Background: Preterm birth is an important cause of perinatal mortality and morbidity in developing countries. Objective: To determine the burden of preterm birth in Aba, Southeastern Nigeria. Materials and Methods: A review of all preterm deliveries at the maternity hospital annex of the Abia State University Teaching Hospital, Aba, Nigeria between January 1, 2002 and December 31, 2006 was performed. Results: During the studied period, 5566 women delivered at the hospital. Three hundred and ninety-three of them had preterm birth, giving a preterm birth delivery rate of 7.1% in the hospital. Majority of the women, 229 (58.2%) had late preterm birth. Iatrogenic delivery was responsible for the preterm deliveries in 59 (15%) parturients. The mean of 1-min Apgar score was 5, while the mean of 5-min Apgar score was 7. The mean birth weight of babies was 1700 g (range 550-2800 g) whilst the total number of preterm deaths was 157, giving a preterm mortality rate of 40%. Conclusion: Preterm birth is a burden in Aba, Southeastern Nigeria. Improved care of preterm babies and measures to reduce the burden of preterm birth are urgently needed.

Objective: The aim was to determine the prevalence and pattern of congenital malformations. Materials and Methods: A retrospective study of neonates with congenital anomalies delivered at Federal Medical Centre Abakaliki, Ebonyi state over 10 year period was conducted. Data were extracted from the delivery records of neonates and mothers. Results: The prevalence of congenital anomalies was 0.42%. Highest frequency of congenital anomalies occurred in the digestive system (36.7%), followed by the skeletal system and the least in the cardiovascular system (5%). Majority of cases (83.3%) were term babies while 85% had normal birth weight. Highest proportion of babies with congenital anomalies (35%) was delivered by mothers aged 25-29 years and 40% by those of parities 4, 5. Ninety-three percent of the mothers were booked. Conclusion: The prevalence of congenital malformations in this study was 0.42%.Congenital malformations of the digestive system are the most prevalent in this study.

Background: Dermatomycoses, although a common health problem amongst diabetics, is often misdiagnosed and consequently undertreated. Objective: The aim was to obtain information on the pattern of dermatomycoses in diabetics in Aba, Abia State, Nigeria. Design: Data sources from patients attending diabetic clinics in three major hospitals in Aba, Abia State, Nigeria. Setting: Abia State University Teaching Hospital, Living Word Hospital, and New Era Hospitals, all in Aba, Abia State, Nigeria. Materials and Methods: A total of 400 diabetic patients were recruited for this study. Results: A total of 97 (24.3%) diabetics had lesions suspected to be dermatomycoses and dermatophytoses was the most common infection observed. Others are candidiasis and pityriasis. Trichophyton mentagrophytes was the most frequently isolated fungal organism. Lesions occurred more often at the inguinal region. Fasting blood sugar (FBS) levels ranged from 6.6 to 20.3 mmol/L. The prevalence of dermatomycoses was higher in diabetics with poor metabolic control. Conclusion: Fungal skin infections are common in diabetics, especially in those with poor control.

Health manpower is an important aspect of health care services. Like most of the countries in the world our country lacks resources for health care, hence the need for proper allocation and efficient utilization. There is no policy on health manpower or materials provided in the National Health Policy. In the absence of this there is nothing in the policy to prevent brain drain of doctors trained on public money. As a developing country, we can ill afford to have the dubious distinction of Indian doctors accounting for highest Educational Commission for Foreign Medical Graduates certifications and verification of credentials. The government should urgently address the need for arresting the trend of brain drain among Indian doctors

Background: Scaling up the practice of sanitary refuse disposal is currently a challenge facing Abia State Environmental Protection Agency in Aba. Objectives: The objective was to identify factors contributing to low level practice of sanitary refuse disposal in Aba and to determine the effects of health promotion intervention in addressing these factors. Design: A prospective, interventional study. Setting: Aba North and South Local Government Areas in Aba. Materials and Methods: Interventional study was carried out in two randomly selected communities in Aba March 2013 to September 2013. Sample size of 443 persons was systematically selected for the study. Instrument for data collection was questionnaire. Chi-square and McNemar statistic were used in testing for statistical significance. Results: Factors contributing to low level practice of sanitary refuse disposal in Aba were broadly categorized into four: Ignorance, inadequate sanitary refuse bins at homes and collection centers, poor attitude toward sanitation, delay in refuse evacuation. Conclusion: Health promotion intervention increased the practice of sanitary refuse disposal by 62% and is hereby recommended as a veritable tool for scaling up the practice of sanitary refuse disposal in urban areas.

Background: Smokeless tobacco has been used in various forms orally alone or in combination with other ingredients. In India, tobacco is taken in gutkha form by a large section of the population. Use of gutkha indeed represents a health concern of growing magnitude among these groups. As a consequence of its addictive qualities, the consumption of smokeless tobacco often becomes a lifelong habit with cumulative and deleterious effects on health. Chewable tobacco has been advocated as a substitute for cigarette smoking. On the contrary, the use of smokeless tobacco is fraught with health risk and needs to be discouraged. Previous reports have described long term harmful effects of nicotine on various body parameters, little is known about acute effect of smokeless tobacco on cardiopulmonary parameters. Very few studies have been undertaken on the acute effect of use of gutkha, a common form of smokeless tobacco in India on cardiopulmonary parameters of youngsters. Materials and Methods: Treadmill exercise testing and pulmonary function tests were done before and after maximal exercise testing to assess cardiopulmonary efficiency in two groups' viz., healthy sedentary controls and healthy gutkha chewers. Results: On studying the differences in cardiopulmonary efficiency in the two groups the resting heart rate (HR) was found to be statistically significantly higher in the study group and the delta HR was found to be statistically significantly lower among gutkha chewers. There was no significant difference seen in parameters like maximal oxygen consumption, maximum oxygen pulse, maximum voluntary ventilation, and maximum minute ventilation as an acute effect of gutkha chewing. Conclusion: In this study, it appears that gutkha chewers are physically fit like controls, but after immediate tobacco chewing a lesser delta HR suggests a higher risk for cardiovascular mortality. Stopping gutkha chewing at this juncture can be helpful in reverting back the risk and parameters like resting HR, recovery HR, and delta HR can be used as prognostic assessment tools for any intervention therapy to stop gutkha chewing in asymptomatic individuals.

Abbreviated new drug application is required to submit to United States Food and Drug Administration for approval of the generic version of an innovator drug. This application is for (DuLocap) ^® duloxetine hydrochloride delayed release (DR) capsules 60 mg manufactured by alpha pharmaceuticals. This application is an abridged application claiming essential similarity to the brand product that is, Cymbalta ^® (duloxetine HCL DR capsules) 60 mg, mfg by Lily S.A, Spain and marketed by Eli Lilly, This is application is filed on the basis of para III (patent expires on June 11, 2013).

Volvulus of the Caecum is a rare cause of mechanical intestinal obstruction. A 30-year-old young man with acute mechanical intestinal obstruction from cecal volvulus is presented. Cecal volvulus is a rare cause of mechanical intestinal obstruction and preoperative diagnosis might be difficult.

Rapunzel syndrome is a rare trichobezoar, involving strands of swallowed hair extending as a tail through the duodenum, beyond the stomach. Trichobezoar usually occur in patients with history of trichotillomania, characterized by compulsive behavioral disorder of pulling own hairs, combined with trichophagia that consists of ingesting that hairs. It typically occurs in the stomach and rarely affects the small intestine. Trichobezoars are more common in adolescent females. Common presentation is a gastrointestinal tract obstruction with nausea, vomiting, gut perforation, hypo chromic anemia, vitamin B12 deficiency, weight loss, an abdominal mass, or other serious problems. Trichobezoar with Rapunzel syndrome is an uncommon diagnosis in children with <40 cases reported. It is predominantly found in emotionally disturbed or mentally retarded youngsters. Trichobezoar is a rare condition that may pose a diagnostic challenge. Patients with this condition often have an underlying psychiatric illness, and history may not be easily forthcoming. The condition should be entertained especially in young females. Delay in diagnosis may lead to futile complications. We present the case of a 14-year-old girl who presented with abdominal pain, vomiting and a nontender abdominal mass.

Osteoarthritis is degenerative joint disease increasing linearly with age. The hip joints are part of the spectrum of involvement with its weight bearing functions. This was worsened with excessive weight of our patient who was evaluated with conventional radiography, computed tomogram, and magnetic resonance imaging.

Electrical injuries are relatively uncommon. The mechanism may be by a direct electrocution, arcing or flash burn. The arcing or flash injuries may result in superficial burns, whereas the cases of electrocution are often deep and can result in loss of limbs following amputation of charred or gangrenous limbs or death following bleeding jugular vessels. Three cases are presented to highlight some patterns of electrical burns ranging from flash injuries with minimal sequelae to electrocution with resultant limb amputation and death following bleeding jugular vessels. Electrical injuries, though uncommon, are still adding to limb amputations and death in this environment. This can be minimized by proper education in handling electrical gadgets and reduced interference with high tension cables.

Cavernous sinus thrombosis is a fatal disease and require aggressive treatment. This progresses rapidly and sometimes there is intracranial extension. Here, we report a case of pansinusitis and cavernous sinus thrombosis that eventually developed middle cerebral artery territory infarct. Patient was middle aged diabetic and was having a history of tooth extraction 10 days back. We suggest that unusual complication of ischemic stroke with cavernous sinus thrombosis should be kept in mind, while dealing with these patients.