inferential statistics. Statistical significant level was set at P < 0.05. Results: There were 210 participants comprising 113 males and 97 females, aged 17-35 years. Sacroischial sitting weight of 51.86 (6.57) kg was the highest followed by ischiofemoral sitting weight of 49.52 (6.19) kg and ischial sitting weight of 44.87 (5.99) kg; the differences were statistically significant (P = 0.001). Similarly, ischial feet weight was 19.64 (2.49) kg, followed by ischiofemoral feet weight of 15.92 (2.08) kg and sacroischial feet weight of 12.60 (1.90) kg in sitting positions; the differences were statistically significant (P = 0.000). There was a significant correlation between sitting and feet weights in the different sitting postures and each of height, weight, body mass index (BMI) and femoral length (P < 0.05). Conclusion: The ischial sitting position had the least sitting load, whereas the feet bears the least load in sacroischial sitting. The amount of load experienced in sitting, and the corresponding feet weight was influenced by height, weight, BMI and femoral length. It is implied that sitting position with the highest amount of trunk load has the least amount of feet weight and vice versa.

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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: The safest blood is obtained from voluntary, non-remuneration blood donors. Objectives: This study was carried out to assess the knowledge, attitude, and practice of voluntary blood donation, and to determine the factors associated with willingness to donate blood among residents of Badagry, Lagos State, Nigeria. Methods: This descriptive cross-sectional study used quantitative and qualitative techniques. Multistage sampling method was used to select 439 respondents and pretested, interviewer-administered questionnaires were used to collect the quantitative data. Qualitative data were collected through two focus group discussions (FGDs) with male and female adult residents. Ethical approval was obtained from the Human Research and Ethics Committee of the University of Lagos, Lagos, Nigeria. Results: Most of the respondents were male (55.1%), married (60.6%), of Yoruba ethnicity (71.4%), and had, at least, a secondary education (81.0%). The mean age was 36.7 ± 11.1 years. All the respondents had heard of blood donation primarily from health workers (46.7%). Only 35.5% had ever donated blood, and this was primarily for a relative or friend (72.8%). Only 2.3% of previous donations were for an unknown person. Males were more likely to have donated blood (P < 0.001) and more willing to donate blood voluntarily (P = 0.015) compared to females. The FGDs showed that voluntary blood donation practice within the community was poor. Conclusion: The respondents are knowledgeable about blood donation and expressed positive attitude. However, this has not been translated into practice. Health authorities should collaborate with rural communities to organize blood donation campaigns to provide opportunities for altruistic blood donation.

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Background: Kidney transplantation (KT) is the best form of treatment for end-stage renal disease (ESRD); however, worldwide, there are potential barriers along the pathway to transplantation. Objective: The aim of this study was to identify the major impediments to KT programme in Lagos, Nigeria. Materials and Methods: This was a cross-sectional, descriptive study of patients with ESRD who have been on regular dialysis for at least 3 months at the Lagos University Teaching Hospital from January 2012 to December 2014. Using pretested questionnaire, relevant clinical and demographic information was obtained including the challenges faced with access to kidney transplant programme. Results: Fifty-seven patients were recruited, of which 30 (52.6%) were male, with a mean age of 40.6 ± 12.8 years. The common aetiologies of ESRD were hypertension (40.4%) and chronic glomerulonephritis (26.3%). The mean duration on dialysis was 8.7 ± 5.84 months (range, 3–28 months). The greatest challenges were lack of donors and lack of funds in 38.5% concurrently, whereas 25% said that they had donors but lack the funds, 5.8% had funds but no donor and 7.7% said that they were not psychologically prepared for kidney transplant at the time of the study. Conclusion: The greatest challenge to KT in Nigeria was scarcity of both donors and funds. Government and health insurance agencies should incorporate renal replacement therapy into their policies. The donor pool could be expanded through establishment of deceased-donor transplant programme in Nigeria.

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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: 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: 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: 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: 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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Background: One of the most important organs that regulate various physiological processes in the body is the liver. The liver, if diseased or damaged by toxic agent (s) could contribute to the cause of morbidity and mortality globally. Phyllanthus amarus is highly valued in African traditional medicine for its hepatoprotective, anti-inflammatory and several related ailments. Aim: The aim of the present study was to investigate the effects of the administration of P. amarus on garlic-induced hepatotoxicity in rats. Settings and Design: Albino rats (n = 30) weighing 170-200 g were randomly divided into five Groups (I-V) of six. Group I (control) received orally 1 ml/kg body weight of distilled water while Groups II, III, IV and V were administered orally same volume of garlic homogenate corresponding to 5 g/kg body weight on a daily basis for 14 days to induce liver toxicity. Similarly, Groups III, IV and V were orally administered with 100, 200 and 400 mg/kg body weight of P. amarus aqueous leaf extract, respectively, for another 7 days. Materials and Methods: The levels of serum alkaline phosphatase (ALP), aspartate transaminase (AST), alanine transaminase (ALT)  and total bilirubin (TB) were determined by standard methods. Histopathological analysis of the liver tissue was carried out as described by Druby and Wallington. Statistical Analysis: Results were expressed as mean ± standard errors of means. Statistical analysis was performed using one-way ANOVA and Bonferroni post hoc test was used to determine the difference between means at 95% level of significance. Results: The results showed that all the doses of the extract of P. amarus significantly decreased (P < 0.05) the levels of ALP, ALT and AST and TB relative to those administered 5 g/kg body weight of garlic only (Group II). The histopathological analysis of the liver samples also confirmed the hepatocurative potential of P. amarus against the hepatotoxicity caused by garlic. The ameriorative effect of P. amarus is suspected to be due to the presence of some antioxidants (phenols and flavonoids) as determined and quantified in the present work. Conclusion: It was concluded that P. amarus showed hepatocurative effect having ameliorated the lobular necrosis and inflammation of the liver induced by garlic homogenate in albino rats.

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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: 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: 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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Irritable bowel syndrome (IBS) is a chronic continuous or intermittent gastrointestinal tract dysfunction encountered by the health professionals. IBS patients are afflicted with intestinal and extraintestinal somatic morbidities. The aim of the present case study was to explore the effect of osteopathic treatment (OT) on somatic comorbidities in IBS patients. The author reported a 43-year-old female case who presented with a headache, abdominal pain, pain in the one-half of the body, lower back pain, increased the frequency of stool passage in a day, with alternating diarrhea or constipation, bloating; with few occasions of nausea and vomiting. The patient had history of 3-year-old hysterectomy and with no other relevant medical history. On endoscopic, colonoscopy, and blood investigations, no abnormality was detected. In this case, the osteopathic diagnosis was made as visceral somatic dysfunction and the OT made the remarkable difference in the patient symptoms as assessed by bowel symptom scale.

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Background: Good oral hygiene is necessary for optimal oral health and sound systemic health. Oral hygiene practices of undergraduates in various disciplines are well documented, but little is known about their oral hygiene status in relation to the oral hygiene practices. Objective: The objective of the present study was to determine the oral hygiene status and practices of undergraduate students at the Obafemi Awolowo Obafemi University, Ile-Ife, Nigeria. Methods: Demographic details and oral health practice information were obtained from consenting participants using structured, examiner-administered questionnaires. The participants were randomly selected from all the university undergraduate students and examined. Oral hygiene status was determined using simplified Green and Vermilion Oral Hygiene Index (OHI). Data were analysed using STATA 11 statistical software. Results: A total of 150 participants, comprising 78 (52.0%) females and 72 (48.0%) males, participated in the study. The mean (standard deviation) age of the participants was 22.8 (2.7) years with a median age of 23 years. Seventy-three (48.7%) of the 150 participants had good oral hygiene with mean OHI of 0.86 (0.9). Majority (148, 98.7%) of the participants cleaned their teeth with toothpaste and toothbrush. Seventy (46.6%) attended dental care only on account of pain. Faculty of Dentistry had the highest proportion of students with good oral hygiene. Conclusions: Less than 50% of the participants had a good oral hygiene. This was rather not encouraging for undergraduate students. The fact that Faculty of Dentistry had the highest proportion of students with good oral hygiene suggests that long-term exposure to oral health education and knowledge of good oral health practices are important for oral health hygiene. This was supported by the fact that those with longer stay in university had higher proportion of students with oral hygiene.

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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: Sociocultural norms influence everyday behaviour and social interactions. These norms may influence behaviour and interactions between students and lecturers in the classroom. Objective: The study explored ways by which sociocultural norms influenced classroom behaviour of dental students. It also explored the differences in students' perceived and lecturers' expectations of classroom behaviours displayed by students. Methods: A close- and open-ended questionnaire was administered to final year students and lecturers in the Dental School of Obafemi, Awolowo University, Ile-Ife, Nigeria, to identify the perception of students' and lecturers' expectations of classroom behaviours, and their perception on how sociocultural norms influenced their interactions. Descriptive and bivariate analysis was conducted. Qualitative data were analysed using the ground theory. Results: Thirty-seven (78.7%) of 47 eligible students and 13 (81.3%) of 16 eligible lecturers responded. While 12 (92.3%) lecturers expected their students to feel free to share views contrary to their opinion, only 6 (16.2%) students felt lectures expected this behaviour (P < 0.001). All lecturers felt that student–lecturer interaction on study subjects should continue beyond the classroom compared to 25 (67.6%) of students (P = 0.02). Also, all lecturers felt students should have the freedom to express any perspective beyond the conventional thoughts on the subject matter while only 20 (54.1%) students felt lecturer expect that (P = 0.002). In addition, 18 (49.8%) students compared with 11 (84.6%) lecturers expected informal student–lecturer interactions during classroom sessions (P = 0.003). Both students and lecturers felt that sociocultural norms about 'respectful behaviour' limit classroom behaviour and interactions. Conclusion: Sociocultural norms significantly influenced classroom behaviour of dental students and interfered with critical thinking and mentorship processes. Students and lecturers in the faculty need to undergo value clarifications to overcome the influence of personal sociocultural values on learning processes.

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Background: Diabetes in pregnancy constitutes a high risk factor for increased maternal and perinatal morbidity and mortality. There is inadequate knowledge of the diabetic pregnancy and its impact on neonatal health in our environment, hence the need for more research. Objective: To describe the morbidity pattern among infants of diabetic mothers (IDMs). Materials and Methods: Hospital records of all neonates diagnosed as IDMs and admitted into the neonatal ward of a tertiary hospital in South-Western Nigeria over a 10-year period were reviewed. Relevant data were extracted and analyzed. Results: Twenty-four cases met inclusion criteria, with a slight male preponderance. Mean (standard deviation [SD]) gestational age was 38.1 (1.8) weeks while the mean (SD) birth weight was 3.9 (0.4) kg. Fifty-eight percent of the subjects were delivered by cesarean section. 12 (50%) babies were macrosomic while the most common morbidities among the subjects were hypoglycemia, neonatal jaundice, and birth asphyxia which were observed in 75%, 75%, and 33.3% of the study population, respectively. Less frequently observed conditions include prematurity, transient tachypnea of the newborn, neonatal sepsis, and birth injury. 2 (8.3%) babies presented with congenital malformation affecting the heart and central nervous system, respectively. There was only one case of mortality. Conclusion: IDMs are prone to macrosomia, hypoglycemia, neonatal jaundice, and birth asphyxia in our environment. Early antenatal screening of all pregnant women for diabetes mellitus is required and good glycemic control of diabetic pregnancies should be the ultimate goal in order to minimize neonatal complications.

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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: 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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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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Objective: The protective role of the aqueous stem bark extract of Musanga cecropioides against paracetamol-induced liver damage was investigated in Wistar rats using silymarin as a reference drug. Materials and Methods: The animals were randomly assigned into five groups of six rats each (A, B, C, D, and E). Rats in group A served as controls and received an equivalent volume of distilled water used to dissolve the extract. To effect liver damage, animals in groups B-E were administered paracetamol at 500 mg/kg body weight orogastrically for 14 days using a metal cannula. Animals in groups C, D, and E were simultaneously pretreated with silymarin at 25 mg, 250 mg, and 500 mg, of the extract, per kg body weight, respectively. The effects of M. cecropioides and silymarin were examined on hepatic marker enzymes; aspartate amino-transferases (AST), alanine amino-transferases (ALT), alkaline phosphatase (ALP), and total protein (TP). Antioxidant enzyme activities such as superoxide dismutase (SOD), catalase (CAT), and lipid malondialdehyde (MDA), as well as changes in liver histology, were also evaluated. The animals were sacrificed via cervical dislocation and blood was collected via cardiac puncture into plain bottles. Furthermore, liver tissues were excised and processed for routine hematoxylin and eosin staining. Results: M. cecropioides and silymarin produced significant (P < 0.05) hepatoprotective activity by decreasing the serum levels of AST, ALT, ALP, and lipid peroxidation marker, MDA significantly (P < 0.05) increased the levels of TP, SOD, and CAT except for the group administered 250 mg/kg of M. cecropiodes. Liver histology revealed the presence of vacuolations and mild chronic infiltrates of inflammatory cells in the livers of paracetamol treated animals. Pretreatment with silymarin and M. cecropioides extract produced a remarkable reduction in the severity of vacuolations. Conclusion: Crude aqueous extract of M. cecropioides protected against paracetamol-induced liver damage perhaps, by its antioxidative effect on hepatocytes, hence eliminating the deleterious effects of toxic metabolites of paracetamol.

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Background: Homozygous sickle cell disease (SCD) (SS), also called sickle cell anemia (SCA) is the most common SCD in Nigeria. Studies done in the developed world showed that serum lactate dehydrogenase (LDH) levels correlated positively and significantly with clinical severity of the disease. This study attempts to provide information on the relationship between the plasma LDH level and the clinical severity of SCA in Nigerian children. Objective: The objective of this work was to assess plasma LDH level in Nigerian SCA children, aged 5-15 years, as a clinical indicator of disease severity. Methods: Plasma LDH level was measured quantitatively using Randox LDH reagent kit. A semi-quantitative assessment of clinical severity of SCA was carried out on all the SCA subjects using the Bienzle et al. assessment profile modified for this study. Subjects were classified as having mild, moderate, or severe disease based on their clinical severity score. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21 software. Results: Eighty SCA children, 40 in steady state and 40 in hemolytic (with or without vaso-occlusive) crises were studied. Mean plasma LDH level was significantly higher in SCA subjects in crises than for those in steady state (P = 0.0284). Only steady state plasma LDH level correlated positively and significantly with clinical severity score (P = 0.0151). Conclusion: Plasma LDH appears to be a reliable indicator of SCA disease severity in the steady state in Nigerian children.

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Background: The staging of human African trypanosomiasis (HAT) has been greeted with different benchmarks ranging from white blood cell counts to the use of immune component profiles across regions. Objective: The aim of this study was to analyze an array of cytokines to identify potential markers that could be used in the staging of HAT in Nigeria. Methods: Sera and cerebrospinal fluid (CSF) of 35 HAT seropositives from Abraka, Delta State, Nigeria were subjected to cytokines (interleukin-10 [IL-10], tumor necrosis factor-α, IL-1α, IL-7, and IL-13) analysis using enzyme-linked immunosorbent assay. Welch t-test and Tukey analysis of variance were used to analyze the data. Results: Comparing mean cytokine levels of weakly, moderately, and strongly positives and between as early and late stages results showed significantly depressed CSF levels of IL-1α and IL-7 while IL-10 was significantly elevated in the strongly positives as well as in the late stage. Conclusion: We strongly suggest that IL-10 could be playing a key role in the immuno-pathology of HAT, thus should be considered a biomarker for the late stage.

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