Background: Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability. It is extremely prevalent among university students and is a widespread problem globally. This study was conducted to determine the prevalence of depression and the academic factors that are associated with it among students of Ahmadu Bello University (ABU), Zaria, Nigeria. Methodology: This was a cross-sectional study conducted among 127 undergraduate students of ABU. Data were collected using a structured, self-administered Patient Health Questionnaire-9 (PHQ-9) and were analyzed using IBM-Statistical Software for Social Sciences, version 20.0. Results: Majority of the respondents (58.2%) had depression, with 37.0%, 15.7%, 3.9%, and 1.6% having mild, moderate, moderately-severe, and severe depression, respectively, according to the PHQ-9 scoring system, using a cutoff score of 5. There was no statistically significant association between depression and academic performance of respondents (P = 0.360) nor with interest (or lack thereof) in the course of study (P = 0.266). Conclusion: Depression, at different levels of severity, was noted among respondents. More screening and counseling services should be made easily accessible to students in the study area. Further research on nonacademic factors that could predispose to depression is recommended. This will aid in formulating policies for prevention and control of depression in the study area.

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Background: Cold chain management is a system of transport and storage of vaccines in a potent state from the time of manufacture to the time of administration. Preserving vaccines from its manufacture through administration requires adequate cold chain infrastructure, compliance with standards, and effective management. At the end of the chain, are healthcare providers who should have adequate knowledge to manage the cold chain. Aim: The aim of this study is to assess knowledge, attitude, and practice of cold chain management among primary health care (PHC) workers. Materials and Methods: A cross-sectional study was carried out using a pretested, structured, interviewer-administered questionnaire. A multistage sampling method was used in selecting the 78 respondents. Data were collated and analyzed using Statistical Package for Social Sciences version 23. Data were presented using frequencies and proportions. Results: Majority (71.8%) of the respondents knew the correct temperature range for which vaccines should be stored. Only 3.8% of the respondents had good knowledge of cold chain management. About two-thirds (75.6%) of the respondents agreed that cold chain management is important. Most respondents (78.5%) showed a positive attitude toward cold chain management. Only over half (51.3%) of the respondents had appropriate practice. Conclusion: This study has shown that the PHC workers in the study area had poor knowledge, about two-thirds had a positive attitude and only about half of them had appropriate practice on cold chain management. The local government department should improve on training and retraining of PHC workers on cold chain management.

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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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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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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: Healthcare workers treating cases of Ebola virus disease (EVD) are at greatest risk of getting infected themselves. The risk increases when these workers do not have appropriate protective clothing or do not wear them properly or handle contaminated clothing incorrectly. This risk is particularly common in parts of Africa where health systems function poorly and where the disease mostly occurs. The study was carried out to assess the knowledge and practice of EVD preventive measures among health workers in a tertiary hospital in Northern Nigeria. Methodology: A cross-sectional survey was carried out using a self-administered, structured questionnaire, with a sample size of 80 health workers selected through multistage sampling technique. The data obtained were entered, cleaned, coded, and analyzed using IBM Statistical Package for the Social Sciences statistics 20. Results: All the respondents had heard of EVD, with 73% of them having good knowledge of the disease. Majority (62.2%) of the respondents had excellent knowledge of preventive measures of the disease. Positive attitude toward EVD preventive measures was demonstrated by 84% of the respondents. Only 41% of the respondents practiced hand washing all the time when attending to patients, 69% always used hand gloves for procedures which may involve contact with blood and body fluids, while 27% always used facemasks and goggles for procedures that may involve splashes of blood and body fluids, and 34% of the respondents, however, still practiced recapping of used needles. Conclusion: A third of the health workers still practiced recapping of needles, and very few health workers always use facemasks and goggles for procedures that may involve splashes of blood and body fluids. Management of tertiary hospitals should improve staff training on EVD preventive measures.

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Context: Reduction in risk of stroke is possible through prevention, modification, or treatment of the emerging or established modifiable risk factors. Aims: The aim of this study is to assess the knowledge regarding stroke risk factors and factors affecting this knowledge among residents of Shika, Zaria. Settings and Design: A community-based cross-sectional descriptive study was conducted among 133 respondents in Shika community. Subjects and Methods: A pretested, semi-structured, interviewer-administered questionnaire was used to obtain data from the respondents. Statistical Analysis Used: Data were analyzed using IBM-SPSS version 21. Descriptive summary statistics such as mean and standard deviation (SD) were used to present numeric data such as age while frequencies and proportions were used for categorical data such as knowledge level. Chi-square test and Fischer's exact test were used to determine the association between categorical variables at a significant level of P< 0.05. Results: Majority of the respondents were males (64.7%), with a mean (± SD) age of 33 ± 14 years, and had tertiary education (46.6%). About 82.0% of them had ever heard of stroke. Only 21.8% of respondents had good knowledge (any respondent able to identify ≥2 established factors) of stroke risk factors. There was a statistically significant relationship between knowledge of stroke risk factors and gender of respondents (P = 0.04, χ² = 6.25) as well as with the educational status of respondents (P < 0.001). Conclusion: Knowledge of stroke risk factors was found to be poor among the respondents, and educational status and gender of respondents were found to be associated factors. To increase public knowledge of stroke, community-based educational strategies based on the results of this study should focus on people with poor educational background.

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Background: Resveratrol (RSV) is a biomolecule that has been demonstrated in numerous studies to possess therapeutic potentials with multiple targets. Despite the reported low bioavailability, it could exhibit novel role in clinical pain management. Objective: To investigate the systemic analgesic and anti-inflammatory effects of RSV in comparison to diclofenac and etoricoxib. Materials and Methods: Following institutional ethics approval, the study was conducted in the physiology research laboratory. The animals (42 male Wistar rats) used were divided into seven groups (n = 6) in separate cages. Chemical pain was evaluated using formalin-induced nociception test. Statistical analysis was done using analysis of variance and Kruskal–Wallis statistical tests. Results: There is a significant change in nociceptive score in the early phase; however, no significant changes in the late phase in the formalin test. Anti-inflammatory studies showed that RSV 50 mg/kg has a significantly potent anti-inflammatory effect when compared to control, but similar in activity to etoricoxib. Tumor necrosis factor alpha and interleukin-2 concentration did not significantly differ between the groups. Conclusion: RSV may elicit its analgesic actions by inhibiting the direct activation of nociceptors. It may be suggested that systemic RSV at a dose of 50 mg/kg in Wistar rats significantly reduces inflammation comparable to etoricoxib, but possibly less potent than diclofenac. Thus, RSV may be useful in the management of acute and chronic pain with significant inflammatory components. Further broad based human clinical studies on the analgesic and anti-inflammatory properties of resveratrol are required to confirm its potential role in clinical pain management.

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Background: Nasopharyngeal carcinoma (NPC) is uncommon cancer with unique geographical variations and strong association with Epstein–Barr Virus. The increasing incidence of NPC in Nigeria in recent years has reinforced the need for more studies to be done. This study aims to determine the frequency, age, and sex distribution as well as the histopathological patterns of NPC seen over a period of 22 years, from 1992 to 2013. Materials and Method: It was a retrospective study of all NPCs diagnosed in the Department of Pathology, Ahmadu Bello University Teaching Hospital from January 1^st 1992 to December 31^st, 2013. The request forms, histopathology reports, slides, and paraffin-embedded tissue blocks of all histologically diagnosed NPCs within the study period were retrieved and examined. The age, sex and site/nature of the biopsy were extracted. Histopathological diagnosis was in accordance to the 2005 World Health Organization classification. Results: NPC showed a frequency of 0.3% (112 cases) with a significant rise in incidence in the last decade. There was a male preponderance with M: F of 3.5:1. The age range was 6–91 years, mode 40 years, mean age 42.4 years, and peak age of incidence 40–49 years (18.8%). Histologically, nonkeratinizing carcinoma (NKC) was the most common (94.6%) followed by keratinizing squamous cell carcinoma (KSCC, 4.5%) and a single case of basaloid squamous cell carcinomas (bscc, 0.9%). Undifferentiated subtypes made up 79.4% of NKC, 12.7% differentiated and 7.9% mixed. In addition, 44.4% were of Regaud type growth pattern, 34.9% Schmincke type, and 20.6% were mixed. The nasopharynx was the most common site of surgical biopsy (57.1%) followed by the nasal cavity (17.9%) and cervical lymph node (11.6%). Conclusions: NPC showed a recent increase in frequency, a male preponderance and a unimodal age pattern that peaked in the 5^th decade with an overall mean age of 42.4 years. NKC over KSCC and a solitary case of BSCC was seen. A significant number of biopsies were from sites outside the nasopharynx, suggestive of advanced disease with poor prognosis.

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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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Background: Street-food vendors play an important role in the etiology of foodborne disease outbreaks. Foodborne disease pathogens may be transferred by street-food vendors to food either directly or by cross contamination. Deeply concerned by this, the 53^rd World Health Assembly in May, 2000 adopted a resolution calling on the World Health Organization (WHO) and its member states to recognize food safety as an essential public health function. The resolution also called on WHO to develop a global strategy for reducing the burden of foodborne diseases. This study, therefore, was aimed at assessing the personal and food hygiene among street-food vendors in Sabon Gari Local Government Area of Kaduna State. Materials and Methods: A cross-sectional descriptive study was conducted among 109 adults food vendors that sell cooked food or food items by the roadside or open spaces in the streets of Sabon Gari local government area (LGA) using multistage sampling technique. Observation checklist and a pretested interviewer-administered questionnaire with closed-ended questions were used for data collection. The obtained data were entered into a computer, cleaned and analyzed using IBM SPSS statistics version 20. Univariate and Bivariate analyses were conducted among the variables. Associations between categorical variables were tested for significance using Chi-square or Fischer's exact test. Statistical significance was said to be achieved where P ≤ 0.05. Results: Most of the street-food vendors were within the age group 35–44 years (40.4%), while 49.5% of the people who patronized them were passers-by. Half (50.5%) of the street-food vendors normally operate under a shade to sell food to customers. All of them did not receive any formal training on personal and food hygiene. Half (50.4%) of the respondents and 48.6% of them had poor practices of personal and food hygiene, respectively. However, 67.0% of the street-food vendors had a fair environmental sanitation status around their vending sites. Conclusion: The study found that none of the street-food vendors had ever received any form of formal training on personal and food hygiene. Many of them have poor personal and food hygiene practices; however, a significant proportion of them have a fairly good environmental sanitation status around their vending sites. Formal training on personal and food hygiene should be conducted among all street-food vendors in the LGA to improve on their personal and food hygienic practices for the vending of safe food to their consumers.

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Background: Visceral metastasis from breast cancer usually results in high tumor burden with poor prognosis. Aim: This study aimed to document the pattern, treatment, and outcome of breast cancer patients with visceral metastasis in our hospital. Patients and Methods: This is a 5-year prospective study of breast cancer patients with visceral metastasis from January 2011 to December 2015. All patients had tru-cut biopsy to establish diagnosis. Chest X-ray, abdominopelvic ultrasound, and computed tomography of the thoracoabdominal region were done to establish the extent of visceral organ involvement. Information documented included patients' biodata, histology, site of visceral metastasis, treatment, and outcome. Results: Two hundred and fourteen out of 1087 patients with breast cancer had visceral metastasis (19.7%). Their age ranged 15–83 years. Eighty-four (39.4%) patients had metastasis to the lungs. Thirty-nine (18.3%) patients had metastasis to the liver. Fifty-eight (27%) patients had metastasis to two or more visceral organs. One hundred and eighty-one (84.6%) patients had chemotherapy, 158 (73.8%) had hormonal therapy, whereas 103 (49.1%) had surgery. The mortality at 3-year follow-up was 58.4%. Conclusion: The lungs were the most common organ of visceral metastasis followed by the liver in this study. A significant percentage had metastasis to two or more visceral organs. Early presentation will reduce the incidence of visceral metastasis and the high mortality associated with it.

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Introduction: Iron is one of the most important micronutrients that play a vital role in hemoglobin (Hb) synthesis, cellular metabolism, and psychomotor function in humans. Iron deficiency is a major cause of anemia worldwide, particularly in children. The nomadic Fulanis have a migratory lifestyle determined by the availability of water and pasture for their livestock, making them difficult to reach, thus the paucity of knowledge on their health status. Objectives: To assess the Hb concentration, red cell indices, serum ferritin, and transferrin receptor levels among nomadic Fulani children in Ladduga grazing reserve of Kaduna state, Nigeria. Materials, Subjects, and Methods: This was a cross-sectional, descriptive study using questionnaires and physical examination of 340 children (5–15 years). Their complete blood count was determined by automation; serum ferritin and soluble transferrin receptor (sTFR) levels were assayed using enzyme-linked immunosorbent assay technique. Data obtained was analyzed using SPSS version 20.0. Level of significance was set at P ≤ 0.05. Results: The prevalence of anemia was 40.3%, which was significantly higher among the children aged 5–9 years (54.7%) compared to 30.5% in the 10–15 years age group (Z-statistic = 4.5, P= <0.001). Iron deficiency anemia was observed in only 19 (5.6%) of the study population. Median (interquartile ranges) serum ferritin and mean ± standard deviation sTFR levels were 56.0 (55.8) μg/L and 34.73 ± 14.29 nmol/L, respectively. Majority (77.4%) of the participants had normal iron stores and only 18.8% had low stores. Among the 137 participants with anemia, 19 (13.9%), 76 (55.5%), 102 (74.5%), and 76 (55.5%) had serum ferritin <30 μg/L, sTfR > 28.1 nmol/L, mean corpuscular volume <80 fl, and mean corpuscular hemoglobin <27 pg, respectively. Conclusion: There is a high prevalence of anemia among nomadic Fulani children at Ladduga grazing reserve. However, iron deficiency is not the only cause of anemia.

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Background: Temporomandibular joint (TMJ) ankylosis is a condition associated with restricted mouth opening. Following induction of general anesthesia, airway obstruction may occur leading to “can't ventilate and can't intubate scenario.” The anticipation of difficult airway and choice of appropriate intubation techniques usually prevent anesthetic morbidity and mortality. Patients and Methods: Both the surgeons' and the anesthetic review, as well as the anesthetic chart of the 36 patients managed at Ahmadu Bello University Teaching Hospital between January 2006 and December 2017, were studied. Data collected were bio-data of the patients, extent of mouth opening, and the techniques of intubation used. Results: The mean age of the patients was 26.9 ± 1.64, with a male to female ratio of 1:1.1. There were more male 19 (52.8%) than female 17 (47.2%). Tracheal intubation was achieved with the aid of nasal fiberoptic technique in 22 (61.1%) patients, 8 patients (22.2%) were intubated by tracheostomy, 4 patients (11.1%) were intubated by blind nasal intubation, while 2 patients (5.6%) required endotracheal intubation through conventional oral laryngoscopy. The interincisor gap was between 0 and <1 cm in all the patients which indicated significantly restricted mouth opening, with an average of zero interincisor gap. Conclusion: Fiberoptic intubation was the most used approach of achieving tracheal intubation in patients with TMJ disorder.

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Background: Maxillofacial injury has been described in the medical literature as early as 2500 BC. Although, these injuries appear very fearsome. They cause menace to life only, if they obstruct the airway. This is of utmost concern to the anesthetist, because of their closeness to the airway. Patients and Methods: A retrospective study of patients who underwent surgery for facial fractures within the period of 10 years in a Nigerian tertiary health care facility. Results: There were 264 cases of facial fracture with panfacial fracture, i.e., 123 cases (46.6%) constituting the bulk. The majority, i.e., 187 (70.8%) were male and the mean age was 33 years. Nasotracheal intubation (213 [81.5%]) was the technique widely used followed by orotracheal intubation (41 [15.5%]). The majority of the patients, i.e. 145 (54.9%) was Mallampati III and had advanced airway management. Most of our patients had the American Society of Anesthesiologists II, complications occurred in only 6% of patients. Conclusion: Nasal intubation was the preferred mode of intubation by the maxillofacial surgeons and the anesthetists.

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