Hospital In North-Western Nigeria Research Articles

Molecular characterization of antimicrobial resistance and virulence factors in coagulase – negative staphylococci nasal isolates among adult patients in a tertiary hospital in North-Western Nigeria

Coagulase-negative staphylococci are harmless microorganisms that can become pathogenic when the host resistance is impaired. Their ability to exhibit multidrug-resistance and form biofilm limit treatment options and contributes to the health and financial burden on health care systems worldwide. This study aimed to provide data on the acquisition and expression of genetic elements associated with resistance and virulence in the organisms from nasal colonization of adults admitted to a University Teaching Hospital in Nigeria. One hundred and twenty-three presumptive staphylococci isolates were obtained from the medical microbiology laboratory of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. The isolates were characterized, and the antibiotics susceptibility pattern assessed. Biofilm formation was evaluated by the micro-titre plate method, and polymerase chain reaction was used to detect resistance genes (mecA and ermB), virulence gene (psm-mec) and adhesin genes, (icaAB, icaC and icaD) in the isolates. Out of the 60 coagulase-negative staphylococci isolates, 50 (83.3%) were strong biofilm formers, 5 (8.3%) were moderate biofilm formers and 5 (8.3%) were weak biofilm formers. For the 14 isolates that were characterized by PCR, mecA and ermB resistance genes were detected in 78% and 71% of the isolates respectively. Twenty-one percent had psm-mec virulence gene while biofilm adhesin genes, icaAB and icaD were detected in 36% and 57% respectively, icaC gene was not detected. This study confirmed formation of biofilm, carriage of resistance and virulence genes which have been shown to play a role in pathogenesis. This study shows the necessity of the periodical monitoring of the drug resistance pattern and virulence factors of coagulase-negative staphylococci.

A survey of knowledge, attitude, and practice of oral hygiene amongst healthcare workers at a tertiary hospital in Northwestern Nigeria

The overall well-being of an individual cannot be complete without adequate oral health since the oral cavity is the gateway to the whole body and an integral part of the Gastrointestinal Tract (GIT). Many systemic illnesses manifest in the oral cavity and can be diagnosed easily by its simple clinical examination. The involvement of other healthcare workers in the hospital, such as medical doctors, nurses, and laboratory scientists, for effective and efficient dissemination of oral health education to the general populace, is of paramount importance by virtue of the large number of patients they come in contact with in their daily practice. However, this could not be arbitrarily assumed without calibrating their knowledge, perception, and practice of oral health to ascertain if they can truly impart positively to the patients. This study determined the knowledge, attitude, and practice of oral hygiene amongst healthcare workers at the Federal Medical Centre Gusau, northwestern Nigeria. A descriptive cross-sectional study was conducted amongst healthcare workers in Federal Medical Centre Gusau, Zamfara State, Nigeria. A total of 200 self-administered questionnaires were distributed using a convenient sampling technique. Data collected was analyzed using the Statistical Package for Social Sciences (SPSS; IBM Corp., Armonk, NY, USA) software for Windows version 25.0. Of the 200 questionnaires distributed, 193 (96.5%) were retrieved. The mean age of the participants was 37.1±8.53 years, with a range of 21 to 60 years. Study participants comprised of 114 (59.1%) males and 79 (40.1%) females. The majority (79.3%) were Muslims, while about one-fifth (20.7%) were Christians. About half (48.2%) of the participants were nurses, followed by laboratory scientists (31.1%), while medical doctors were 40 (20.7%) of the population. Slightly above half (50.8%) obtained their oral health information from oral health workers, while 58 (30.1%), 24 (12.4%), and 13 (6.7%) obtained their information from leaflets, family and friends, and newspapers, respectively. The average knowledge, attitude, and practice score amongst all the participants was good, as about 75%, 69%, and 63% answered correctly in the knowledge, attitude, and practice domains, respectively. There was a statistically significant difference between the different cadres of health workers in the attitude and practice domains tested (p<0.05). The oral health knowledge attitude and practice in the studied health workers is satisfactory. However, there are other aspects of the attitude and practice that need to be modified through continuous medical and dental education to be anchored by the Preventive Dentistry Department in conjunction with the Public Health Department of the state Ministry of Health.

Causes of Childhood Morbidity and Mortality in Emergency Pediatrics Unit of Rasheed Shekoni Specialist Hospital, Dutse, Jigawa State, Nigeria

Context: Under-five mortality rate in Nigeria is still high. Majority of the death are due to preventable diseases. Aim: To identify the causes of morbidity and mortality and mortality rate among children admitted to the Emergency Pediatrics Unit. Setting and Design: The study was a retrospective. Medical records of children admitted to Emergency Pediatric Unit of state specialist hospital in north-western Nigeria from January 2017 to December 2018 were retrieved. Material and Method: A designed proforma was used to extract information from medical records. Ethical clearance was obtained from the hospital. Statistical Analysis Used: Data were analyzed using SPSS version 16. Results: Records of 1,126 children admitted were analyzed. Their ages were 1 month to 13 years. Severe malaria (45.6%) and sepsis (13.9%) were the common reasons for admission. Majority (60.0%) were discharged home, 29.0% were transferred to the ward, and 0.5% discharged against medical advice. Mortality rate was 10.5%. Majority (50.3%) of the mortalities occurred less than 24 hours of admission. Under-five children had highest mortality (66.9%). Conclusion: Infectious diseases especially malaria and sepsis are still common causes of morbidity and mortality in children admitted to emergency unit.

Evaluation of Radiation Dose to the Thyroid Gland on Infant Patients Undergoing Anteroposterior Chest X-Ray at a Tertiary Hospital in North-Western Nigeria

The study aims at measuring the entrance surface dose (ESD) of the thyroid gland of infant patients undergoing anterior-posterior (AP) chest x-ray in Usmanu Danfodiyo University Teaching Hospital Sokoto (UDUTHS). The study further determines the effective dose to the thyroid on infant patients undergoing AP chest x-ray. Also, compare the entrance surface dose of infant patients obtained from the study with other similar studies and diagnostic reference levels (DRLs) recommended by the International Commission on Radiological Protection ICRP. This is a prospective cross-sectional study and the primary source of data was obtained. Pediatric patients used for the study who are referred to the radiology department for an anteroposterior chest x-ray, UDUTH, Sokoto state, Nigeria. A non-probability sampling technique was adopted for the patient who came in for a chest x-ray (AP) and as recommended by ICRP that a minimum of 10 patients should be used to determine the ESD for each projection, therefore 15 patients were adopted for this study. The result of the ESD obtained for the thyroid on infant patients undergoing chest x-ray (AP) was averaged and the mean of the ESD was 1.38 mGy. This result was compared to similar studies done within the country and outside the country and with the European Commission on radiological protection as seen in Table 6 and Figure 3. The ESD obtained in this study is much higher than those obtained in similar studies as well as the recommended Diagnostic Reference Levels (DRLs). The method adopted in the study was recommended by the international commission on radiological protection, as a result of this, comparisons were reliably made with the reference values and similar studies. The result has shown that entrance surface doses and radiation doses to the thyroid exceed the permissible value in Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto.

Colorectal carcinoma in a tertiary hospital in North-western Nigeria: a histopathologic retrospective review

Colorectal Carcinoma (CRC) accounts for about 3.9% of all malignant lesions in human beings with several studies identifying it as the most common gastrointestinal malignancy. It was previously considered to be more common in developed nations of the world but recent studies have reported increasing trends in developing nations. The study was done on all cases of colorectal carcinomas diagnosed between 1st January 2001 and 31st December 2010 in the Department of Histopathology of a tertiary institution. The laboratory request forms and the duplicate copies of histology reports were retrieved for extraction of relevant clinical information like age, sex, anatomical sites of the lesions and clinical presentations. Histological diagnoses and grading were also extracted. Corresponding haematoxylin and eosin-stained slides were retrieved and evaluated. Special stains were carried out where necessary. The lesions were classified according to the World Health Organization (WHO) histological variants and tables and figures were used to illustrate the results. A total of 186 cases of colorectal carcinoma were diagnosed during the period, representing 3.9% of the total malignant tumors and 50.4% of the gastro-intestinal malignancies. One hundred and ten cases (59.1%) and 76 cases (40.9%) were in males and females respectively with a male:female ratio of 1.46:1. The age range was from 17-87 years with a mean of 42.8 years and peaked at 61-70 years. Site distribution showed rectosigmoid lesions accounted for 64.5%, caecum, ascending colon, transverse and descending colons accounted for 9.1%, 3.8% and 2.2% each respectively. Most of the cases were adenocarcinoma (71.0%), followed by mucinous carcinoma (23.7%) and signetring cell carcinoma (3.8%). Colorectal carcinoma is prevalent in our environment and is the commonest malignant gastro-intestinal tumors. There is a slight male preponderance with adenocarcinoma the commonest lesion and rectosigmoid as the most common site.

A Two-Phase Survey of Psychiatric Morbidity among Females with Infertility in a Tertiary Hospital in North-Western Nigeria

ABSTRACT Background: The inability of couples to conceive or infertility has been identified as a major source of psychiatric morbidity. In several studies in sub-Saharan Africa, the psychological burden, often higher among females, is mostly assessed through screening measures and hardly by diagnostic instruments. This study evaluated the prevalence and clinical pattern of psychiatric morbidity among adult female patients attending Aminu Kano Teaching Hospital (AKTH) infertility clinic using the two-phase survey method. Methods: In the first phase, 281 respondents were assessed using sociodemographic, clinical, and the 12-item General Health Questionnaire (GHQ-12). The second phase was by using the World Health Organization Schedule for Clinical Assessment in Neuropsychiatry (SCAN) to interview all probable cases on the GHI-12 with a score of 3 or more, and 10% of non-cases. Psychiatric diagnosis was made in accordance with the diagnostic criteria of the 10th edition of the International Classification of Diseases (ICD-10). Results: The point prevalence of psychiatric morbidity in this study was 29.2% with a weighted prevalence rate of 64.8% projected onto the infertile population seeking medical help within the 3-month study period. Depression (21%) was the most occurring diagnosis. Generalized Anxiety Disorder and Somatisation were diagnosed in 6% and 2% respectively. There was a significant relationship between psychiatric morbidity and age, educational status, religion, and the duration of marriage (p<0.05). Conclusion: About one-third of infertile women in this study had psychiatric morbidity with depression being the most prevalent diagnosis. Psychiatric morbidity was significantly associated with increasing age, high educational attainment, religion and longer duration of marriage. The study demonstrated the need to include Consultation-Liaison Mental Health Practitioners in the management of women with infertility in order to meet their unmet mental health needs.

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Clinicopathological Correlates of Patients with Prostate Cancer in a Tertiary Hospital in Northwestern Nigeria

Knowledge, Attitude and Practices of Health Care Workers towards NOMA in a Tertiary Institution in North-western Nigeria

Background: NOMA is a potentially life-threatening necrotizing condition characterized by the destruction of oral and perioral tissues. NOMA is fatal in 90% of cases but the rate is reduced to about 8% with early recognition and treatment.
 Objective: To evaluate the knowledge, attitude, and practices of health workers towards Noma in a tertiary teaching hospital in north-western Nigeria.
 Methods: This was a cross-sectional study carried out among health care personnel using a self-administered questionnaire between October 2019 and February 2020. The questionnaire consisted of 20 questions covering the domains of knowledge and, attitude/practices. The total score for each domain was obtained and then categorized as low (less than or equal to 50%), fair (51 to 69%), and good (70% and above).
 Results: A total of 156 respondents filled and returned the questionnaires. Male respondents constituted 103(66%) as against 53(34%) Female respondents. The age range of respondents was 19 –54 years with a mean±SD of 32.8±6.6 years. Out of 156 respondents, 123(78.8%) were aware of Noma. The total score recorded in both the knowledge and attitude/practice domains were 72.5% and 47.5% respectively.
 Conclusion: The awareness of Noma among the study population was good. Those that were aware of the disease have good knowledge of it, however, the attitude and practices were low. Therefore, there is a need for continuous medical education among health care workers.

Challenges of contact tracing during COVID-19 pandemic response in a tertiary hospital in Northwestern Nigeria

Abstract Background: Contact tracing is a traditional pillar of infectious disease control, especially for illnesses involving direct transmission from person to person, such as COVID-19. Several challenges have arisen from COVID-19 contact tracing activities, particularly in low-resource settings. These include refusal of positive clients to disclose their close contacts, difficulties in conducting risk assessment for contacts traced, among others. Objectives: To explore the activities and identify challenges of contact tracing during COVID -19 pandemic response in a tertiary hospital in Northwestern Nigeria from May, 2020 to March, 2021. Methodology: A mixed method approach was done with quantitative secondary data analysis of COVID-19 contacts traced, and qualitative assessment through Key Informant Interviews (KII) of Ahmadu Bello University Teaching Hospital staff involved in COVID-19 outbreak response during the period. Results: A total of 2,249 clients were tested for COVID-19, of which 925 (41.1%) were healthcare workers. The identified challenges included problems with contact identification, delay in notification of results, refusal to disclose contacts by cases, contacts refusing to allow risk assessment, and health workers being overwhelmed by the task of contact tracing. Conclusion: Challenges identified include refusal of cases to disclose their contacts, overwhelming number of contacts, and delay in notification of results. There is need to institute contact tracing protocols to mandate cases to disclose their contacts, train more manpower to reduce the burden of contact tracing, and improve the notification of results.

Chest x-ray findings of paediatric patients seen at a Teaching Hospital in North-western Nigeria

Abstract Introduction: Plain radiography is the first line of radiological examination used for the evaluation of paediatric chest, and also a rapid imaging technique that allows lung abnormality to be identified. X-ray is used to diagnose conditions of the thoracic cavity, including airways, ribs, lungs, heart, and diaphragm. Chest x-ray has a high sensitivity for pulmonary tuberculosis and thus is a valuable tool to identify a differential diagnosis for a patient. Methodology: Two hundred and eleven paediatrics chest x-ray reports were studied between February 2017 to September 2018. Data were collected retrospectively from the hospital archives using a data capture sheet. Results: Two hundred and eleven radiographs were assessed and the age of patients whose radiographs participated in the study ranged from 0-15 years. Also, a greater number of male patients 133(63.03%) participated in the study than female patients 78(36.97%). Among all the radiographs used in this study, the most common age group for this study ranged from 0-3 years. Results from the study also revealed that bronchopneumonia was the most common finding totaling 105(49.76%) followed by radiographs which are normal findings 77(36.49), pulmonary tuberculosis, 19(9.00%), congestive heart failure 4(1.90%), pleural effusion 3(1.42%), enlarged adenoid 2(0.95%) and dextrocardia 1(0.47%). Conclusion: This study report bronchopneumonia was the most common paediatrics radiographic finding in a chest x-ray. Plain radiography is an effective tool to examine various respiratory and cardiac pathologies and is the first line of investigation for chest pathologies.

Development and reliability testing of a cervical cancer patients knowledge and practice of self-care management of treatment-related adverse events questionnaire.

Cervical cancer (CC) treatment-related adverse events (AEs) were found to be among the major reasons for treatments delays and medication non-adherence. Knowledge and practice of self-care management of these AEs are therefore needed to complement the pharmacotherapeutic interventions. Instruments for assessing CC patients' knowledge and practice of self-care management of treatment-related Adverse Events (AEs) are lacking. Hence, the rational for this study. A prospective, cross-sectional study was conducted on CC patients receiving chemotherapy, radiotherapy or both, with or without surgery in Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, a tertiary hospital in North-Western Nigeria. A panel of 14 experts judged the content validity of the items initially selected. Purposive sampling technique was used, 31 CC patients were recruited and interviewed for the questionnaire pre-testing. Descriptive statistics and psychometric analysis were conducted using SPSS Version 20.0 for Windows. A Cronbach's alpha coefficient ≥0.70 was considered acceptable. A 12-domain questionnaire instrument was developed. Eight (57.1%) of the expert panelists rated the questions' items as "Very good for the study" and none of them rated any of the content "not relevant for the study". The reliability studies showed that the overall knowledge and practice questions response rates were 71.0% and 77.4% and Cronbach's alpha (α) values were 0.956 and 0.913, respectively. A reliable, 12-domain cervical cancer patients' knowledge and practice of self-care management of treatment-related adverse events questionnaire was developed. Further research on the psychometric qualities of the instrument is needed.

Correlates of Depression among Elderly Patients Attending the General Out-Patient Department of a Tertiary Hospital in Northwestern Nigeria

Background: Depression is a common mental health problem in the geriatric population associated with significant morbidity (including decreased physical, cognitive and social functioning) and mortality. Although patients differ in their presentations, certain social and demographic characteristics are common to the elderly population with depression. It is hoped that identifying these patients based on their sociodemographic characteristics will help reduce the difficulties in diagnosis.
 Objective: The objective of this study is to determine the risk factors for depressive illness among elderly patients attending the GOPD of AKTH.
 Methods: This cross-sectional questionnaire-based study involved 392 elderly patients systematically selected from Family Medicine Clinic attendees in Kano, Nigeria. Data collected included sociodemographic and clinical characteristics. Geriatric Depression Scale was used to screen for depression. Chi-square test and logistic regression analysis were used to determine the association between categorical variables and predictors of depression among participants, respectively.
 Results: The prevalence of depression prevalence was 22.4%. Most participants were females aged 60-69 years (62.5%), Hausas (77.6%) and living with their spouses and children (77.3%). Gender, marital status, marital setting, socio-economic class, osteoarthritis and body-mass index were associated with depression. The predictors of depression were female gender (p=0.014, OR=1.401, CI=1.757- 2.591), widows/widowers (p=0.030, OR=4.533, CI= 1.186-17.317) and obesity (p=0.001, OR=5.644, CI=2.759-11.544).
 Conclusion: The high prevalence of depression among this population highlights the need for screening. Females, widows/ widowers and obese geriatric patients are more likely to be depressed and should be targeted for screening in our busy outpatient setting.
 Author
 F Damagum 1, B A Grema 1, G C Michael 1

Histological pattern of bladder cancer at a tertiary hospital in North Western Nigeria: an update

Background: An update on the histopathological patterns of bladder cancer in our environment is pertinent to determine the current prevalent histological type and if there is worsening schistosomal infestation as these can guide the management of bladder cancer.Methods: This is a prospective study of patients managed for bladder cancer at the urology unit, department of surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria between 02 February 2018 and 01 February 2019. Histology of biopsy specimens were done at the histopathology department of Usmanu Danfodiyo University Teaching Hospital, Sokoto. Data was collected using a structured proforma and analyzed using statistical package for the social sciences (SPSS) version 20.0.Results: A total of 65 patients were recruited into the study with mean age of 51.9 years and standard deviation of ±14.7. The male to female ratio was 6:1 and the commonest occupation of the patients was farming (41.5%). A total of 46 patients (70.8%) had squamous cell carcinoma following histology, followed by transitional cell carcinoma seen in 9.2% of patients and adenocarcinoma seen in 3.1% of patients. Schistosoma ova was seen in 13.8% of the patients while 3.1% of the patients had cystitis cystica.Conclusions: The commonest histological type of bladder cancer in our environment is squamous cell carcinoma. In this current study, the percentage of patients with squamous cell carcinoma is higher than the previously reported percentages while the percentage of patients with transitional cell carcinoma is lower than the previously reported percentages thus revealing worsening schistosomal infestation in our environment.

Some Oxidative Stress Biomarkers among Patients with Prostate Cancer in Sokoto, North Western Nigeria

Globally, prostate cancer (PCa) is the most common malignancy and the second leading cause of cancer-related death in men. It is a significant contributor to the burden of diseases and affects over a million men. This study investigated the levels of malondialdehyde and plasma total antioxidant capacity among patients with prostate cancer in Sokoto. This case-control study was conducted among 28 confirmed prostate cancer patients attending the Urology clinics in Usmanu Danfodiyo University Teaching Hospital and Sokoto Specialist Hospital in North Western Nigeria. Twenty-eight age-matched healthy males were monitored as controls. Determination of Total Antioxidant Capacity (TAC) was determined using Ferric Reducing Antioxidant Power (FRAP) reagent while the Malondialdehyde in serum was determined as a conjugate with Thiobarbituric acid (TBA) acid. Data were collected using a semi-structured interviewer-administered questionnaire. Data were processed using SPSS version 20 and results were reported as Mean ± Standard deviation. The malondialdehyde level was significantly increased (p s evidence of redox imbalance. Subjects in monogamous relationships compared to polygamous, rural dwellers, farmers, individuals of Hausa ethnicity and subjects who reported no family history of the disease were more predisposed to prostate cancer. Further epidemiological studies are needed to determine the predisposing factors and the potential role of these markers in the diagnosis, prognosis and management of prostate cancer patients in Sokoto in particular and Nigeria in general. We recommend that Malondialdehyde and Total Antioxidant Capacity be routinely monitored among patients with prostate cancer patients in the area.

Prescription patterns of evidence-based heart failure medications in a Tertiary Hospital in North-Western Nigeria—A retrospective study

Context: Several large clinical trials on the use of medical therapy in the management of heart failure have shown angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), beta blockers (BBs), and mineralocorticoid receptor antagonists (MRAs) to be of proven benefit and are recommended by guidelines. Aim: The aim of this study is to describe the trend of prescription and dosing of evidence-based medications used for chronic heart failure (CHF) in our population. Settings and Design: This is a retrospective study on the pattern of prescription of evidence-based heart failure medications on 200 consecutive patients with CHF who attended the cardiology clinic or were admitted into the Medical wards from January 2020 to December 2020 at Murtala Muhammed Specialist Hospital, Kano, North-Western Nigeria. The data was obtained from patients' records. Statistical Analytics Used: Data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 23 software. (SPSS Inc. Illinois, USA). Results: ACE inhibitors or ARBs were prescribed in 89 (44.5%), BBs in 76 (38%), and MRAs, in 192 (96%). None of the patients were prescribed angiotensin receptor-neprilysin inhibitors (ARNi) or sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors). Conclusion: Evidence-based heart failure medications are underutilized in patients with CHF in our population. Improved uptake and up-titration are needed for better patients' outcomes.

Triple-negative Breast Cancer (TNBC) and Its Luminal Androgen Receptor (LAR) Subtype: A Clinicopathologic Review of Cases in a University Hospital in Northwestern Nigeria.

Breast cancer (BC) is a common malignancy; the most frequent in Nigeria. BC characteristically exhibits great biologic diversity. Amongst its variants, the triple-negative subtype is also characterized by heterogeneity (thus making it a study in diversity within diversity) and also by some unique clinicopathologic features including clinical aggressiveness, lack of response to current targeted therapies, and tendency to cluster amongst young premenopausal women especially in populations of women of African ancestry. The objective of this study was to conduct a retrospective clinicopathologic survey of all breast carcinomas to profile the triple-negative breast cancers (TNBCs) amongst them and illustrate their immunohistochemical pattern of luminal androgen receptors (LARs) expression. All the cases entered into the departmental records as breast carcinomas over the study period were extracted including patients' request cards, hematoxylin and eosin-stained slides, and paraffin-embedded tissue blocks of those diagnosed as triple-negative cancers. These were immunohistochemically stained using a monoclonal antibody for androgen receptor (AR). The whole data were analyzed and presented in tabular formats. A total of 660 breast carcinomas of which 89 (13.48%) cases were identified as TNBCs with a mean age of occurrence of 42.89 ± 11.88 years. Most TNBCs (95.5%) were carcinoma no special type and 61.8% had low or intermediate histologic grading. LAR expression was noted in 11.24% of the TNBCs. Triple-negative cancer in this study shares some of the known characteristics but also portrays some divergence from the commonly described features.

Spectrum and Management of Urological Emergencies at Tertiary Hospital in Northwestern Nigeria

Spectrum and Management of Urological Emergencies at Tertiary Hospital in Northwestern Nigeria