Nigerian Journal of Basic and Clinical Sciences
The Nigerian Journal of Basic and Clinical Sciences (ISSN: Print - 0331-8540) is a peer-reviewed journal published on behalf of the College of Health Sciences, Bayero University, Kano. The journal publishes high-quality and impactful research works, reviews, and proceedings relevant to health sciences. It also serves as a medium for publicizing meetings, conferences, the latest books, and news related to advances in health sciences in Africa and globally. The journal is published twice a year (June and December). ISSN: Print - 0331-8540
Ophthalmic manifestation of leukemias in Aminu Kano Teaching Hospital,Kano,Nigeria
Background: Haematological disorders, particularly leukemias, constitute a significant public health burden in Nigeria due to their associated morbidity and mortality. This study aimed to evaluate the ophthalmic manifestations of leukemia among patients at Aminu Kano Teaching Hospital (AKTH), Kano. Methodology: A cross-sectional study was conducted among 61 patients with confirmed leukemia attending AKTH. Data were collected using a semi-structured questionnaire and analysed with SPSS version 22. Results: Among the participants, 36 (59.0%) were males, with a mean age of 29.7 ± 13.1 years. Chronic myeloid leukemia was the most common subtype (52.5%), followed by chronic lymphocytic leukemia (23.0%), acute myeloid leukemia (16.4%), and acute lymphoblastic leukemia (8.2%). Ocular manifestations attributable to leukemia were observed in 21.3% of patients, with retinal venous tortuosity being the most frequent finding (13.1%). Other manifestations included lid changes (8.2%), conjunctival changes (3.3%), and proptosis (1.6%). Ocular involvement was highest among patients aged 6–15 years (8.2%) and lowest among those aged 16–25 and 26–35 years (1.6% each). A statistically significant association was found between ocular changes and low-level occupation (p = 0.03). Ocular manifestations were more common in patients with high white blood cell counts (9.9%), low red blood cell counts (16.4%), and low platelet counts, with the latter showing a statistically significant association. Conclusion: Ocular involvement is relatively common in leukemia and may have prognostic significance. Routine ophthalmic screening at diagnosis and during follow-up is recommended, particularly for patients with identified risk factors.
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Characterization of Enterobacteriaceae from the Soil and Water of selected Abattoirs in Osun State Nigeria
Background: Environmental reservoirs of extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae are poorly documented in Nigeria despite increasing concerns about antimicrobial resistance. Objective: To characterize Enterobacteriaceae isolated from soil and water in selected abattoirs in Osun State, Southwestern Nigeria, and determine their antibiotic susceptibility patterns and the presence of β-lactam resistance genes (blaTEM, blaSHV, blaCTXM, and blaOXA48). Methods: A cross-sectional study was conducted in Osogbo, Ede, and Sekona abattoirs. Soil and water samples were collected during the dry season over a three-month period. Isolation and identification were performed using standard microbiological and biochemical methods. Antibiotic susceptibility was determined using the Kirby Bauer disk diffusion method, while polymerase chain reaction (PCR) was used to detect ESBL genes. Results: A total of 101 Enterobacteriaceae isolates were recovered (soil: 52; water: 49). Predominant soil isolates were Salmonella spp. (36.5%), Enterobacter spp. (32.7%), Escherichia coli (19.3%), and Klebsiella spp. (11.5%). Water samples were dominated by E. coli (48.9%). Multidrug resistance was observed in 82% of isolates. ESBL genes detected included blaOXA-48 (40%) and blaSHV (35%), while blaTEM and blaCTX-M were detected in single isolates. Molecular confirmation using 16S rRNA sequencing identified representative isolates as E. coli and Enterobacter cloacae. Conclusion: Improved abattoir waste management, environmental monitoring, and antimicrobial stewardship are essential to limit the spread of resistant bacteria and protect public health within a One Health framework.
Healthcare workers' perceptions of targeted institutional strategies to improve Autologous Blood Donation awareness and practice in a Tertiary Healthcare Facility in Northeastern Nigeria
Background: Autologous blood donation (ABD) is an evidence-based strategy that minimizes exposure to allogeneic transfusions and associated risks. Despite its clinical benefits, ABD remains underutilized in low-resource settings such as northeastern Nigeria, where institutional support is limited. Healthcare workers (HCWs) are critical for policy advocacy, patient education, and operationalizing transfusion practices. Understanding their perceptions of targeted institutional strategies is essential for enhancing ABD uptake. This study assessed healthcare workers' perceptions of targeted institutional strategies to improve ABD awareness and practice in a tertiary hospital. Methods: A cross-sectional survey was conducted in August 2025 at FUHSTHA, Nigeria, among 237 HCWs, doctors 59 (24.9%), medical laboratory scientists 16 (6.8%), and nurses/midwives 162 (68.3%) using a validated questionnaire (Cronbach's α = 0.7). Data were analyzed with SPSS 26, employing chi-square tests to examine associations (p ≤ 0.05). Ethical approval and informed consent were obtained. Results: Cadre was significantly associated with support for in-service training (χ²(6)=15.08, p=0.020, V=0.178), formal ABD policy (χ²(10)=19.63, p=0.033, V=0.204), patient awareness campaigns (χ²(10)=23.48, p=0.009, V=0.223), departmental ABD champions (χ²(6)=16.51, p=0.011, V=0.187), inclusion in standard surgical care (χ²(6)=24.30, p<0.001, V=0.226), and institutional support preferences (χ²(30)=69.65, p<0.001, V=0.383). Collaborative decision-making (p=0.223) and personal willingness to participate (p=0.698) were not significant. Effect sizes were weak to moderate, suggesting broad support across cadres with modest differences. Conclusion: Healthcare workers in this tertiary facility support structured governance, training, coordination, and audit to improve ABD practice, emphasizing a comprehensive institutional approach over financial incentives.
Community Pharmacists' Attitudes and Practices toward Public Health in Saudi Arabia
Background: Community pharmacists play an increasingly important role in public health delivery in Saudi Arabia, particularly in line with national reforms under Vision 2030. Although several regional studies have explored aspects of this role, there is limited national evidence assessing pharmacists' overall readiness and the factors that influence their engagement. Objectives: To evaluate the knowledge, attitudes, and practices of community pharmacists in Saudi Arabia regarding public health services; identify key barriers affecting their involvement; and examine demographic and professional predictors associated with these domains. Methods: A cross-sectional survey was conducted between March and June 2025 across the five main regions of Saudi Arabia. A structured questionnaire assessed pharmacists' knowledge and attitudes (11 items), practices (9 items), and perceived barriers (8 items). Descriptive statistics and nonparametric tests were used to analyze the data. Results: A total of 388 pharmacists participated. Knowledge and attitudes were generally strong, with more than half (55.2%) strongly supporting involvement in public health services. Actual practice was more variable, with basic screening activities such as blood glucose testing (47.6%) and blood pressure measurement (45.3%) reported most often. Key barriers included lack of training (mean 3.82) and limited funding (mean 3.69). Educational level, experience, and region showed significant differences across the KAP domains. Conclusion: Community pharmacists in Saudi Arabia demonstrate strong readiness to support public health initiatives, but their contribution is constrained by system-level and organizational barriers. Addressing training needs, strengthening institutional support, and aligning practice expectations with national reforms will be essential for expanding their public health role.
Maxillo-Mandibular Advancement Surgery for Obstructive Sleep Apnea in Adults: Evidence from an Overview of Systematic Reviews and Meta-Analyses
MMA surgery is used for the treatment of OSA. An overview of systematic reviews published regarding the single-stage MMA in the management of OSA was conducted. The Cochrane Library and PubMed/MEDLINE databases were searched. A qualitative data analysis was undertaken, with quality assessment completed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. The initial search yielded 814 articles, the titles and abstracts of 787 articles were screened and the full texts of 128 articles were assessed for eligibility. Twenty-five articles met the inclusion criteria while thirteen were excluded because the systematic reviews included surgical procedures other than single-stage MMA. Finally, twelve systematic reviews were analyzed. The AMSTAR score ranged from 2-11. Only two of the SRs included randomized controlled trials (RCTs), while the majority of the included primary studies were retrospective in design. The umbrella review presents significant insights into the strengths and limitations of the current systematic reviews on the role of single-stage MMA in the treatment of OSA, uncovers gaps in knowledge, and highlights the need for higher-quality prospective studies to strengthen the evidence base.
Lifestyle Modifications for the Prevention of Acute Myocardial Infarction: A Narrative Comparative Review of Obese and Non-Obese Populations
One of the biggest causes of illness and death in the world is still acute myocardial infarction (AMI). Obesity is a significant modulator of cardiovascular risk, and variable lifestyle factors account for a significant share of AMI incidents. We narratively compare the long-term effects, difficulties, and effectiveness of lifestyle changes in preventing AMI in adult populations that are obese and non-obese. PubMed and Google Scholar were used to perform a narrative review of the literature. Studies on adult human populations published in English between 2000 and 2024 were taken into consideration. Included were original research papers, randomized controlled trials, observational studies, and appropriate reviews examining lifestyle modifications to prevent AMI. A qualitative synthesis of the evidence was conducted with a comparative focus on obese and non-obese populations. Dietary changes, exercise, avoiding tobacco use, and behavioral techniques are examples of lifestyle treatments that have been linked to a lower risk of AMI in all BMI groups. Because of metabolic, inflammatory, and psychosocial barriers, obese people frequently need more intensive, diverse treatments, while non-obese people benefit from risk-factor and long-term behavioral preventative measures. In both obese and non-obese people, changing one's lifestyle can effectively lower the risk of AMI. In general, obese people need specialized, intensive, and long-term interventions. Certain public health activities are essential for improving cardiovascular outcomes, especially in low- and middle-income countries (LMICs).
Household Food Security and Women’s Empowerment in a selected Rural Community, North-West Nigeria
Background: Food security is an urgent global challenge driven by gender inequality. Women's empowerment is seen to improve household food security. This study determined household food security and its association with women's empowerment in Jaja, a rural community in Kaduna state, Northwest Nigeria. Methodology: A cross-sectional study of women 15 to 49 years selected from each house in the community using simple random sampling by balloting. Following an informed consent, a pretested semi-structured interviewer-administered questionnaire was used to obtain socio-demographic and household characteristics. Some domains of empowerment measured were level of education, literacy and income. Household food insecurity was assessed using the Household Food Insecurity Access Scale (HFIAS). Data was analysed with IBM SPSS version 26 software, and associations between variables were tested at p<0.05 level of significance. Results: The study enrolled 371 women, who were predominantly married, Hausa and Muslims. Mean age of respondents was 26.9(SD±7.3) years, 197(53.1%) had no formal education, 259 (69.8%) were literate and their median monthly income was 500 Nigerian Naira only. 182(49.2%) households were not food secured. Household food insecurity was significantly associated with age (p<0.001), education (p=0.001), literacy (p<0.001) and income (p=0.045). There were significant associations between food security and household size (p<0.001), keeping a backyard garden (p=0.016) and ownership of farmland (p=0.006). Conclusion: Household food insecurity remains prevalent in this rural community and is significantly associated with key proxies of women's empowerment. Interventions that promote women’s empowerment, improved education, income generation, and agricultural access are needed to strengthen household food security.
Cardiovascular Risk Factors among Pregnant Women attending Antenatal Care at Primary Health Care Centres in Sokoto Metropolis
Background: Cardiovascular disease risk factors in pregnancy, including hypertension, obesity, and gestational diabetes, substantially increase the risk of maternal and fetal complications such as pre-eclampsia and preterm birth. Understanding their burden in antenatal populations is crucial for early detection and targeted interventions. Objectives: This study determined the prevalence of hypertension and obesity among pregnant women in Sokoto Metropolis and examined their associations with key socio-demographic factors. Methods: A cross-sectional study was conducted in nine randomly selected Primary Health Care facilities in Sokoto Metropolis using the WHO STEPS approach. Through multistage stratified sampling, 205 pregnant women were enrolled. Data were collected via structured questionnaires and physical measurements. Analysis was done using IBM SPSS version 25. Results: Of the 205 participating pregnant women, the mean age was 26 years. The prevalence of hypertension was 21 (10.2%). The prevalence of obesity (BMI ≥ 30 kg/m²) was 12 (5.9%), and an additional 58 (28.3%) were overweight. Cigarette smoking and alcohol consumption were reported by 2 (1%) and 4 (2%) of respondents, respectively. Educational level and occupational status showed significant associations with elevated blood pressure (p = 0.026 and p = 0.012, respectively). No significant association was observed between ethnicity and cardiovascular risk factors. Conclusion: This study found notable hypertension and obesity prevalence among pregnant women in Sokoto PHC antenatal clinics, highlighting the need for routine screening, strengthened health education, and targeted interventions to reduce cardiovascular risks during pregnancy.
General Practitioners' Knowledge On The Diagnosis and Management of Gout and Hyperuricemia in Northern Nigeria: A Cross-sectional online Survey
Background: Gout is a common inflammatory arthritis; however, gaps in general practitioners' (GPs) knowledge and confidence regarding its diagnosis and management remain a concern. This study assessed the knowledge, clinical practices, and confidence of GPs in managing gout in Northern Nigeria. Methods: A cross-sectional online survey was conducted between 2nd and 11th September, 2022, among 101 GPs recruited by purposive sampling from 19 states across three geopolitical zones in Northern Nigeria. A self-administered questionnaire, developed using standard gout classification and management guidelines, was pretested and reviewed by rheumatology experts to ensure content validity. The survey was distributed via Nigerian Medical Association WhatsApp platforms, and data were analysed using SPSS version 21. Results: The mean (SD) age of respondents was 39.0 (8.2) years, with 75.2% practicing in tertiary health facilities. Most participants (89.1%) had previously diagnosed gout, predominantly based on hyperuricemia (85.6%), while 42.6% reported using joint aspiration. Hyperuricemia was considered synonymous with gout by 13.9% of respondents and essential for diagnosis by 58.4%. Approximately 80% did not recognise fever, low-dose aspirin, or urate-lowering therapy as gout precipitants. Allopurinol was prescribed for acute gout by 69.3%, whereas 20.8% used colchicine. Only 19.8% had received continuing medical education (CME) on gout. Confidence levels were low: 5.1% for diagnosis, 6.1% for acute management, and 7.1% for hyperuricemia management. Conclusion: General practitioners in Northern Nigeria exhibit gaps in gout-related knowledge and clinical practice as well as low confidence with its management. Regular CME programs are needed to improve guideline-based management and patient outcomes.
Toll-like Receptor-8, Liver Enzymes and some Antioxidant Markers among Hepatitis C Virus infected Subjects in Kano Metropolis
Background: Hepatitis C virus (HCV) remains a major global health issue, contributing to significant hepatic damage. The quest to avert morbidity and mortality-related complications requires concerted efforts of researchers through exploring Toll-like receptor-8 (TLR8), superoxide dismutase (SOD), and glutathione peroxidase (GPx) biomarkers. The aim of the study was to assess TLR8, some liver enzymes, and some antioxidant markers among subjects with HCV infection in Kano metropolis. Methodology: One hundred and twenty subjects comprising of 80 HCV cases and 40 healthy individuals as controls participated in this study. Serum alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP) and Gamma glutamyl Transferase (GGT) were determined using enzymatic kinetic methods, while serum TLR8, SOD and GPx were measured using sandwich ELISA technique and body mass index (BMI) was calculated using the weight and height of the subjects by standard method. Results: The mean ALT and TLR8 were significantly higher, while SOD and GPx were significantly lower in HCV subjects compared with controls. BMI, AST, and ALP were not significant in HCV subjects compared with controls. There was a significant positive correlation between serum TLR8 and ALT (r=0.56, p=0.02), a significant negative correlation was observed between serum TLR8 and SOD (r=0.50, p=0.03). There was no significant correlation between TLR8 with AST, ALP, GGT and GPx (p > 0.05). Conclusion: These findings suggest that increased TLR8 activity may be associated with hepatic inflammation and reduced antioxidant defense in HCV patients, highlighting the potential role of TLR8 and antioxidant marker in HCV pathogenesis.
Essential Best Practices for Preventing and Controlling Healthcare-Associated Infections
Introduction: Healthcare-associated infections (HAIs) remain a major global threat, affecting hundreds of millions of patients yearly with high morbidity, mortality, and economic costs. Common types include catheter-associated urinary tract infections, surgical site infections, central line-associated bloodstream infections, ventilator-associated pneumonia, and Clostridioides difficile infections. Evidence shows 30–70% of HAIs are preventable through systematic evidence-based practices, which this narrative review synthesizes across foundational principles, device strategies, stewardship, surveillance, and implementation. Literature was searched comprehensively in PubMed, Cochrane Library, Google Scholar, and Web of Science, focusing on 2010–2025 publications, with key earlier works included. Gray literature from WHO, CDC, ECDC, and SHEA supplemented sources. English-language studies on HAI prevention in healthcare settings were selected, covering guidelines, systematic reviews, trials, quality reports, surveillance data, and consensus statements for a broad evidence overview. Hand hygiene via the WHO Five Moments framework reduces HAI rates by 15–50% with consistent adherence. Device bundles for insertion and maintenance cut central line infections, urinary tract infections, and pneumonia by 50–80%, enabling zero rates in high-fidelity programs. Surgical site prevention via preoperative optimization, timely prophylaxis, sterile technique, and wound care lowers rates by 40–70%. Antimicrobial stewardship reduces inappropriate use by 20–35%. Cleaning high-touch surfaces decreases reservoirs by 30–50%, while precautions interrupt transmission. Multimodal strategies tackle barriers at individual (knowledge gaps), environmental (supplies/staffing), and cultural levels. HAIs are largely preventable using hand hygiene, precautions, cleaning, device bundles, surgical strategies, and stewardship. Multimodal approaches with surveillance address implementation barriers through leadership, resources, education, redesign, and safety cultures. Organizations should prioritize these as ethical and economic imperatives, engaging staff for sustained reductions and enhanced patient safety.
Assessment of Doctors’ Knowledge on Management of Acute Blood Transfusion Reactions in a Tertiary Health Facility in North-Western Nigeria
Background: Blood transfusion is lifesaving but may cause severe immunologic and non-immunologic reactions requiring prompt recognition and management. In low- and middle-income countries, including Nigeria, transfusion safety is compromised by underreporting and limited physician awareness, weakening haemovigilance systems. Aim: This study assessed doctors' knowledge of managing acute blood transfusion reactions in a tertiary health facility in North-Western Nigeria. Materials and Methods: A cross-sectional survey was conducted among doctors at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, using a structured, pretested, interviewer-administered questionnaire. Of the 654 eligible doctors, 242 were randomly selected and 205 valid responses analysed. Data were collected between April and July 2017 and analyzed using SPSS version 22. Results: Participants had a mean age of 34.6 ± 0.5 and ranged 25–54 years with a male-to-female ratio of 2.5:1. Clinical experience ranged from <1 year (27.3%) to >20 years (8.3%). Years of practice were significantly associated with prior involvement in managing BTRs (p = 0.035). Knowledge of first-line management, immediate cessation of transfusion and maintenance of intravenous access was high across experienced groups (p = 0.83). While awareness of pre- and post-transfusion blood sampling was satisfactory, knowledge of urine-based investigations was poor, with a significant gender difference for post-transfusion urine sampling (p = 0.018). Frontline notification was well recognized, awareness of laboratory and institutional reporting pathways was limited. Conclusion: Doctors showed good initial management knowledge but significant gaps in investigations and reporting, highlighting the need for improved haemovigilance training.
Retrospective Epidemiological Assessment of Pediatric Acute Bronchitis at Ibn Al-Atheer Teaching Hospital, Mosul (2024)
Background and objective: Acute bronchitis (AB), also known as lobular pneumonia, is a common pediatric illness. The main clinical symptoms of AB include fever, headache, cough, asthma, dyspnea, and general malaise. The objective of the study was to identify the prevalence of acute bronchitis among children in Mosul City. Materials and methods: A retrospective study of the Ibn Al-Atheer Teaching Hospital's Statistics Center's acute bronchitis patient records was conducted. Data were collected retrospectively from the Ibn Al-Atheer Teaching Hospital in Mosul, using records for children with acute bronchitis. From January 12, 2025, to April 30, 2025, the study was conducted. The information was collected in 2025 between February 2 and February 27. Only data from 2024 was gathered, and it was broken down by month for every month of the year. Additionally, it was gathered by age and gender. SPSS version 27 was used to enter and analyze the data. Results: According to this study, the hospital's most common acute bronchitis patients are children between the ages of 1–4 years, forming a ratio (37.58%). Males exhibit a higher incidence than females across almost all age groups, at a rate (54.87%). Conclusions: The study concluded that acute bronchitis was diagnosed in more boys than girls. Children under one year old were more likely than any other age group to have acute bronchitis.
Beyond the Bruises: The Physical and Psychological Impact of Falls in Older Adults: A Narrative Review
Falls among older adults represent a major public health challenge, contributing substantially to injury, disability, loss of independence, and increased healthcare use. Evidence shows that a significant proportion of adults aged 65 years and above experience at least one fall annually, with risks rising with advancing age. While physical consequences such as fractures, head injuries, pain, and functional decline are well recognized, the psychological sequelae, including fear of falling, anxiety, depression, and social withdrawal, are often underappreciated. This review synthesizes existing literature on the combined physical and mental health consequences of falls in older adults. A comprehensive search of PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, PsycINFO, DOAJ, and Google Scholar was conducted. Peer-reviewed English-language quantitative, qualitative, and mixed-methods studies involving adults aged ≥60/65 years were included, examining physical and psychological consequences of falls using relevant free-text and MeSH terms. Falls frequently initiate a cycle of reduced activity, deconditioning, and recurrent falls, while persistent fear of falling may occur even without serious injury, further limiting mobility and participation. The bidirectional interaction between physical and psychological effects accelerates frailty and dependence. Notably, evidence from low- and middle-income countries (LMICs) remains limited. Addressing both dimensions through integrated, multidisciplinary interventions is essential to improve outcomes and preserve independence in older adults, especially in the LMICs with limited access to mental healthcare, rehabilitative and geriatric care facilities.
Analysis of Caesarean Section Trends in a Northern Nigerian Teaching Hospital Using Modified Robson Classification
Background: Caesarean section (CS) rate is a key indicator of the quality of obstetric care within a health facility or region. Although rates are generally reported to be low in Sub-Saharan Africa, an increasing trend has been observed in many tertiary hospitals, including those in Nigeria. The contributing factors are multifactorial and sometimes controversial, and there is often no standardized method for comparison across settings. The Robson classification has been recommended as a uniform tool for assessing and comparing CS rates, but its use remains limited in our environment. This study aimed to determine the trend of CS rates over a five-year period and to evaluate the indications for CS using a modified Robson classification. Methodology: This retrospective cross-sectional study was conducted at Ahmadu Bello University Teaching Hospital, Zaria. Delivery records from January 2016 to December 2020 were reviewed, with a retrieval rate of 82%. Annual CS rates were calculated, and indications were categorized using the modified Robson classification. Ethical approval was obtained from the hospital's research and ethics committee. Results: The overall CS rate was 28%, with a rising trend from 21% in 2016 to 31.2% in 2020. The highest CS rates were observed in Robson Groups 9, 7, and 5. Notably, the CS rate among women with a previous CS was 70%. Conclusion: CS rates increased steadily over the study period. The Robson classification proved to be a practical and reproducible tool for evaluating and comparing CS rates across settings.
Health Risk Assessment of Heavy Metals in Local and Imported Milk Consumed in Nnewi, Nigeria
This study assessed the potential health risks associated with cadmium (Cd), mercury (Hg), lead (Pb), zinc (Zn), iron (Fe), copper (Cu), and arsenic (As) in locally produced and imported milk consumed in Nnewi, Anambra State, Nigeria. A total of 24 milk samples were collected and categorized into four groups: locally produced liquid milk, imported liquid milk, locally produced powdered milk, and imported powdered milk. Heavy metal concentrations were determined using atomic absorption spectrometry. The results showed that locally produced liquid milk contained the highest concentrations of Cd, Zn, Fe, Pb, and Cu, while imported powdered milk exhibited the highest levels of arsenic and mercury. Significant differences (p < 0.05) were observed in copper concentrations between foreign and local powdered milk samples, as well as in cadmium, zinc, and iron concentrations between foreign and local liquid milk samples. The estimated daily intake (EDI) of iron from liquid milk exceeded the reference oral dose across all age groups, indicating a potential health risk. The hazard quotient (HQ) values for all metals in powdered milk were below one, suggesting no significant non-carcinogenic risk. However, the hazard index (HI) values exceeded one for several milk sample groups, indicating potential health risks to consumers, with the highest HI observed among females and powdered milk consumers. The study concludes that heavy metal contamination of milk poses a significant public health concern. Continuous monitoring and strict regulatory control of both locally produced and imported milk are essential to assess dietary exposure to heavy metals and mitigate potential health risks.
Epstein-Barr Virus (EBV) Expression in Nasopharyngeal Carcinoma in Kano
Background: Nasopharyngeal carcinoma (NPC) is one of the most common types of head and neck cancers and has a distinct geographic distribution. However, the prevalence of Epstein-Barr virus (EBV) involvement in its development has been rarely studied in Nigeria. This study aims to evaluate the immunohistochemical expression of EBV in NPC cases. Methods: This was a retrospective study covering five years (2015 to 2019) and included all NPC cases diagnosed at the Department of Histopathology, Aminu Kano Teaching Hospital, Kano (AKTH). The collected data included patient demographic details, clinical information, histological diagnosis, and EBV Immunohistochemistry positivity. Results: NPC cases showed a bimodal age distribution, with a mean age of 40 years. The majority of patients were male, giving a male-to-female ratio of about 3:1. EBV positivity was observed in nearly half of the cases, more frequent in males than females. Keratinising squamous carcinoma was the most common subtype among EBV-positive tumours. Conclusion: This study highlights the distinct immunohistochemical profile of NPC within this population, emphasising the role of IHC as a vital, accessible tool for characterisation. The findings underscore the necessity of integrating molecular EBV subtyping into routine diagnostics to refine risk stratification and personalise therapeutic strategies for NPC patients in this region.
Gut Microbiota Dysbiosis, Endotoxigenic Index, Atherogenic Index of Plasma, Dyslipidemia, and Liver Enzymes in Chronic Hepatitis B Virus: A Case-Control Study
Context: Gut microbiota dysbiosis has been associated with chronic inflammation, dyslipidemia, and the progression of liver damage in chronic hepatitis B virus (CHBV) infection. Aim: To evaluate serum endotoxin (LPS), lipid profile, liver enzymes, and platelet count (PLT) in subjects with CHBV and assess the potential role of gut dysbiosis in dyslipidemia and liver disease progression. Settings and Design: This case-control study was conducted at a tertiary healthcare facility to assess the impact of gut microbiota dysbiosis on dyslipidemia and liver function in CHBV patients. Materials and Methods: The study enrolled 40 subjects with CHBV and liver fibrosis (LF), and 40 healthy controls. Serum LPS levels were measured using ELISA. Liver enzymes, lipids, and PLT were determined using spectrophotometry and an automated hematology analyzer, respectively. LDL and VLDL cholesterol, endotoxigenic index (EI), and atherogenic index of plasma (AIP) were computed. Data were analyzed using ANOVA, Tukey-HSD post hoc tests, receiver operating characteristic (ROC) curves, and Pearson’s correlation at p < 0.05. Results: Compared with controls, subjects with CHBV and LF had significantly elevated liver enzymes, lipids, LPS, EI, and AIP, and reduced PLT (p < 0.05). Liver enzymes and LPS were significantly higher in dyslipidemic CHBV patients than in CHBV patients with normal lipid levels (p < 0.05). EI correlated positively with AIP (r = 0.559, p = 0.000). ROC analysis showed that EI and ALT had area under the curve (AUC) values of 1.000 and 0.916, maximum Kolmogorov-Smirnov metrics of 1.000 and 0.717, and sensitivities/specificities of 100%/100% and 92%/80%, respectively. Conclusion: Gut microbiota dysbiosis, dyslipidemia, endotoxigenic index, and AIP may serve as useful adjunctive markers for evaluating CHBV severity and progression. Further longitudinal and mechanistic studies are warranted to validate these findings.
Nephrotoxic Effects of Odogwu Bitters Herbal Drink in Adult Male Wistar Rats
Context: Herbal alcoholic drinks, like other alcoholic beverages, can be intoxicating and potentially harmful to the kidneys and other vital organs when consumed excessively. This study investigated the nephrotoxic effects of graded doses of Odogwu Bitters herbal alcoholic drink in adult male Wistar rats. Materials and Methods: Sixteen adult male Wistar rats, weighing 195–230 g, were divided into four groups (A–D) of four rats each. Group A served as the control and received only feed and water. Experimental groups received daily doses of Odogwu Bitters: Group B (0.45 mL), Group C (0.75 mL), and Group D (1.05 mL). The study duration was five weeks. Kidney function tests (creatinine, urea, and uric acid) were performed, and renal histology was examined for structural changes. Results: Histological analysis showed no pathological changes in Group B, while Groups C and D exhibited mild mesangial hypercellularity. Kidney function tests revealed no statistically significant differences between the control and experimental groups for creatinine, urea, and uric acid levels. Conclusion: Moderate and high doses of Odogwu Bitters consumed over five weeks caused mild renal changes, whereas low doses did not adversely affect kidney function or histology. These findings suggest that mild consumption may be relatively safe for renal health, while higher doses may exert mild nephrotoxic effects.
Antimicrobial and Antioxidant Activities of the Ethanol Leaf Extract from Medicago sativa
Context: Medicago sativa is a plant of significant ethno-medical importance and is valuable for research on oxidative and biological activities. This study aimed to evaluate the antimicrobial and antioxidant properties of its ethanol leaf extract. Materials and Methods: The antibacterial activity of the ethanol leaf extract of M. sativa was tested against clinical strains of Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Enterobacter aerogenes, Staphylococcus aureus, and Proteus mirabilis, with cefoxitin as a reference. Antioxidant activity was assessed using the DPPH spectrophotometric assay to determine free radical scavenging capacity at various extract concentrations. Nitric oxide scavenging potential was evaluated by exposing sodium nitroprusside to different extract concentrations. Phytochemical analysis of the ethanol extract was also performed to identify its bioactive constituents. Results: The ethanol leaf extract exhibited significant antibacterial activity against the tested pathogenic bacteria. Free radical scavenging activity varied with extract concentration in both DPPH and nitric oxide assays, indicating strong antioxidant potential. Phytochemical screening revealed the presence of alkaloids, glycosides, flavonoids, saponins, reducing sugars, tannins, steroids, and terpenoids. Conclusion: The ethanol leaf extract of Medicago sativa demonstrates potent antibacterial and antioxidant activities, supporting its traditional medicinal use in Africa. Its ability to scavenge free radicals and inhibit bacterial growth highlights its potential as a source of natural therapeutic agents.
Knowledge of Dentists in Tertiary Institutions on the Use of Clear Aligners as a Means of Orthodontic Treatment
Context: Clear aligner therapy (CAT) is a rapidly growing, patient-friendly, and compliance-oriented orthodontic modality. Its adoption in Nigeria remains limited, primarily due to higher costs compared to conventional fixed orthodontic treatments. Aims: To assess Nigerian dentists’ knowledge regarding the use and applications of CAT in orthodontic practice. Settings and Design: A cross-sectional analytical study conducted among dentists of various specialties and cadres practicing across all regions of Nigeria. Materials and Methods: Data were collected via a pretested, self-administered online questionnaire (Google Form) consisting of yes/no and Likert-scale items. Statistical analysis was performed using SPSS version 21. Categorical data were summarized as frequencies and percentages, while numerical data were presented as means ± standard deviations. Group differences were evaluated using the Kruskal-Wallis test with post hoc comparisons, associations were assessed using Spearman’s rank correlation, and predictors of knowledge were identified via binary logistic regression. Statistical significance was set at p < 0.05. Results: A total of 161 dentists from various tertiary health centers participated, with a mean age of 33.12 ± 4.89 years. Most respondents were aged 31–40 years (62.7%) and male (70.0%). The majority were registrars (54.0%), while dental officers were the least represented (9.9%). Participants included oral surgeons (23.6%), general practitioners (14.3%), and other dental specialties. Half of the respondents (50.9%) practiced in the midwestern region, while the eastern region was least represented (9.9%). Using a baseline knowledge score of 24.67 from orthodontic senior registrars, only 21.1% of participants demonstrated good knowledge of CAT. Knowledge scores varied significantly by age (p = 0.024), rank (p = 0.036), specialty (p = 0.001), and years of experience (p = 0.003). Binary logistic regression identified specialty as the only significant predictor of knowledge (p = 0.005), with orthodontic residents having significantly higher knowledge than other residents. Conclusion: Despite its global popularity, knowledge and use of CAT among Nigerian dentists remain limited. Integrating CAT into dental curricula, workshops, and research initiatives is critical to enhance awareness, improve adoption, and align orthodontic practices in Nigeria with international standards.
Influence of Three Different Oral Hygiene Practices on the Success of Orthodontic Miniscrews
Context: The success of orthodontic miniscrews is influenced by multiple factors, among which post-insertion oral hygiene plays a critical role in maintaining peri-implant health and ensuring implant stability. Aims: To evaluate the effect of three different oral hygiene practices on the success of orthodontic miniscrews placed for en-masse anterior retraction following first premolar extractions in adult patients. Setting and Design: A prospective study conducted in a tertiary hospital to assess the effectiveness of three oral hygiene regimens among patients undergoing fixed orthodontic appliance therapy. Materials and Methods: Participants were randomly assigned to one of three oral hygiene protocols for 12 weeks: Twice-daily tooth brushing Twice-daily tooth brushing plus twice-daily warm saline mouth rinse Twice-daily tooth brushing plus twice-daily 0.12% chlorhexidine mouth rinse Gingival inflammation and miniscrew mobility were assessed at day 7, week 4, week 8, and week 12 post-insertion. Statistical analyses were performed using the Chi-square test, with significance set at p < 0.05 and confidence level at 95%. Results: A total of 60 miniscrews were placed in 18 participants, divided into three groups of six participants each based on the assigned oral hygiene practice. Significant differences in peri-implant gingival inflammation were observed across groups at day 7 (p = 0.010), week 4 (p = 0.010), and week 12 (p = 0.010) post-insertion. Conclusion: Adjunctive use of warm saline or chlorhexidine mouth rinses did not provide a significant additional benefit in peri-implant stability or miniscrew success when compared to routine tooth brushing alone.
Efficacy of Miswak as an Adjunct to Tooth Brushing for Gingival Health: A Clinical Study in Qassim
Context: There is a global rise in the prevalence of oral diseases, increasing the need for oral hygiene methods that are safe, effective, economical, and easily accessible. Plant-derived chewing sticks have long been used as traditional oral hygiene tools. Salvadora persica, commonly known as Miswak, is the most widely used plant for this purpose. Aim: To evaluate the efficacy of Miswak as an adjunct to tooth brushing in improving gingival health among male patients in Qassim. Materials and Methodology: This case–control clinical study was conducted at Qassim University Medical City Dental Hospital, Al-Rass, involving 30 male patients. Participants used tooth brushing alone for 14 days, followed by 14 days of tooth brushing combined with Miswak use. Plaque Index (PI) and Gingival Index (GI) scores were recorded at baseline (T0) and after each intervention period. Results: There was a statistically significant reduction in Plaque Index between baseline and the tooth brushing plus Miswak period (p = 0.01214). A similar significant improvement was observed in Gingival Index scores (p = 0.011062813). Post-hoc t-test analysis showed a statistically significant difference in Plaque Index scores between T0 and the TB+M 14-day period (two-tailed p = 0.004525). Gingival Index scores also showed a statistically significant improvement between T0 and TB+M 14 days (two-tailed p = 0.00553982). Conclusion: Within the limitations of this study, the combination of tooth brushing and Miswak significantly improves plaque control and gingival health.
Sonographic Evaluation of Thyroid Lesions in Patients With Abnormal Thyroid Function Test in AKTH
Context: Thyroid lesions are highly prevalent, particularly among individuals with abnormal thyroid function tests. Their incidence increases with age and occurs more commonly in females. Ultrasound is an excellent imaging modality for characterizing thyroid lesions and assessing the risk of malignancy using the Thyroid Imaging Reporting and Data System (TIRADS). Aim: To evaluate the sonographic characteristics of thyroid lesions in patients with abnormal thyroid function tests at Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Methods: This cross-sectional comparative study included patients with recent abnormal thyroid function tests. Thyroid parenchyma was evaluated and classified according to the TIRADS system. Data were analyzed using SPSS version 23 for Windows. Results: A total of 270 participants were enrolled, comprising 45 males (16.7%) and 225 females (83.3%). The modal age group was 31–40 years. There was a statistically significant difference between the mean ages of males and females (p ≤ 0.05). Most participants (73%) had thyromegaly, while 27% had normal thyroid gland size. Hyperthyroidism was present in 218 participants (80.7%), and 52 (19.3%) had hypothyroidism. Among hyperthyroid patients, 161 (73.7%) were classified as TIRADS 2, followed by 47 (21.7%) as TIRADS 3. Among hypothyroid patients, 29 (55.8%) were TIRADS 2, and 19 (36.5%) were TIRADS 1. Differences in TIRADS categories between hyperthyroid and hypothyroid patients were statistically significant (p < 0.001). Conclusion: Thyroid lesions are more common in females, and the majority of participants had thyromegaly. TIRADS 2 was the most frequent category in both hyperthyroid and hypothyroid patients.
Comparison of Nasolabial Symmetry in Children with Repaired Unilateral Complete Cleft Lip and Non-Cleft Controls in Kano, Nigeria
Background Assessment of surgical outcomes following unilateral cleft lip repair may be incomplete without comparison with matched non-cleft controls from the same ethno-racial group, as nasal morphology varies across populations. Evaluating nasolabial symmetry in this context provides a more accurate understanding of reconstructive success. Aim To compare the nasolabial symmetry of children with repaired unilateral complete cleft lip—with or without palate involvement—with matched non-cleft controls in Kano, Nigeria. Methods This prospective comparative study assessed nasolabial symmetry in children who had undergone repair of a unilateral complete cleft lip and matched non-cleft children. Nasal parameters measured included nostril width, nostril height, and alar base width. Labial parameters included vertical lip height, vertical philtral height, horizontal lip length, and vermilion height. Data were analyzed using the independent sample t-test. Results Comparison between cleft and non-cleft participants showed that only vermilion height demonstrated no statistically significant difference between the groups (p = 0.184, p = 0.790). All other nasal and labial parameters differed significantly, indicating persistent asymmetry despite surgical repair. Conclusion Following surgical repair of unilateral complete cleft lip in Kano, notable differences remain in several nasolabial parameters when compared with non-cleft peers. Cleft surgeons are encouraged to consider ethnic and regional norms of facial morphology during surgical planning to optimize aesthetic outcomes.
Unilateral Complete Cleft Lip and Palate
Does the Pederson Difficulty Index Accurately Predict the Difficulty of Mandibular Third Molar Extraction?
Context This study aimed to determine the relationship between the Pederson Difficulty Index and the Modified Parant Scale, and to evaluate the effectiveness of the Pederson Index in predicting the difficulty of mandibular third molar extractions. Settings and Design A cross-sectional study was conducted among patients indicated for mandibular third molar extraction. The Pederson Difficulty Index was used preoperatively to assess anticipated extraction difficulty, while postoperative assessment was carried out using the Modified Parant Scale. Methods Eighty-five participants scheduled for surgical extraction of mandibular third molars under local anaesthesia were recruited between February and July 2018. The relationships between the Pederson Difficulty Index, Modified Parant Scale scores, and duration of extraction were examined. Descriptive statistics summarized sociodemographic data. Student’s t-test was used to compare group means, and correlations were computed between the Pederson Index, Modified Parant Scale, and surgery duration. Results The study included 85 participants with a mean age of 25.8 ± 4.6 years, with no significant gender difference (p = 0.87). The Pederson Difficulty Index showed a sensitivity of 46.4% and a specificity of 89.5%. A moderate correlation was observed between the Pederson Index and duration of surgery (r = 0.35, p < 0.001), as well as between the Pederson Index and Modified Parant Scale scores (r = 0.36, p < 0.001). Conclusion Preoperative assessment is essential for predicting the difficulty of mandibular third molar extraction. While the Pederson Difficulty Index demonstrates moderate predictive value, its relatively low sensitivity raises concerns regarding its reliability as a sole predictor of surgical difficulty.
The Impact of Social Support on Depression and Generalized Anxiety Disorder Among Women with Breast Cancer in Northwestern Nigeria: A Cross-Sectional Study
Background Breast cancer is a major health burden in Nigeria, particularly in Northwestern Nigeria, where it accounts for approximately 25% of all female cancer diagnoses. Beyond its physical effects, breast cancer is associated with substantial psychological distress—including depression and generalized anxiety disorder (GAD)—which negatively impacts quality of life, treatment adherence, and overall outcomes. Social support plays a protective role by buffering psychological distress; however, its influence among breast cancer patients in Northwestern Nigeria remains underexplored. This study aimed to assess the impact of social support on depression and GAD among women with breast cancer in this region. Materials and Methods This cross-sectional study involved 240 female breast cancer patients attending various oncology clinics. Depression and GAD were evaluated using the Mini International Neuropsychiatric Interview (MINI), while social support was assessed with the Oslo Social Support Scale (OSSS-3). Descriptive statistics were computed, and associations between social support, depression, and GAD were evaluated using chi-square or Fisher’s exact tests. Variables with significant bivariate associations were entered into a binary logistic regression model to identify independent predictors. Statistical significance was set at p < 0.05. Results Participants with poor social support experienced significantly higher rates of depression (p = 0.012) and GAD (p = 0.04). Logistic regression analysis further demonstrated that poor social support was an independent predictor of both conditions, significantly increasing the likelihood of depression and GAD among breast cancer patients. Conclusion Poor social support is strongly associated with increased rates of depression and GAD among women with breast cancer in Northwestern Nigeria. Strengthening social support systems may serve as an important intervention to improve the psychological well-being and overall treatment outcomes of this population.
Prevalence and Pattern of Mental Ill Health Among Divorced Women in Kano, Northwestern Nigeria
Context Divorce is one of the recognized ways of dissolving marriages. Evidence from existing literature—predominantly from Western settings—indicates that divorced women experience higher rates of psychiatric illnesses compared to their married counterparts. However, the mental health status of divorced women remains under-researched in many low- and middle-income countries, including Nigeria. This study examined the prevalence and pattern of psychiatric illnesses among divorced women in Kano, Northwestern Nigeria. Materials and Methods A cross-sectional study was conducted among divorced and married women in Kano. The General Health Questionnaire (GHQ-12) was used to screen for mental ill health. Participants who scored ≥4 on the GHQ-12, as well as 10% of those who scored <4, subsequently underwent assessment using the Mini International Neuropsychiatric Interview (MINI 6.0.0). Data were analyzed using SPSS version 20. Chi-square test was used to determine associations between marital status and psychiatric diagnoses. Results A total of 300 women aged 15–60 years participated (150 divorced, 150 married). Psychiatric illness was significantly more prevalent among divorced women (58.7%) than married women (34.7%), p < 0.001, with an odds ratio of 2.7 (1.7–4.3). Generalized Anxiety Disorder (GAD) was the most common diagnosis—25.3% among divorced women and 18.0% among married women—followed by depression (23.3% vs. 10.7%, respectively). Comorbid GAD with depression was also more frequent among divorced women (10.0%) compared to married women (6.0%) (p < 0.001). Conclusion Psychiatric illnesses were significantly more common among divorced women than married women in Kano. GAD was the most prevalent diagnosis, followed by depression and comorbid GAD with depression. Public health interventions are needed to address the mental health needs of divorced women, with emphasis on screening, early diagnosis, and psychosocial support.
Estimation of Knowledge, Attitude, and Practice of Oral Premalignant Conditions Among the General Population
Context Oral precancerous conditions and oral cancer remain major public health concerns for both the general population and healthcare professionals. Early diagnosis of oral cancer significantly improves survival outcomes. Aim To assess the knowledge, attitude, and practice (KAP) regarding oral cancer and oral premalignant conditions among the general population using a structured questionnaire. Materials and Methods A pre-tested, structured 22-item questionnaire was administered to 320 participants to evaluate their KAP related to oral premalignant conditions. Data collected were statistically analyzed using SPSS version 22.0. Results Out of 326 individuals approached, 320 completed the survey, yielding a response rate of 97.5%. Dental problems post-COVID-19 were reported by 10.6% of participants. Approximately 136 (42.5%) respondents were aware of the causes of oral cancer, and 205 (64%) reported that regular dental check-ups aid in early detection. Overall, participants demonstrated average to good knowledge of oral precancerous conditions, with statistically significant knowledge levels (P < 0.05). A large majority (84%) knew that dentists can diagnose oral cancer. Additionally, 268 (83.8%) participants recognized that oral screening camps help detect precancerous or early-stage oral cancer. About 82.5% expressed interest in learning about oral cancer risk factors, while only 8.7% had attended an oral health screening camp or program. Conclusion Participants in this study exhibited average to good levels of knowledge, awareness, and attitude regarding oral precancerous conditions. Early detection of oral cancer can significantly improve quality of life. Efforts should be intensified to promote awareness and provide educational initiatives on oral precancerous conditions among the general public.
A Study of Plasma and Follicular Fluid Levels of High-Sensitivity C-Reactive Protein in Women Undergoing In-Vitro Fertilization Treatment at National Hospital, Abuja: A Prospective Cohort Study
Context The prevalence of infertility is increasing globally. In-vitro fertilization (IVF) offers the highest pregnancy rates for infertile couples worldwide; however, success rates remain relatively low (11–46%). Implantation failure is the most common cause of IVF failure. The role of inflammatory mediators in implantation outcomes—particularly the potential use of follicular fluid biomarkers as indicators of oocyte quality—is currently under investigation. Aim To investigate the relationship between plasma and follicular fluid levels of high-sensitivity C-reactive protein (hs-CRP) and implantation outcome in women undergoing IVF treatment. Settings and Design A prospective cohort study involving 150 women undergoing IVF treatment at National Hospital, Abuja. Methods and Materials Plasma levels of hs-CRP were measured at down-regulation. Follicular fluid (FF) levels of hs-CRP were measured during oocyte retrieval. Implantation outcome was assessed using plasma β-hCG levels measured on the 14th day post-embryo transfer. Statistical analysis was conducted using the Statistical Package for Social Sciences (SPSS), Version 20 (Chicago, Illinois, USA). Results Plasma hs-CRP: Median level (overall): 6.00 mg/L (IQR = 6.81) Negative implantation outcome: 7.48 mg/L (IQR = 7.50) Positive implantation outcome: 3.62 mg/L (IQR = 7.17) Difference: Not statistically significant (p = 0.259) Follicular Fluid hs-CRP: Median level (overall): 3.69 mg/L (IQR = 5.18) Negative implantation outcome: 4.72 mg/L (IQR = 5.18) Positive implantation outcome: 2.25 mg/L (IQR = 5.01) Difference: Statistically significant (p = 0.035) Conclusion Follicular fluid hs-CRP levels were significantly higher in women with negative implantation outcomes than in those with positive implantation outcomes. This suggests that elevated FF hs-CRP may be associated with poorer implantation success, highlighting its potential role as a biomarker for IVF outcomes.