Background: Disclosure of human immunodeficiency virus (HIV)-positive status to sexual partner is crucial and helpful for treatment adherence, HIV transmission reduction, PMTCT interventions, partner testing and acceptance of referrals for HIV-related care, treatment and support. This study assessed the awareness, practices as well as factors associated with serostatus disclosure among HIV positive clients receiving anti-retroviral treatment in a tertiary health facility in northwest Nigeria. Methodology: A cross-sectional study was conducted among 129 HIV positive clients receiving anti-retroviral therapy selected using a systematic random sampling technique. Data were collected using a structured interviewer-administered questionnaire containing open- and close-ended questions, and analyzed using SPSS Statistics version 21.0. Result: The mean age of respondents was 38.0 ± 10.6 years and most (89.9%) of the respondents were on antiretroviral therapy for more than one year. Majority of the respondents have a positive attitude to serostatus disclosure (67.4%) and have disclosed their serostatus to their partner (79.8%), but only 57.3% did so within one month of knowing their serostatus. Their main reason for disclosure were concern for partner's health (74.6%) while partners' reactions were supportive in 35% and understanding in 21.4% of respondents. Disclosure was high among those currently married (odds ratio = 0.075 96% confidence interval: 0.0230-0.237, P = 0.001) but there was no statistically significant association between disclosure and age, gender, religion, educational status and average monthly income. Conclusion: This study found a good partner disclosure rate of HIV serostatus among PLWHA receiving treatment at Nasara Clinic, ABUTH, and client's marital status as currently married was a significant factor that influenced disclosure rate.

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Aim and Objectives: We sought to compare the hemodynamic effects of 5 international unit (IU) and 10 IU of intravenous (IV) boluses of oxytocin and their efficacy in reducing blood loss during cesarean section and also to determine the incidence of postoperative nausea and vomiting (PONV) and postdural puncture headache (PDPH). Patients and Methods: One hundred and ten parturients of American Society of Anesthesiologists' I and II scheduled for cesarean section under spinal anesthesia were randomized into two groups. Group A (n = 55) received 5 IU IV bolus of oxytocin and Group B (n = 55) received 10 IU IV bolus of oxytocin after delivery. Ten milliliters per kilogram of 0.9% saline was administered to both groups as volume preload. Subarachnoid block was performed with size 24G spinal needles at L2/L3 or L3/L4 intervertebral space with the patients in sitting position. Two milliliters of 0.5% heavy bupivacaine was administered slowly intrathecally. Following delivery of the baby, IV boluses of 5 IU (Group A) or 10 IU (Group B) of oxytocin were administered slowly, and recording of heart rate, systolic, diastolic, and mean arterial blood pressure was done every minute for 5 min after bolus injection. IV infusion of 30 IU of oxytocin in 500 ml of 0.9% saline (60 mU/ml) at a rate of 125 ml/h was continued in both groups till the end of surgery. Estimated blood loss (EBL) was assessed by visual estimation. Patients were monitored continuously until 24 h after surgery to evaluate PDPH and PONV. Results: There were no statistically significant differences in the EBL between the two groups. There was no significant rise in heart rate and no significant decrease in mean arterial blood pressure in Group A compared to Group B. The incidence of PDPH and PONV was also comparable in both groups. Conclusion: Five IU of IV bolus of oxytocin is as effective as 10 IU of IV bolus in reducing blood loss during cesarean section.

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A newborn infant with congenital epulis (CE) can be a striking miserable sight for both parents and health care professionals involved in neonatal care. These tumours of the infant mouth can be remarkably large, occupying much of the oral cavity and posing a risk of airway obstruction or interfering with feeding with marked facial deformity. Neumann first described congenital epulis of newborn in 1871. It is most frequently located on the anterior maxillary alveolar ridge with slight female predilection. It clinically appears as a pedunculated protuberant mass. In cases with large lesions, mechanical oral and nasal obstruction can impair fetal deglutition and neonatal respiratory efforts resulting in polyhydramnios prenatally or respiratory impairment postnatally. Histologically Congenital epulis shows characteristic large cells with granular cytoplasm and spindle cells resembling fibroblasts. The exact histogenesis is still uncertain, various theories of origin are epithelial, undifferentiated mesenchymal cells, pericytes, fibroblast, smooth muscle cells and nerve related cells. Herein we report a newborn female child with Multiple Congenital epulis arising from maxilla and mandible with investigation, management and follow-up.

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Midgut volvulus due to intestinal malrotation is a rare occurrence in adult life. Malrotation is a congenital, developmental anomaly that results from an arrest of the physiological rotation of the gut through 270°. It is often thought that complications due to it, present themselves early during childhood and rarely occur among adults. However, a few cases have occurred and have been reported among adults. When it does occur in adults, it is often associated with catastrophic consequences. We present the case of a 45-year-old man with malrotation resulting in midgut volvulus. Our patient is a 45-year-old man, who presented with sudden onset of colicky abdominal pain and abdominal swelling of 24 h duration. He had been having recurrent abdominal pain since childhood. Physical examination revealed a patient in shock with markedly distended abdomen and anterior abdominal wall edema. Plain abdominal X-ray showed multiple air-fluid levels with thickened bowel outline. A diagnosis of intestinal obstruction was made. The patient was fully resuscitated and planned for emergency exploratory laparotomy under general anesthesia. Intraoperative findings revealed a 360° clockwise rotation of the small bowel around the mesenteric pedicle of the superior mesenteric artery and vein including about 350 cm of bowel gangrene. Resection and anastomosis were done. The early postoperative period was uneventful. However, he had anastomotic dehiscence on the 5^th postoperative day and had to be reoperated but sadly he died 24 h later due to complications of anesthesia. Nonspecific recurrent abdominal complaints in adults of any age should raise suspicion of the possibility of a midgut malrotation or malfixation with or without intermittent volvulus. This case highlights the importance of early diagnosis and treatment.

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Objective: Obesity is rising in the developing countries because of changing life style, and this has its burden on fertility and its management. This study determined the prevalence of obesity and clinical correlation of obesity with menstrual abnormalities, as well as the rate of spontaneous conception among obese infertile women on nonsurgical weight loss therapy. Methodology: A cross-sectional longitudinal study was done among women that presented with infertility to the gynecology clinic. The main outcomes measured were percentage of infertile women that are obese, menstrual pattern of these women, and spontaneous conception among obese infertile women following weight loss therapy. Results: Of the 205 patients, 68 (33.2%) were found to be obese; there was a significant association between obesity and abnormal menstrual pattern (P = 0.0002). Oligomenorrhea and hypomenorrhea were also found to be significantly associated with obesity (P = 0.009 and P = 0.022, respectively). Following average of 12-month follow up, spontaneous conception among obese infertile women while on weight loss therapy was 21.1%. Conclusion: The prevalence of obesity was high with a significant association between obesity and menstrual abnormalities. Weight loss among obese infertile women led to improvement in spontaneous conception.

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Background: Sickle-cell disease (SCD) is a common disorder worldwide, affecting 2% of the Nigerian population. Patients with SCD require emergency care, especially during crises. However, specialists are scarce in hospitals in most towns and cities of Nigeria. Effective primary care may be life-saving where there are no specialists. Objectives: To determine the knowledge, perception, and attitude of patients with SCD toward primary care in Zaria. Materials and Methods: It was a researcher-administered questionnaire-based cross-sectional study of patients attending the adult SCD clinic of Ahmadu Bello University Teaching Hospital, Zaria. Results: There were 78 respondents including 55 (70.5%) females and 23 (29.5%) males. The median and interquartile range age of respondents was 22 (7) years. Most respondents have attained secondary (58.1%) and tertiary (35.5%) levels of education. Fifty-six (71.8%) respondents have visited a primary care facility in the past. While 24/76 (31.6%) respondents felt that the nonspecialist doctor was the major primary care provider, 8/76 (10.5%) each felt that the community health officer and the chemists were the primary care providers. Bone pain (26, 66.7%) was the main reason for seeking primary care. However, 8 (14.3%) respondents felt that services were poor and 4 (7.1%) felt that services were excellent at primary care centers. Conclusion: SCD patients have a fair understanding of primary care; however, there is low patronage and poor perception about the quality of care provided by the primary care providers.

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Introduction: Risky sexual behavior among adolescents is a major contributory factor to adolescent morbidity. This is mainly because during adolescence, cognitive, and psychological maturity coupled with increased need for autonomy translates into a greater desire for independent decision-making. The study assessed reproductive health decision-making and its sociodemographic determinants among adolescent senior secondary school students. Methods: This was a cross-sectional study involving 384 adolescent senior secondary school students selected through multi-stage sampling. Data were collected through a self-administered questionnaire and analyzed using IBM SPSS Statistics version 20 and results are presented in tables and charts. Results: Mean age of the respondents was 17.5 ± 1.3 years, and 170 (44.6%) were <18 years old. Reproductive health decision-making was good in 116 (30.1%). If they were sexually abused, 187 (48.4%) said that they would report first to their parents. Reproductive health decision-making showed statistically significant association with gender (P = 0.04), and class of the study (P < 0.0001), but not with age (P = 0.24), ethnicity (P = 0.86), religion (P = 0.16), and marital status (P = 0.99). Conclusion: Reproductive health decision was generally poor, and it was influenced by gender and class of the study. Therefore, Government should consider ways of improving reproductive health decision-making among the secondary school students, possibly by including it in their school curriculum. Future studies should identify locally applicable interventions to promote parent–child connectedness for improving reproductive health decision-making among adolescents.

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Introduction: Preanesthesia assessment of patients is a major component of the perioperative care of surgical patients. The benefits of outpatient preoperative assessment clinics (PAC) were recognized over 67 years ago. However, these clinics are not used in Nigeria as part of surgical care. Search of the literature did not reveal any hospital in Nigeria that operates PAC, and therefore, its implementation in this country is still in process. This may not be unconnected with scarce financial, material, and human resources. Materials and Methods: This study was a questionnaire survey of the views of anesthetists, surgeons, and hospital administrators in some Nigerian Federal Teaching Hospitals on the usefulness and limitations of PAC. Structured questionnaires were sent to surgeons, anesthetists and Chairmen, Medical Advisory Committees in the selected Hospitalsand the results were analyzed. Results: Respondents indicated the benefits of preanesthesia assessment clinics as decrease in the incidence of surgery delays and cancelations, shorter lengths of hospital stay, improvement in the logistics of preoperative preparation, improved patient knowledge of anesthesia, and preoperative care as well as the role of the anesthetist in surgical care. Limiting factors to successful preanesthesia clinics were lack of cooperation from anesthetists and surgeons, other medical specialists, lack of supporting staff, finance, and appropriate office space. Conclusions: Preanesthesia assessment clinic increases the overall efficiency of the period of stay of the surgical patient in the hospital. Its benefits outweigh its disadvantages, and its successful implementation requires effort, time, money, and close collaboration with hospital administrators.

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