Context: The World Health Organization 2013 estimates revealed 49,000 newborns died from neonatal tetanus (NT), a 94% reduction from the late 1980s. Over 24 countries, including Nigeria, have still not reached maternal and NT elimination status. Aims: The aims of the study were to assess knowledge and determine the extent of tetanus toxoid (TT) coverage among women of reproductive age in Kwarbai, Zaria, challenged by effects of tetanus and inadequate vaccination. Settings and Design: Kwarbai is essentially an agrarian, trading, and blacksmithing Hausa Muslim-dominated community with rich culture exhibited in its creations, festivals, and local events that bring together people from all over to socialize and share information. Subjects and Methods: The cross-sectional descriptive study was conducted between December 2014 and January 2015. Semi-structured, interviewer and self-administered questionnaires were used to obtain data on reported findings. Statistical Analysis Used: Statistical Package for the Social Sciences software SPSS^® version 20 was used. Descriptive statistic measures presented as tables and graphs. Chi-square was applied for the comparison of proportions and associations between categorical variables. Results: Respondents' median age was 27 years, Hausa/Fulani (99%), Muslims (100%), married (82%), have more than four children (25%), and half attained tertiary education (54%). Women, 20–34 years, received more than one dose with education as major determinant of immunization uptake. Although level of TT knowledge is high, very few received the recommended five doses. Misconceptions linked to perceived benefits of the vaccine, route of administration, being a contraceptive and religion were some of the factors that reported to hinder respondents' uptake of the TT vaccine. Unavailability/short supply (81.8%) identified as reason for not receiving vaccine at health facilities. Conclusions: Despite high knowledge, completion of recommended doses of TT vaccine was not guaranteed due to stock-outs coupled with detrimental cultural and religious beliefs.

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Introduction: Periodic health examination (PHE) serves as a medium through which the workpeople receive recommended interventions to help them remain in a state of fitness throughout their period of employment. This study comparatively analyzed the awareness and practice of PHE among workers in public and private establishments in Zaria, Kaduna State, Northwestern Nigeria. Materials and Methods: A cross-sectional, descriptive study was carried out among 115 workers in private and 140 in public establishments in Zaria town, selected through a multi-stage sampling technique. Data were collected using a structured, self-administered questionnaire containing close-ended questions. Data were analyzed using SPSS version 17.0. Results: The mean age of the workers was 34.04 ± 9.65 years in private and 40.94 ± 8.99 years in public establishments. Majority of the workers in public 106 (93.0%) and private 125 (89.3%) were aware of PHE, but only 42.0% in private and 44.3% in public establishments had a good practice. Conclusion: The awareness of PHE among workers in both public and private establishments in Zaria was high; however, the practice was generally poor. There is the need for an intervention study among the establishments that will help translate such high awareness into practice for their benefit.

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Objective: Hyperprolactinemia may be associated with galactorrhea, menstrual abnormalities, and infertility. When diagnosed and appropriate treatment instituted, there may be early relief of these symptoms and pregnancy rate may increase. This study determined the prevalence of hyperprolactinemia among infertile patients with menstrual abnormalities and/or galactorrhea. Patients and Methods: A cross-sectional study of women attending the infertility clinic who had galactorrhea and/or menstrual abnormalities. Menstrual abnormalities for this study refer to those with oligomenorrhea and amenorrhea. Results: Out of the 207 women studied, 75 of them have hyperprolactinemia, giving a prevalence of 36.2%. Galactorrhea has higher sensitivity (68%), a higher positive predictive value (39.5%), and a higher negative predictive value (69.3%) when compared with menstrual abnormalities which had sensitivity of 44%, positive predictive value of 29.7%, and negative predictive value of 56.3%, respectively. They, however, have the same specificity of 40.9%. Conclusion: The prevalence of hyperprolactinemia is high in this study. Galactorrhea is a better clinical indicator of hyperprolactinemia when compared with menstrual abnormalities.

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Background: Workers in bakeries face many hazards in their work environment, and these hazards have the potential to cause injury or illness. The study assessed the knowledge of occupational hazards and the use of preventive measures among bakery workers in Kaduna North Local Government Area of Kaduna State. Materials and Method: The cross-sectional descriptive study was carried out in January 2017. The data collection tools were 258 pretested semi-structured interviewer-administered questionnaires and observational checklist. The collected data were manually cleaned, checked for completeness; entered into SPSS software version 20.0 and analyzed. The results were presented as tables and charts. Results: Majority (77%) were within the age bracket of 15–30 years with a mean age of 23 ± 2.1 years, 63% of males and 37% had secondary education with different job descriptions. The mean working experience was 5 years with only 14% and 2% of the workers having had training on prevention of workplace hazards and the use of fire extinguisher, respectively. The workers had poor awareness of occupational hazards such as tightness on the chest (30%), skin reactions/allergy (16%) and falls (17%) but with better awareness of burns (46%), cuts (37%) and hearing problems from excess noise (40.0%) among others. The most encountered symptoms/problems by workers were a muscular problem (72%), recurrent catarrh (65%), tightness on the chest (54%), recurrent cough (54%) and sneezing (52%) and symptoms of asthma among others. Apron, hand gloves and face masks were the commonly used protective devices by the workers and only 19% of the bakeries had functional first aid boxes. Burning was the most common method of solid waste disposal (52%). Conclusion: The workers had poor to average awareness of some occupational hazards with some encountering some problems as a result of their work. The use of personal protective devices such as apron, hand gloves and face masks were encouraging. However, the availability of functional first aid box and training on the use of fire extinguishers were major problems. There is a need for continuous training of the workers on prevention of workplace hazards, use of fire extinguisher and provision of basic functional first aid box among others in the workplace.

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Stroke is a major contributor to morbidity and mortality during pregnancy and puerperium. The most important risk factor of stroke in pregnancy is preeclampsia and eclampsia. The occurrence of cerebrovascular event in preeclampsia is often associated with a higher likelihood of mortality if not managed appropriately and in a timely fashion. A 32-year-old multiparous patient at 34 weeks 5 days of gestation presented to our hospital with 9 h history of headache, inability to speak, and inability to move the right side of her body. On examination, she was aphasic, had elevated blood pressure, right-sided hemiplegia, and significant proteinuria. A diagnosis of severe preeclampsia with cerebrovascular accident was made. She was jointly managed with the cardiologist and physiotherapist. She was commenced on antihypertensive and magnesium sulphate and was delivered of a live baby boy weighing 2.0kg through an emergency lower segment cesarean section. Pregnancy-related stroke is rare. There should be a high index of suspicion among caregivers, and multidisciplinary management is the key.

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Aim: To describe the causes, visual potential and the proportion of aphakics that can be prevented from being blind in BDTH, Kaduna. Method: A retrospective review, the records of all aphakics that had refraction from January 2011 and December 2015 was retrieved from the refraction unit of our hospital. Patient's biodata, presenting visual acuity, corrected visual acuity, spherical correction and diagnosis were extracted and analyzed using SPSS version 20. Outcome Measures: Presenting visual acuity, corrected Visual acuity and spherical correction. Results: In 5 years, 56 eyes of 42 patients were refracted, with a mean age of 68.9years, 24 (54.8%) were males and 19 (42.2%) were females. Aphakia was caused by surgery in 29 (51.8%), couching in 23 (41.1%) and trauma in 4 (7.1%). Most eyes were corrected with +10D lens and aphakic spectacles could prevent 45 (83.4%) eyes from blindness. Visual outcome depended on the aetiologic cause of aphakia. Conclusion: There are still a few patients blind from aphakia mainly following cataract surgery. Adequate refraction and provision of spectacles can prevent blindness in a large proportion.

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Context: Numerous methods have been used for obtaining intermaxillary fixation (IMF) in the treatment of mandibular fractures. Conventional methods such as arch bars and eyelet wires have been the most common methods for achieving IMF, but they have their own disadvantages. During the last two decades, IMF using intraoral, self-tapping IMF screws have been introduced for the treatment of minimally displaced fractures of the mandible. The present case control study evaluated the efficacy and associated complications of self-tapping IMF screws in the treatment of minimally displaced mandibular fractures. Materials and Methods: A total of twenty patients of minimally displaced mandibular fractures were divided into two groups and were treated with open and closed reduction methods using self-tapping IMF screws to evaluate the efficacy of IMF screws and associated complications. Results: The most common complications encountered were pain and edema in almost all patients. In Group I treated with open reduction, damage to the roots of teeth occurred in two patients, which later became nonvital after 6 weeks, while in Group II treated with closed reduction, two patients were seen with tissue overgrowth and screw loosening. In one case, postoperative malocclusion was also observed in Group I. Conclusion: Use of self-tapping IMF screws for IMF is a valid alternative to conventional methods in the treatment of minimally displaced mandibular fractures. Iatrogenic injury to roots of the teeth is the most important complication of the IMF screws but that can be minimized and/or overcome by a careful evaluation and treatment planning of the cases.

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Introduction: The World Health Organization recommends that infants should be exclusively breastfed to achieve optimal growth, development, and health. Nonexclusive breastfeeding (EBF) causes infant malnutrition which is widespread in most developing countries and accounts for 11% of global disease burden. The aim of the study was to determine the effect of integrated nutritional intervention on maternal knowledge, practice of exclusive breastfeeding, and nutritional status of under-five children in two rural communities of Kaduna State, Nigeria. Materials and Methods: The study employed a quasi-experimental design, carried out between November 2014 and June 2015 with baseline, intervention, and postintervention phases in two rural communities of Kaduna State, Nigeria (Dangaiya (Sabon Gari Local Government Area [LGA] and Kufena [Zaria LGA] communities). The intervention was conducted among 167 mother/child pairs independently selected from the study and control areas through a multistage sampling technique. Data were collected using interviewer-administered questionnaire at baseline and 6 months after intervention from both communities. Weights and heights/length of recruited children were measured. Data were analyzed using SPSS statistics software version 20.0. (IBM). Results: The result indicated that malnutrition exists among under-five children in the study area. Postintervention, mothers of the children in the study community had better knowledge of EBF (P = 0.001), duration of EBF (P = 0.001), and recommended total breastfeeding duration (P = 0.001). The change in the malnutrition status of the children was not statistically significant (P > 0.05). Conclusion: In this study, nutritional education of mothers only had positive impact on their level of knowledge of EBF but not on their practice; therefore, there is a need for the Kaduna State Ministry of Health and Local Government Authorities to put in place prolonged (>4 weeks) integrated nutritional interventions with emphasis on correct exclusive breastfeeding practices to improve the level of malnutrition in the state.

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Introduction: This study assessed two strategies for distribution of misoprostol using identified and trained community persons (village heads) and distribution in a Primary Health Care (PHC) facility during antenatal visits and its uptake for the prevention of postpartum hemorrhage (PPH) in two semi-urban communities in Sabon-Gari Local Government Area of Kaduna State, Northwest Nigeria. Materials and Methods: Using a quasi-experimental study design, two semi-urban communities, Hayin Dogo and Basawa, in Sabon-Gari LGA of Kaduna State were selected, and each was assigned either of the two misoprostol distribution methods using balloting. At baseline, 300 women who had delivered within 6 months of onset of the study were sampled in the two communities using multistage sampling technique. Using structured, interviewer-administered questionnaires, information was collected on their knowledge of PPH, misoprostol and its uptake after delivery. This was followed by communication interventions, mainly through community dialogues to raise awareness and create demand for misoprostol, identification, and training of traditional birth attendants (TBAs) and drug keepers in the two communities and positioning of the drug in the PHC center in Hayin Dogo and at community level in Basawa community. Subsequently, all the 320 deliveries in the two communities that occurred during the 6 months following intervention were identified at endline and the same questionnaire administered to the women. A monitoring phase was carried out for 6 months in between the pre- and postintervention where 284 deliveries in Hayin Dogo and Basawa communities were monitored whether they used or did not use misoprostol during home births. Results: Respondents knowledge significantly improved from 2.0% at baseline to 7.1% postintervention in Hayin Dogo (χ² = 4.7; df = 1; P < 0.05) and from 2.7% to 7.3% in Basawa, (χ² = 3.4; df = 1; P < 0.05). The uptake of misoprostol rose from 0% to 48.5% in Hayin Dogo and 37.7% in Basawa. There was no statistically significant difference in uptake of misoprostol in the two communities (z = −1.9; df = 318; P > 0.05). The educational level of the women had a greater influence on their use of misoprostol. Conclusion: There was an increase in knowledge of prevention and treatment of PPH. The intervention led to significant increase in the use of misoprostol, but the method of distribution did not significantly affect the uptake of the drug. Both strategies are feasible for distributing misoprostol for increasing its use at home deliveries.

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