搜索结果：Nigerian medical journal : journal of the Nigeria Medical Association

Medical education is known to be demanding and stressful, often leading to mental health challenges such as stress, anxiety, and depression among students. Understanding the prevalence and factors contributing to these issues is crucial for effective intervention and support. A descriptive cross-sectional study was conducted among 400 medical students at the College of Health and Medical Sciences at Babcock University. Data was collected using a standardised questionnaire comprising sections on sociodemographic characteristics, depression (PHQ-9), anxiety (GAD-7), stress (PSQ), and health-seeking behaviour. Statistical analysis was performed using SPSS version 22, with descriptive statistics and chi-square tests applied. The value for p was <0.05, which is statistically significant. The prevalence of depression was 53.5% with 186(45.3%) having mild depression, more than half of the respondents had minimal anxiety, 202(50.5%), and a high level of stress, 214(53.5%), respectively. Factors affecting mental health included lack of institutional support 170 (42.5%), poor awareness of available services 125 (31.3%), and poor utilization of mental health services 310, (77.5%). Age was found to be statistically significant (x2=15.792, P=0.015) in terms of anxiety level. Additionally, significant associations were observed between stress and depression (x2=37.497, P<0.001), as well as between stress and anxiety (x2=44.286, P<0.001). This study shows that the levels of depression, anxiety, and stress are moderately high among the medical students, underscoring the urgent need for intervention and support mechanisms. Enhancing institutional support, integrating mental health education into the curriculum, and conducting regular screenings will go a long way in creating a supportive environment conducive to the mental well-being and academic success of its medical students.

Nigeria, the most populous country in Africa, is broadly divided into Northern and Southern geopolitical regions based on a historical, geographic, and political divide. While this division is predominantly geopolitical, it also aligns with deep-rooted disparities in socioeconomic development, educational attainment, infrastructure, and healthcare access. This opinion paper sheds light on the inequitable distribution of the 65 Medical and Dental Council of Nigeria-approved medical schools (as at July 2025) between Northern and Southern Nigeria. The inequitable distribution of accredited medical schools between Northern and Southern Nigeria is in a ratio of 1:3. Six states in the North do not have any fully accredited medical schools. The North's 13 fully accredited schools have the capacity to graduate a little above 1,700 medical students, whereas the South's 32 fully accredited schools have the potential to graduate almost 4,000 medical doctors in every given academic calendar. Factors including historical educational disadvantage, economic constraints, sociocultural factors, and insecurity were major contributory factors to this disparity. Strengthening political will, using public-private partnerships and innovative funding mechanisms, and encouraging inter-regional migration of health workers are key to a multipronged approach to addressing this inequity.

Professional Indemnity Insurance (PII) is an important cover for health professionals against the risks of legal and financial consequences of medical malpractice lawsuits. Nigerian medical doctors are still not adequately informed about it. This cross-sectional study evaluated PII knowledge and awareness among 300 registered physicians across different settings in Nigeria, including urban tertiary hospitals, rural clinics, and private practice. A self-validated questionnaire collected socio-demographic data, medical specialties, and the extent of PII knowle1dge. Descriptive and inferential statistics were used to analyse the data. Outcomes revealed that merely 32% of participants possessed sufficient knowledge about the purpose and scope of PII. Knowledge was significantly correlated with years of experience (p=0.03), with senior physicians exhibiting higher awareness, as well as practice setting (p=0.04), with doctors working in urban tertiary institutions performing better than those practising in rural clinics. In particular, 45% of urban tertiary hospital physicians expressed familiarity with PII, compared with 22% of rural clinic physicians, presumably due to greater access to professional resources. These disparities indicate a large gap in PII awareness, particularly in the countryside. To address this, the integration of medico-legal modules into medical training, as implemented in South Africa, would enhance knowledge among newly qualified doctors. Targeted education interventions, such as workshops and continuing medical education courses in diverse practice settings, would be required to bridge the gap. This would empower Nigerian doctors with the knowledge needed to access PII and hence better protect themselves and patients.

Peer-assisted learning (PAL) is the development of knowledge and skill through active help and support among matched companions.This study was carried out to evaluate the effectiveness of PAL on the outcome of undergraduate medical exams among the final year medical students at the University of Jos. This was a retrospectivecohort study onfinal year medical students. Multivariable logistic regression was used to determine the association between PAL participation, sociodemographic characteristics, and the outcome in their 2nd, 3rd, 4th& 5th undergraduate exams, with a confidence interval of 95% and a level of significance at p value <0.05. A total of 120 students participated,with 72(60%) males(M) and 48(40%) females(F). Marital status: 102(85%) were single and 18(15%) married. Mean Age (SD) of participants: 29 (4.2) years. Good outcome in the final year exam was associated with gender, age, and marital status: F:M Odds Ratio(OR)= 3.9 (95% CI: 1.1-15, p=0.036); students<30 years:>30 years OR=7.2 (95% CI: 2.4-22.2, p<0.001); married:singles(OR=0.2, 95% CI: 0.1-0.4, p<0.001).The pass rate of students who participated in PAL varied from 59.0-84.5%, similar to the non-PAL students: 59.3-86.1%.There were no statistically significant associations between PAL participation and exam outcome across all examinations.There was a steady rise in the participation and pass rate over the years for those who engaged in PAL. This study found no difference in exam pass rate among students who participated in PAL and those who did not. However, students who had a good exam outcome in the final year were either young, female, or unmarried. Also, PAL participation steadily increased over the years of the undergraduate training.

Peripheral Arterial Disease (PAD) is a significant complication among patients with Type 2 Diabetes Mellitus (T2DM), characterized by atherosclerosis that leads to reduced blood flow to the extremities. This article assesses the traditional risk factors for PAD and the predictive value of the new inflammatory biomarkers like fibrinogen and C-reactive protein (CRP), and the implications of PAD in T2DM patients, drawing from recent studies and findings. The presence of PAD in T2DM patients poses serious health risks, including increased risk of foot ulcers, limb amputation, and cardiovascular events, necessitating comprehensive cardiovascular risk management. The study aims to assess the effectiveness of various diagnostic tests for PAD, particularly the Ankle-Brachial Index (ABI), in detecting PAD and stratifying cardiovascular risk in T2DM patients. The study population comprises the recruitment of 112 Type 2 DM patients and an equal number and sex matched healthy participants as controls from three centres in Calabar, making a total of 224 participants. Socio-demographic information was collected. After physical examination and anthropometric measurements, the ABI was performed using a Doppler ultrasound device. Descriptive statistics were used to summarize clinical and demographic characteristics, and comparative analysis was done using chi-square for categorical variables and t-test for continuous variables. Logistic regression was used for independent risk factors associated with PAD. The median ages for the Type 2 DM patients and the controls were 58 years (IQR 10) and 58 years (IQR 11), respectively. The prevalence of PAD using ABI<0.9 in this study was 37.5% in people living with type 2 diabetes and 14.3% in controls. The prevalence of PAD for Type 2 DM patients and controls using symptoms of palpation of pedal pulsations and intermittent claudication was 17.0% vs 3.6% and 11.6% vs 2.7% respectively. There was a statistically significant relationship between advanced age, hypertension, duration of diabetes, glycaemic control, fibrinogen, as well as CRP, and PAD among people living with Type 2 diabetes. After multiple regression analysis, the predictors of PAD in this study were age, duration of Diabetes, and elevated serum CRP. There was no correlation between smoking, obesity, and lipid profiles with PAD. There is a high prevalence of peripheral artery disease among people with T2DM in Calabar. The use of ABI is of great value in the detection of PAD, as evidenced by a more objective assessment of PAD compared to intermittent claudication and reduced/absent pedal pulses. Routine screening of PLWDM for PAD using ABI would enhance early diagnosis and intervention.

The recent outbreak of diphtheria in Nigeria, lasting over 18 months, is largely attributed to a lack of vaccination, but other factors may have been contributory. The study aims to describe the characteristics of cases and control measures of a localised outbreak of diphtheria in Edo State, Nigeria. This was a descriptive study of patients who met the case definition for suspected diphtheria in Edo state between May and September 2024. A multidisciplinary management strategy was instituted for sample collection, integrated disease surveillance, contact investigation, awareness creation and standard treatment protocols. Data (age, gender, immunization status, signs and symptoms, receipt of Diphtheria Antitoxin (DAT), laboratory results and outcomes) were extracted from the case notes, entered into an Excel spreadsheet and exported into an SPSS spreadsheet for analysis. Continuous data were expressed as median (IQR), categorical data were summarized as proportions, and the level of immunity was categorized into adequate and inadequate. Ethical approval for the study was obtained from the University of Benin Health Research Ethics Committee with Protocol Number: ADM/22/A/VOL.VII/4831141825 and dated May 28th 2025. Of the19 suspected cases, 5(26.3%) were laboratory confirmed, and 4/5(80.0%) of the confirmed cases were older than 9 years. The commonest symptoms were catarrh12(63.2%), sore throat and neck swelling 11(57.9%) each, and fever and hoarseness 10(52.6%). The majority, 89.6% were vaccinated. Of the ten cases that had serology done, 7(70%) had inadequate immunity. No secondary cases were found on contact investigation. A multidisciplinary team approach ensured this outbreak did not spread widely. With diphtheria occurring in almost 90% of previously vaccinated children, waned immunity was likely a major contributor to this outbreak. It is recommended that booster doses be included in the immunization schedule of Nigerian children.

One of the most commonly performed surgical procedures in Obstetrics is caesarean delivery (CD), and certainly the oldest surgical operation. Caesarean delivery is life-saving, especially when there is a failure or contraindication to vaginal delivery. However, the health risk and the cost of the surgery may be quite challenging, especially in low-resource countries like Nigeria. The observed increased prevalence rate in recent times is alarming and has become a major public health concern, calling for regular appraisal of its indications in order to reduce the prevalence. This study was undertaken to determine the prevalence, trend, indications, maternal and foetal outcomes at Modibbo Adama University Teaching Hospital, Yola, Adamawa State. Nigeria. It was a hospital-based retrospective study of all the cases of CD undertaken between 1st January 2018 and 31st December 2022. Names and hospital numbers of patients were identified; the case folders were traced and retrieved. Necessary information was obtained and analyzed using SPSS version 17 software. Results were presented in percentages, simple graphs, and ratios. During the years under review, there were 8568 deliveries, out of which 2707 had cesarean delivery, giving a cesarean delivery rate of 31.6%. The major maternal indication was prolonged obstructed labor, 627 (23.09%), while that of foetal indication was foetal distress, 418 (15.44%). The trend of caesarean delivery in this study showed a steady increase between 2018 and 2019 and 2021 to 2022, with a drop in 2020. This was due to the lockdown following the COVID-19 pandemic in that year. The maternal mortality ratio was 776/100,000 live births, and case fatality was 0.8%, while perinatal mortality was 41/1000 births. The caesarean delivery rate in this study was very high when compared to most teaching hospitals in Nigeria. Effort should therefore be made to reverse the ugly trend. Therefore, a thorough and meticulous assessment of patients should be done before a decision is taken for surgery, especially elective caesarean deliveries.

Burnout Syndrome (BOS) is a psychological condition increasingly recognised in occupational health, especially within the healthcare sector. It significantly affects doctors' efficiency, job satisfaction, and well-being. Despite its global importance, there remains a lack of empirical studies exploring the prevalence and determinants of burnout among doctors in Nigeria. This study aimed to evaluate the prevalence, patterns, and predictors of Burnout Syndrome among medical doctors at the Federal Medical Centre, Abeokuta, Ogun State, Nigeria. A descriptive cross-sectional study was conducted among 211 doctors between January and December 2020. A semi-structured, self-administered questionnaire was used, incorporating the Minnesota Job Satisfaction Questionnaire and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) for Medical Personnel. Burnout was defined as a high emotional exhaustion score, a high depersonalisation score, and a low personal accomplishment score. Data were analysed using SPSS version 25, with statistical significance set at p < 0.05. Multivariate logistic regression was utilised to identify independent predictors of burnout. The overall prevalence of burnout was 54.5%. High levels of emotional exhaustion, depersonalisation, and low personal achievement were observed in 59.7%, 85.8%, and 96.2% of respondents, respectively. Younger age (31-40 years), absence of children, being a house officer, lack of additional qualifications, and &#x2264;10 years of post-registration experience were significantly associated with increased burnout. In logistic regression analysis, younger age and fewer years of post-registration practice remained significant predictors. Burnout is highly prevalent among doctors in the study location, with younger practitioners and those in early career stages particularly vulnerable. Institutional interventions focusing on wellness promotion, professional development, work-life balance, and institutional support are crucial in reducing the risk of burnout.

The financial burden of caring for a child living with epilepsy and its effect on the family's financial status and quality of life are understudied. This study aimed to determine the cost of care for children with Epilepsy in Port Harcourt. A purposive sampling method was employed. Participants were 37 children with epilepsy and their parents/caregivers. An interviewer-administered semi-structured questionnaire was used to obtain information on the socio-demographic, estimates of the financial costs of epilepsy care, the effect of caregiving on caregiver productivity and income. The average monthly income per family is $332.80 &#xb1; $116.82. The majority, 32(86.5%), financed epilepsy care via out-of-pocket payments. The average cost of epilepsy care is $66 per month ($792 per annum), accounting for 20% of the average family income. There was a negative correlation between hours spent on caregiving and household income (rho =-0.288; p-value = 0.084). Over two-thirds (67.6%) of the caregivers consider their overall well-being negatively affected by having a child with epilepsy. The cost of care of childhood epilepsy in southern Nigeria is high and takes up a significant proportion of household income. Concerted efforts need to be made to encourage subscription to health insurance to alleviate the financial burdens on families.

Epstein-Barr Virus (EBV) is a lymphotropic virus that persists in lymphoid tissues such as the adenoids and tonsils and has been associated with several head and neck diseases. Because adenotonsillar enlargement is common in children, this study investigated whether EBV contributes to hypertrophy of these tissues. A comparative cross-sectional study was conducted at the University of Abuja Teaching Hospital involving 90 age and sex-matched children, 45 test and 45 control. Adenoid size was assessed radiologically using the Fujioka Adenoid-Nasopharyngeal Ratio (ANR), tonsil size was graded with the Brodsky system, and EBV status was determined using Chemiluminescence Immunoassay. Postoperative tissue volumes were also measured. Ninety children (test: 45; control: 45) participated; groups were age- and sex-matched (p = 0.480). Mean ages were 51.7&#xb1;5.4 months (test) and 66.5&#xb1;5.6 months (control). Mean Brodsky grade was 2.80&#xb1;0.99, and mean ANR was 0.72&#xb1;0.21.EBV IgG prevalence for the test group was 91.1% and 8.9% were EBV negative prevalence, and 82% with 17% for control respectively. There was also a significant difference between the mean values of the EBV IgG titers in the test and control groups using the T-test analysis. T= 12.956, p= <0.001. The Odds ratio was 2.6. Only two (2) patients in the test group tested positive for EBV IgM and IgG. There was a positive correlation between EBV status and tonsil volume p=0.0320, r =0.320 and Brodsky grade r= 0.338 p= 0.023. However, the adenoid volume and ANR showed a weaker correlation with the EBV status of the test patients p= 0.466, r= 0.113. These findings suggest that EBV may be associated with the development and progression of tonsillar hypertrophy, and to a lesser extent adenoidal enlargement.

Cervical cancer is the second most common cancer in women in Nigeria and is largely preventable. However, in Nigeria, the absence of universal screening means individual awareness and knowledge significantly impact screening uptake. Previous studies have reported mixed results regarding awareness and screening rates.The study assessed cervical screening uptake rate among women of reproductive age. It was a descriptive cross-sectional study among women of reproductive age across the three senatorial districts in Ogun State, Nigeria, using interviewer-administered questionnaires following ethical approval. Data analysis was performed using IBM SPSS version 25. The outcome variables included the level of awareness and knowledge of cervical cancer and its pre-malignant screening, as well as the level of uptake of cervical cancer. A total of 1310 women were interviewed, with 1233 responses analyzed. The mean age of the respondents was 32.33 &#xb1; 6.25 years. Of the respondents, 592 (48.0%) were aware of cervical cancer, 281 (22.8%) were aware of cervical screening, and 141 (11.4%) had good knowledge of cervical cancer. Eighty (6.49%) participants had been screened at least once, and only nine had been screened at least twice. The majority of the women, despite the poor awareness and knowledge levels, were willing to be screened in the future. There was a statistically significant association between cervical cancer awareness and uptake of screening (X2 = 9.282, df =1, P-value = 0.002). Awareness, knowledge, and screening uptake remain low among women in Ogun State. However, awareness of cervical cancer positively influences screening participation. Therefore, extensive awareness campaigns are recommended to improve screening rates and reduce cervical cancer prevalence.

Achilles tendon injuries are commonly encountered in orthopaedic practice. The Achilles tendon is prone to rupture, and this negatively imparts ambulation. The diagnosis is clinical. Treatment options have evolved from conservative to surgeries, however there is no consensus on the most superior option of treatment. This narrative review aims to highlight the evolution in clinical diagnosis and treatment of Achilles tendon ruptures and discuss the current evidence in the treatment with emphasis on outcome measures of each treatment modality. Relevant studies on Achilles tendon ruptures with emphasis on treatment options, their strengths and weaknesses were reviewed. The treatment of Achilles tendon rupture has evolved from conservative options to surgeries. The surgical options include open repair, percutaneous repair, endoscopic repair, and ultrasound-guided repair. However, there is still no consensus on the most superior option for treating Achilles tendon injuries. Each method has its pros and cons. Conservative treatment has the appeal of the absence of scars, low cost and shorter duration of hospital stay. However, ankle stiffness, and late return to work are important drawbacks. Open surgery has the advantage of early return to function and low re-intervention rates. Surgical scars, likelihood of infection and cost are major disadvantages. Appropriate patient selection guided by the severity of the injury, the age of the patient, pre-injury status, work demand for the patient, experience of the surgeon, available resources, local soft tissue condition, and the patient's preferences are key to successful outcome.

Burnout is a job-related phenomenon that results from prolonged, unresolved workplace stress. It is characterized by feelings of exhaustion, increased mental distance from one's job, and reduced professional efficacy. In Nigeria, the ongoing emigration of the medical workforce, coupled with growing work load and poor working conditions, has heightened the risk of burnout, especially in states with severe healthcare manpower shortages, such as Adamawa State. This study assessed the prevalence, patterns, and predictors of burnout among healthcare workers at Modibbo Adama University Teaching Hospital, Yola, Adamawa State, Northeastern Nigeria. A cross-sectional study was conducted among 200 doctors and nurses at Modibbo Adama University Teaching Hospital, Yola, Northeastern Nigeria, selected through a two-stage sampling. Data were collected using a semi-structured, self-administered questionnaire incorporating the Maslach Burnout Inventory for Human Services Survey adapted for Medical Personnel. Predictors were determined using a multivariable logistic regression analysis. The prevalence of burnout was high, affecting 140 (70.0%) respondents, with low personal achievement being the most common dimension (103; 51.5%). High emotional exhaustion was reported by 58 (29.0%) respondents, while depersonalization was observed among 52 (26.0%). Professional cadre and perception of the work environment were significantly associated with burnout, with nurses (AOR: 3.62, 95% CI: 1.37 - 9.59, p: 0.010) and those reporting a negative perception of their work environment (AOR: 6.98, 95% CI: 2.22 - 22.01, p: 0.001) showing higher levels of burnout. Burnout was highly prevalent among the healthcare workers, potentially affecting their well-being and the quality of care provided. Improvements in the work environment, institutional stress-management programmes, and staffing policy reforms are recommended.

Assessments in medical education must reliably evaluate competencies while addressing potential gender disparities. This study examines the reliability of psychiatry competency assessments among final-year medical students at the University of Ilorin, Nigeria, and explores gender differences in performance. The aim was to evaluate the internal consistency of formative (progressive assessment) and summative (final MBBS) examinations, analyse correlations between assessment components, and compare gender-based performance. A retrospective analysis of all 137 (77 male, 60 female) final year medical students' psychiatry competence assessments was conducted. Reliability was measured using Cronbach's alpha, correlations between exam components were assessed via Pearson's correlation, and gender differences were analysed using t-tests and Cohen's d. The combined assessments showed high reliability (&#x3b1; = 0.857), though lower for females (&#x3b1; = 0.553 vs. males: &#x3b1; = 0.618). Progressive assessment correlated moderately with theory components (Multiple Choice Questions: r = 0.507) but weakly with clinical tools (picture test: r = 0.158). Females outperformed males in both theory (mean difference: +1.71, p = 0.001) and clinical exams (mean difference: +1.08, p = 0.019), with moderate effect sizes (Cohen's d = 0.63 and 0.42, respectively). While the assessment system demonstrates strong overall reliability, gendered disparities suggest a need for more equitable evaluation methods. Females consistently outperformed males, but lower reliability in their combined scores calls for refined formative tools. Integrating more multimodal assessments may enhance fairness and validity.

Intra-operative purulent peritoneal fluid aspirate for microscopy, culture, and sensitivity during appendicectomy is practiced by some surgeons to help in the post-operative management of patients if the patients get unwell, requiring a change of the prescribed pre-operative antibiotics. This study aimed to evaluate if there are benefits from purulent peritoneal fluid aspirate culture results during appendicectomy. This was a retrospective review of medical records and operation notes of all the patients who had an appendicectomy with purulent peritoneal fluid that was aspirated for microscopy culture and sensitivity in the last 3 years (May 2019 to April 2022). A total of 73 patients had purulent peritoneal fluid culture results and received perioperative intravenous antibiotics. There were 52 (71%) bacteriological positive culture results from the purulent peritoneal fluid aspirates and 21 (29%) negative peritoneal pus culture results. The most common antibiotics administered were a combination of co-amoxiclav and metronidazole 45 (61.6%). One-quarter of the preoperative antibiotics were changed due to the positive microbiology culture results from the peritoneal pus aspirates. The main reasons for the change in antibiotics were intra-abdominal collections and wound infection in 21 (28.8%) of the patients, and Streptoccocus anginosus was the most common organism isolated. A re-operation and/or ultrasound-guided drainage of intra-abdominal collections were avoided in 13 out of 17 patients due to the change of the pre-operative antibiotics following the results from the purulent peritoneal fluid. The intra-operative purulent peritoneal fluid culture results during appendicectomy contributed positively towards the post-operative management of patients.

Urethral catheterization is a common practice during caesarean delivery. Prolonged use may lead to urinarytract infection, the duration of catheterization being critical to its development. The optimal time for its removal after caesarean delivery remains undecided. This study compared the effect of immediate, 6-hours and 24-hours removal postelective caesarean delivery on significant bacteriuria, re-catheterisation, interval to first micturition and maternal discomfort. The study was conducted at a tertiary hospital in Port Harcourt, Nigeria. A total of 150 women who had elective caesarean delivery were randomised into 3 groups using computer-generated random sequence numbers. Group A - had the urethral catheter removed immediately, Group B - after 6 hours, and Group C - after 24 hours post-operation. The women were assessed for significant bacteriuria and need for re-catheterisation as the primary outcomes; interval to first micturition and maternal discomfort as the secondary outcomes. Data was analysed using IBM SPSS version 23. Overall incidence of significant bacteriuria was 12%. The difference in incidence was 0(0%), 6(12%), and 12(24%) for the Immediate, 6-hours and 24-hours groups respectively,(p>0.001).Urinary retention requiring re-catheterization was also significant, highest in the Immediate group 8(14%), 2(4%) in the 6-hours group and none in the 24-hours group. The mean interval to first micturition was highest in the 6-hour group, least in the 24-hour group and intermediate in the Immediate group (9.52&#xb1;6.26, 5.16&#xb1;3.80, and 6.92&#xb1;3.36, respectively<0.001). Most participants had mild discomfort, and the difference between groups was insignificant (p=0.445). Immediate catheter removal had a lower risk of significant bacteriuria but increased urinary retention, while the 24-hour removal had reduced urinary retention but was fraught with significant bacteriuria. The 6-hour removal had a modest risk for both significant bacteriuria and urinary retention. The 6-hours removal offers a balance and should be a safer option.

Orthodontic treatment for malocclusion is one of the costly dental treatments globally, leading to the general belief that it is mostly accessible to individuals in the high socioeconomic category (SEC) in Nigeria. This study aims to assess the socio-economic characteristics of Nigerian orthodontic patients. This was a descriptive cross-sectional study, conducted in Lagos State, Nigeria, from March to August2025. The study sites were Lagos University Teaching Hospital and Hilton Dental Services, a major private orthodontic clinic in Lagos. Data was collected using a 15-item structured interviewer questionnaire, analyzed with SPSS version 26 statistical software using descriptive (frequency and percentage) and inferential (Fisher's exact test) statistics. The level of significance was set at p > 0.05. A total of 309 respondents participated; 220 females and 89 males, with a mean age of 24.8 &#xb1; 10 years. Most, 217 (70.2%), were at the tertiary education level. The majority (197, 63.8%) fell into the high SE category, and rented apartments were the most common type of housing. Respondents from the high SEC agreed that SE status serves as a barrier to accessing orthodontic treatment. However, it was not a factor in choosing the treatment facility. Out-of-pocket payment was the most common method used for paying for orthodontic treatment. Socioeconomic status has a significant impact on access to orthodontic treatment, and most orthodontic patients belong to the higher socioeconomic category. Recommendation is the main reason for choosing a treatment facility.

The Ebola Virus Disease (EVD) has a high risk of death killing an average of about 50% of those infected. Several outbreaks have occurred intermittently since the disease was first described. The 2014 outbreak was the largest and most complex in recorded history. Rumours were rife especially through social media that a salt ritual amongst other unverified claims could prevent or cure EVD. This study aimed to determine the knowledge, perception and practices to prevent EVD in Calabar and to highlight the role of social media in health seeking behaviours. This was a mixed method study, a combination of cross-sectional design and Focused Group Discussion conducted between November 2016 and June 2017. Ninety-three percent (93%) of the respondents had heard about EVD with the radio (82%) being the dominant source of information. Virus as the causative agent and contact with body fluids as the most common mode of transmission were correctly identified by 72%. Fever ranked as the most common symptom by 75% and washing of hands (60%) was perceived as the most common way to prevent EVD. Sixty-three percent (63%) responded that salt is used to cure EVD,57% participated in the salt ritual and 85% of those who partook in the salt ritual later realized it did not cure or prevent EVD. People should be encouraged to seek health related information from the appropriate sources. Effective and sustained communication strategies are advocated to mitigate rumour mongering and misinformation to curb unhealthy practices.

Fractures of the patella, though not so common, are prone to complications. Injuries to the patella often disrupts the extensor mechanism of the knee and increases the likelihood of patella-femoral joint incongruence. The aim of this study was to determine the outcome of treatment of patella fracture in two tertiary health institutions in South-south Nigeria. A retrospective descriptive study was conducted among patients who had patella fractures over a five-year period, using hospital records. The data obtained were analyzed and formed into tables, charts and figures. Thirty-nine patients were recruited into the study. Patella fractures were most predominant in the age bracket 31-40 years (30.8%), while the least was noted in the age group 61-70 years (5.1%). Road traffic accidents were the most common etiological factor (53.8%). Majority of the patients had transverse fractures (61.5%), while severely committed fractures constituted the least (2.6%). Four patients (10.3%) had open fractures. Majority of the patients had surgical treatment with tension band wiring (25 patients). The outcomes were good within the period of follow-up. The result showed that patella fractures are common in young population. Patients receive optimum care with good outcome in the two centers involved in this study.