ABSTRACT Background: Pediatric neurological conditions most commonly managed by physiotherapists in Nigeria include cerebral palsy (CP) and obstetric brachial plexus injury (OBPI). Adequate knowledge of risk factors, symptoms, and the role of physiotherapy in the management of these conditions, especially by mothers, may play a significant role in prevention, prognosis, and outcome of care. This study was, therefore, designed to investigate the level of knowledge of risk factors, symptoms, and role of physiotherapy in CP and OBPI among pregnant women in Ibadan, Nigeria. Methods: This is a cross-sectional study conducted in antenatal clinics of six selected hospitals in Ibadan, Oyo State, Nigeria. Two hundred and seventeen pregnant women attending the antenatal clinics across the selected hospitals were recruited. Information on the knowledge of risk factors, symptoms, and role of physiotherapy in CP and OBPI was obtained from the participants. Descriptive statistics of mean, standard deviation, percentages, and frequency distribution were used to summarize the data. Inferential statistics of Kruska–Wallis was used to investigate differences. Results: Only 19.4%, 31.1%, and 47% had good knowledge of the risk factors, symptoms, and role of physiotherapy in OBPI, respectively. Similarly, only 34.6%, 33.2%, and 36.4% had a good knowledge of the risk factors, symptoms, and the role of physiotherapy, respectively, in the management of CP. Conclusion: This study concluded that there is a need to create better awareness of the risk factors, symptoms, and role of physiotherapy in the management of CP and OBPI, especially among pregnant women.

ABSTRACT Congenital prepubic sinus is a rare congenital anomaly of the external genital organs, characterized by an opening on the dorsum with discharge of purulent material in most cases. The condition is not peculiar to males. The etiology behind this anomaly is still elusive, with some proposing that the anomaly is akin to urethral duplication. Immunochemistry findings revealing transitional epithelium in the mucosal lining of the sinus in some reports have corroborated this theory. We report two male pediatric cases. Each had a pustular-looking lesion on the dorsum of the penile shaft. The tracts were cannulated, skeletonized, and completely excised. The histological findings of stratified squamous epithelium were reported separately in our patients. Congenital prepubic sinus is a rare congenital penile lesion. A high index of suspicion is needed for diagnosis. The primary goal of treatment is to excise the entire tract to prevent recurrence.

ABSTRACT Background: Uterine fibroids (UFs) are common benign tumors in women, and their etiology is influenced by multiple factors. A cross-sectional study was conducted to investigate levels of Vitamin D in patients with UFs and explore the potential association between UF symptoms and Vitamin D levels. Methods: The study included 117 subjects: 50 healthy controls and 67 UF cases. Abdominal or transvaginal ultrasonography was conducted to confirm the diagnosis and assess the number, size, and sonographic appearance of the lesions. Blood samples were collected to measure 1,25-dihydroxycholecalciferol (D3) levels using an enzyme-linked immunosorbent assay kit. Multiple logistic regression analysis was used to estimate crude and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) for the risk of UFs. Results: After adjusting the potential confounders, women with high levels of Vitamin D were associated with a lower likelihood of UFs (AOR = 0.97; 95% CI: 0.93–0.99); and the odds of UF had decreased by 3% per unit increase in the level of Vitamin D. However, there were no significant differences in Vitamin D levels based on lesion location, size, or UF-related symptoms. Similarly, an inverse relation was observed between increasing body mass index and the UF (AOR = 0.84; 95% CI: 0.75–0.95). Although advanced aged and menarche, employed women, and economic status (lower) increased the risk of UF, there were no significant associations (P > 0.05). Conclusion: Findings showed that a high level of Vitamin D is associated with a reduced risk of UFs.

ABSTRACT Background: Therapeutic hypothermia is the recommended treatment for moderate-to-severe hypoxic-ischemic encephalopathy (HIE) in newborns. It is not readily available in low- and middle-income countries. Newer promising interventions include erythropoietin (EPO) and magnesium sulfate (MgSO4). This study evaluated the short-term effects of EPO and MgSO4 in the management of term infants with severe perinatal asphyxia. Methods: This was a randomized control trial conducted in the neonatal wards of two tertiary hospitals in Lagos over a 2-year period. Term neonates diagnosed with moderate-to-severe HIE at admission were randomized to receive either EPO (34 infants), MgSO4 (45 infants), or placebo care according to the unit protocol (29 infants). Survivors were followed up for 2 years for neurodevelopmental delay. The neonatal outcomes of the participants were presented here. Descriptive statistics were employed to analyze data using Stata version 16. Results: There were 107 participants; 69% were males, and 76.6% were outborn. The mean gestational age and birthweight were 38.6 (±2.4) weeks and 3000 (±677) g, respectively. The mean age at intervention was 19.0 (10–30) h. Four neonates had HIE 1, 73, HIE 2, and 30 had HIE 3. Only 14 babies received intervention drugs within 6 h of birth. Thirty-eight (35.5%) neonates died. Survival was significantly higher in infants treated with MgSO4 (34/45, 75.6%) compared to the placebo group (14/28, 50.0%, P = 0.03) but not in the EPO group (21/34, 61.8%, P = 0.32). The MgSO4 group had a higher decline in the risk ratio (RR) of neurological abnormalities compared to placebo (AdjRR: 0.34, 95% CI: 0.09–0.93, P = 0.007). Conclusion: Neonates with HIE had a better short-term outcome when treated with MgSO4 compared to placebo.

ABSTRACT Background: Hodgkin’s lymphoma is a malignant tumor of the lymph nodes that causes painless lymphadenopathy. Diagnosing it can be challenging, especially in the early stages, due to often nonspecific symptoms. This study addresses our center’s increased Hodgkin’s lymphoma (HL) incidence. Given the limited literature on this subject, we aim to enhance our understanding of HL’s incidence and clinicopathological features in our environment. Methods: This retrospective study analyzed HL cases from 2010 to 2022 at Lagos University Teaching Hospital and two private laboratories. Clinical data were gathered from case files and laboratory requests, and both hematoxylin-eosin-stained sections and immunohistochemical slides were reviewed to classify the diseases morphologically. Results: A total of 50 HL cases were identified, primarily in the cervical region, with 5 and 4 cases in the inguinal and axillary regions, respectively. Among the 34 with clinical information, there were 35% in Ann Arbor stage I, 15% in stage II, none in stage III, and 9% in stage IV, while 41% had unspecified stages. The cohort comprised 40 males and 10 females, with a male-to-female ratio of 4:1. Ages ranged from 2 to 72 (mean 32.8), and most cases (68%) involved individuals in their third to fifth decades. Histologically, the breakdown was 44% nodular sclerosis, 30% mixed cellularity, 8% lymphocyte-rich, 4% lymphocyte-depleted, and four unclassified cases. Conclusions: HL is common at our center. It typically presents at a late stage, predominantly nodal, and is more frequent in young adult males. The nodular sclerosis (NS) subtype is the most common, and a bimodal peak is not observed. The increased frequency among young people and late presentations indicates a need for improved access to clinical and diagnostic services.

ABSTRACT Background: Anxiety and depression among parents/caregivers during the COVID-19 pandemic largely influence their knowledge, awareness, and practice (KAP) regarding anti-COVID measures and their adherence to the personal protective measures for the prevention of infection. The present study was therefore done to evaluate the presence of anxiety and depression symptoms among parents during the COVID 19 pandemic and to find out its association with KAP and sociodemographic variables. Methods: This cross-sectional study was undertaken in the Department of Pediatrics of a tertiary care hospital from January to March 2021. Parents attending pediatric immunization clinics were interviewed on demographic data, screen time, socioeconomic status, knowledge, awareness, and practices about COVID-19. Probable anxiety and depression were assessed by the Hamilton scale and its association with KAP and sociodemographic characteristics was determined by Chi-square test or Fishers’ exact test. All tests were two-tailed with a significant P < 0.05. Results: Of 166 parents, 73.5% had probable anxiety, while 76.5% had probable depression. The knowledge, attitude, and practice components were good in 83.7%, 82.5%, and 29.5%, respectively. About 81.3% of parents had overall good to fair knowledge, awareness, and practice scores. Anxiety (P = 0.001) and depression symptoms (P < 0.0001) were significantly associated with KAP. Conclusion: The present study showed a good correlation of probable anxiety and depression among parents/caregivers of children with KAP, which impacted the preventive measures undertaken by them. Anxiety and depression symptoms were less in parents/caregivers with good KAP compared to caregivers with poor KAP.

ABSTRACT Clinical teaching is an integral and indispensable part of medical training imparted to undergraduate medical students and plays a vital role in making of competent health-care professional. Acknowledging the wide range of merits associated with clinical training among medical students, it is of utmost importance that targeted efforts and initiatives are taken to strengthen it and ensure the attainment of learning outcomes. The process of clinical training has been linked with multiple challenges related to teachers, students, patients, curriculum-related, and hospitals as well. In conclusion, clinical training has been acknowledged as one of the crucial aspects of medical training. It is imperative that the identified challenges interfering with clinical training should be addressed and students should be given a favorable learning environment to acquire essential skills.

ABSTRACT Background: Hand hygiene is one of the most effective practices for preventing transmission of healthcare-associated infections. However, compliance with guidelines on hand hygiene practices remains a major issue among healthcare workers. Few studies have emphasized dentists’ compliance with hand hygiene in oral health-related units. This study aimed to assess the hand hygiene practices among the different cadres of oral health professionals in a tertiary institution. Methods: This was a cross-sectional study conducted at the dental clinic of a tertiary hospital. A convenient sampling method was used, and the data were collected using a nonparticipatory observational technique. The oral health professional’s compliance with the five moments of hand hygiene, according to the World Health Organization, was assessed. Appropriate use of personal protective equipment and other hand hygiene practices were also evaluated. Descriptive and inferential analysis was carried out using the Statistical Package for the Social Sciences (SPSS) version 25, and the level of statistical significance was set at 5% (P < 0.05). Results: Three hundred oral healthcare workers (HCWs) were observed. Only 19 (6.3%) HCWs washed their hands before gloving and patient contact. Most oral HCWs, 245 (81.7%), touched surfaces after gloving. There was a statistically significant difference in hand hygiene practices among the different cadres of oral HCWs. Twenty percent of consultants washed their hands before gloving, while 10.1% of registrars, 0.9% of house officers, and 2.6% of students washed their hands before gloving. None of the hygienists, dental nurses, and technologists washed their hands before gloving. After treatment of the patient and degloving, 62% of the oral HCWs washed their hands. Conclusion: There was a suboptimal adherence to the hand hygiene protocol among oral healthcare professionals. Good hand hygiene practices should, therefore, be closely monitored by the infection control team of the hospital to prevent cross-infections.

ABSTRACT Background: The WHO surgical safety checklist (SSC) was introduced in 2008 to ensure consistency in patient safety in surgery worldwide. To be effective, it must be properly utilized. This study was conducted to evaluate the compliance and utilization of the WHO SSC at the Lagos University Teaching Hospital (LUTH). Methods: This mixed-method study was conducted over 12 weeks from November 29, 2023, to February 14, 2024. A prospective review of the hospital records of all patients who had surgical procedures was performed to assess the utilization and completeness of the SSC. Direct observation of the use of the SSC assessed the quality of delivery and attention of team members. After data collection, a survey was administered to 100 perioperative staff to determine previous training on the SSC, perception of its usefulness, and barriers to its implementation. Results: Three hundred and twenty surgical procedures were studied, of which 134 had direct observation of checklist implementation. There was 96.9% utilization (310 procedures) of the SSC during the surgeries. Sign-in was done in all but incomplete in 36.6%. Sign-in was similarly performed during emergency cases (98.3%) and elective cases (96.0%), P = 0.253 and during general anesthesia (96.8%), regional anesthesia (97.9%), and monitored anesthesia care (95.2%), P = 0.834. Most surgical specialties recorded 100% sign in except ophthalmology (27.3%). More use of the SSC was noted with the first cases of the day. Time out was done in 89.7% of procedures and completed in all. It was performed significantly more often during emergency cases 95.0% than elective cases 86.6% (P = 0.017). However, general 90.8%, regional anaesthesia 87.5%, and monitored anesthesia care 81.0% were comparable (P = 0.310). Of the 134 observed cases, quality of delivery was good in 72.7% but complete attention was noted in only 48.3%. Sign-out was omitted in all cases (100%). Seventy-four perioperative staff completed the survey, and 62.5% had no formal training on the use of SSC. Ninety-six (96%) agreed that the checklist improves communication and organization in the operating room and the culture of patient safety in the hospital. The main limitation to the use of SSC was stated to be workforce shortage. Conclusion: There are inadequacies in employing the SSC in LUTH. Completeness and quality of delivery required improvement. The importance of sign-out needs to be emphasized. Regular training and retraining of the perioperative staff are necessary to succeed.

ABSTRACT Metabolic syndrome (MetS) is a cluster of metabolic abnormalities, including insulin resistance, obesity, dyslipidemia, and hypertension, increasing the risk of cardiovascular disease and diabetes. Lifestyle factors such as poor diet, sedentary behavior, and smoking contribute to its rising prevalence. Emerging research suggests epigenetic modifications, including DNA methylation, histone modifications, and noncoding RNAs (ncRNAs), play a crucial role in MetS. This review examines how lifestyle factors influence epigenetic mechanisms that contribute to MetS. A comprehensive literature search was conducted using MEDLINE (via PubMed) and Google Scholar, focusing on studies investigating the epigenetic effects of diet, physical activity, and smoking on MetS. Relevant studies from reference lists were also included. Studies analyzing DNA methylation, histone modifications, and ncRNAs in metabolic tissues were prioritized. Exclusion criteria included studies lacking epigenetic analysis or those unrelated to MetS. Key data, including epigenetic findings, were extracted, focusing on links between lifestyle factors and metabolic gene regulation. Poor diet and smoking induce epigenetic modifications that impair insulin signaling, lipid metabolism, and inflammation. Exercise and balanced nutrition promote beneficial epigenetic changes, enhancing mitochondrial function and metabolic health. Lifestyle choices shape the epigenetic regulation of metabolism, influencing MetS risk. While poor habits worsen metabolic dysfunction, exercise and proper diet can mitigate epigenetic damage. Understanding these mechanisms can aid in developing targeted interventions for MetS prevention and management.