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Neurocognitive impairment is a major challenge globally because of the increasing proportion of older persons who are at risk. The condition is classified as either minor when one or more domains of cognition is/are affected without compromise of functional ability or major when both cognition and functioning are impaired. The important clinical types are mild cognitive impairment (MCI), vascular cognitive impairment (VCI) and dementia. In the sub-Saharan Africa, MCI affects between 7% and 39% of older persons, while the age-adjusted prevalence of dementia is 4.7%. About 50% of stroke survivors develop VCI and between 8% and 15% of these progress to vascular dementia. The risk factors include old age, vascular risk factors, frailty and stress. Suggested preventive strategies aimed at reducing the burden of dementia are based on the recommendations of the Lancet Commission on Dementia.

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Background: This study compared the relationship between substance use, self-esteem, and academic performance among undergraduates in private- and public-owned universities. Methods: Using a stratified random sampling technique, undergraduates from Oduduwa University, Ipetumodu; a private university (PrU) and Obafemi Awolowo University (OAU), Ile-Ife; a public university (PuU) responded to a structured, self-administered questionnaire in this cross-sectional survey. The procedure was explained to respondents and data were subsequently obtained. Data were analysed using descriptive and inferential statistics. Results: An 81.9% response rate from 400 undergraduates with an overall mean age of 20.7 ± 2.14 years was recorded in this study. Over 20% of the respondents were observed to have either substantially or severely abused drugs with higher rates occurring among undergraduates in the PrU (14.2%) compared with PuU (6.5%). Overall mean drug abuse score was 5.95 ± 5.78 with a higher score occurring among undergraduates in PrU (t = −4.37; P = 0.001). More than half of the respondents indicated that drug use negatively affected their self-rated academic performance after its use. Respondents' self-rated academic performance after drug use (SAPAD) was weakly and moderately correlated with self-esteem (PrU: ρ = 0.15, P = 0.003; PuU: ρ = 0.20, P = 0.004) and drug use (PrU: ρ =−0.61, P = 0.000; PuU: ρ =−0.52, P = 0.000), respectively. A negative weak correlation existed between respondents' self-esteem and drug use (PrU: R = −0.18, P = 0.009; PuU: R = −0.27, P = 0.000) across the universities. Conclusion: Undergraduates in the selected Nigerian universities have a low level of substance abuse with high self-esteem. Substance abuse among students attending PrU is higher compared to PuU. In addition, the self-esteem of undergraduates as an independent correlate of self-rated academic performance can be used to check substance abuse among university students.

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Introduction: Quality assurance (QA) is indispensable to assure safety and quality in radiation medicine practices. This study performed an in-depth analysis of reject radiographic films to assess the contributory factors and the related implications as a form of audit. Materials and Methods: Data on radiographic films were obtained from the archives of two reputable hospitals in South-Western Nigeria. Information such as type of examination, reasons for rejection, film size and number of rejects were recorded on a purposely designed data collection form. The analysis of data was performed using Microsoft Excel 2016. Results: Reject analysis (RA) performed indicated 4.54% and 3.34% reject rates at Centre 1, and 8.94% and 5.55% reject rates at Centre 2 for 2016 and 2017, respectively. The major factors contributing to film reject at Centre 1 were found to be under-exposure, 21.13%; over-exposure, 20.07%; and fog, 21.30% in 2016 while in 2017, corresponding values were 20.87%, 16.69% and 16.86%. A similar trend was obtained at Centre 2 where the same factors accounted for reject rates at 20.60%, 25.13% and 18.59%, respectively, as above in 2016 and 24.29%, 26.91% and 17.07% in 2017. This study has shown a loss in yearly productive time of up to 150 working hours per machine. Conclusions: Repeating X-ray examinations engender wastage of time and finance as well as additional radiation exposures to the attendants. RA serves as a form of QA audit for monitoring and improving imaging services and the cost-effectiveness of diagnostic practice.

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Introduction: Older people face challenges in the overburdened health-care services in Nigeria, especially when hospitalised. Few available studies on mortality were retrospective, oftentimes with incomplete data which may affect the establishment of the outcome. Objectives: This study determined the 30-day all-cause mortality rate (MR) and associated factors amongst older patients in the medical wards of University College Hospital, Ibadan. Materials and Methods: A prospective cohort study of 417 patients (>60 years) from the 1^st day of admission to death or discharge at the end of 30^th day of admission. Data were collected with a semi-structured questionnaire. Information obtained included respondents' sociodemographic characteristics, anthropometric measurements, frailty and functional status. Others were morbidity profile, quality of life, cognition, nutrition, anxiety and depression. Data were analysed using SPSS version 24 at a level of significance P < 0.05. Results: The mean age was 71.6 ± 8.1 years and 216 (51.8%) were females. Eighty-seven (20.9%) deaths were recorded. The unadjusted 30-day all-cause MR was 13.7 deaths (95% confidence interval [CI]: 11.0–16.9/1000 patient-days). This was significantly higher amongst males than females with a MR ratio (MRR) of 1.93 ([95% CI: 1.23–3.05]; P = 0.01). Factors significantly associated with mortality were being financially self-supporting (MRR = 2.82; 95% CI: 1.01–6.41), having a cognitive impairment (MRR = 1.92; 95% CI: 1.12–3.20), frailty (MRR = 1.65; 95% CI: 1.01–2.84), ischemic heart disease (MRR = 1.93; 95% CI: 1.18–3.07) and acute exacerbation of bronchial asthma (MRR = 3.92; 95% CI: 1.04–9.42). Conclusion: The 30-day MR was high amongst older patients, especially the males. Modifiable factors contributing to hospital mortality should be addressed at admission.

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Background: Mass casualties are frequent occurrences in low income societies where multiple factors result in premature deaths. The pathologist has a crucial role in the effective management of the corpses of victims of mass casualties. This role must be attended to with the engagement of the minimum standards of forensic medicine that would allow revisits to the cases without losing vital records. Aims and Objectives: The study reviewed the autopsies conducted on mass casualties at OAUTHC, Ile-Ife; for the most vulnerable gender, methods of preservation, pattern of injuries, circumstances of death, mechanisms of death, cause of death, challenges encountered in the management of the corpses, and results of toxicology studies. Materials and Methods: There was a review of the reports of autopsies conducted on mass casualties by anatomical pathologists at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife and their jurisdiction of practice over a period of January 2010 - December 2017. Results: A total of 52 cases were analyzed, all homicidal deaths consisting of 46 cases of deaths due to communal crisis and 6 cases of poison related deaths. The homicidal deaths resulted from blunt force to the head in 32 cases, sharp force in 9 cases, severe burns in 3 cases and strangulation in 2 cases. Most of the deaths was due to raised intracranial pressure complicating severe head injury. The cases of suspected poisoning at autopsy showed severe anatomic and pathological changes which were the basis of pathophysiological basis of death but toxicology was unhelpful in the detecting the poison, perhaps due to preservation technique. Conclusions: The role of the forensic pathology is pivotal in the management of deaths in mass casualties. Forensic pathology practitioners in resource limited must at least keep to minimum standards to ensure basic documentation are not compromised.

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