Background and Purpose: Anxiety disorders impact negatively on morbidity and mortality poststroke. Few studies have, however, been done on poststroke anxiety disorders (PSAD), particularly in Africa. The study aims to determine the prevalence, associated clinicodemographic factors, and impact of PSAD on quality of life (QoL) among outpatients at a tertiary hospital in Nigeria. Methods: Seventy stroke survivors attending Outpatient Clinics at Lagos University Teaching Hospital, Nigeria, were recruited into the study. Participants were assessed using sociodemographic/clinical questionnaire, the modified Mini–Mental State Examination, the Modified Rankin Scale, the Schedule for Clinical Assessment in Neuropsychiatry, and the World Health Organization-QoL-Bref. Data collection took 5 months and analyzed using the Statistical Package for the Social Sciences (SPSS^®) software version 17.0. Results: The mean age of respondents was 57.43 (±9.67) years and 38 respondents (54%) were male. Majority of the stroke survivors had infarctive stroke 55 (78.6%), right hemispheric lesions 37 (52.9%), and significant poststroke disabilities 57 (81.4%). The prevalence of PSAD was 10% and agoraphobia with panic attacks was elicited in 42.8% of those diagnosed with PSAD. Participants with PSAD were significantly more likely to be unemployed (P = 0.01) and pay more than ₦10,000 ($62.50 at December 2013) monthly for health care. The mean QoL scores were lower in participants with PSAD across all QoL spheres, and significantly so for overall health (P = 0.04), health satisfaction (P = 0.02), and physical health (P = 0.01) domains. Conclusion: PSAD, especially agoraphobia in association with unemployment and high health-care costs correlated with poor well-being among stroke survivors. Proactive measures to ensure prompt identification and management may potentially improve outcome and QoL after stroke.

Context: Head and neck cancers (HNCs) display variable biological and geographical variations even within the same country. Aims: This study aims to determine the histopathologic pattern of HNCs in three Northwestern states of Kebbi, Sokoto, and Zamfara in Nigeria. Settings and Design: This was an hospital-based descriptive retrospective study carried out at Federal Medical Centre, Birnin Kebbi; Federal Medical Centre, Gusau; and Usmanu Danfodio Teaching Hospital, Sokoto. Subjects and Methods: Medical and histopathologic records of all HNCs seen at these centers between January 2006 and December 2013, were reviewed, and data on time of presentation, sociodemographic, anatomic site, and histology were collected and analyzed using the Statistical Package for the Social Sciences (version 20) (SPSS Inc., Chicago, IL, USA) statistical software. Quantitative data were summarized using simple descriptive statistics of means and standard deviation (SD). Chi-square tests were used to analyze the nonparametric variables. Statistical significance was inferred at P ≤ 0.05. Results: Three hundred and eighty-one malignant HNCs were seen over a period of 8 years with an annual frequency of 47 cases. There was a male to female ratio of 1.2:1, and the mean age was 39.5 ± 19.2 (±SD). About 70.3% of cases were carcinomas, 15.0% were sarcomas, and 8.7% were lymphomas. Squamous cell carcinoma (34.9%) was the highest carcinomas while non-Hodgkin's lymphomas (6.6%) and rhabdomyosarcoma (4.2%) were the most common lymphomas and sarcomas observed, respectively. The most common sites were those of the lips, oral cavity, and pharynx International Statistical Classification of Diseases-10 (C00–C14). Conclusions: This present study demonstrates the rising trend of HNCs in these regions and highlights the urgent need for adoption of grass root policies that would incorporate public participation especially those under 40 years, in the awareness on the harmful use of carcinogenic substances such as tobacco and alcohol and dangerous sexual habits. There should also be concerted promotion of targeted preventive strategies, early screening, treatment, support, and lifelong rehabilitation.

Introduction: There is dearth of information on the impact of oral health information on knowledge and belief of oral health among pregnant women. The objective of the study was to determine the impact of oral health information on oral health knowledge and belief among Nigerian pregnant women. Materials and Methods: This cross-sectional survey was conducted among pregnant women attending the antenatal clinic (ANC) of a large university teaching hospital in Benin City, Nigeria, using interviewer-administered questionnaire as data collection tool. Descriptive and regression statistics were performed on data collected using SPSS version 17.0. P <0.05 was considered statistically significant. Results: A total of 410 pregnant women with a mean age of 29.6 ± 5.3 years participated in this study. Of the participants, 94 (22.9%) exhibited adequate overall oral health knowledge. The significant determinants of oral health knowledge were ever received oral health information and receipt of oral health advice in pregnancy. About two-thirds (61.5%) of the participants held erroneous oral health believes. The erroneous oral health belief was significantly higher among the unmarried, multiparous, nonchristians, illiterate, and nonprofessional indigenous participants. Educational attainment emerged as the only significant predictor of good oral health belief. Conclusion: Data from this study revealed that exposure to oral health information exerted a significant positive impact on oral health knowledge but not on belief of the studied pregnant women. Exploration of the quality and mode of receipt of oral health information among pregnant women is recommended.

Background and Objectives: School health program (SHP) is a critical aspect of the nation's healthcare system integrating education and delivery of health-care services. We sought to explore knowledge of head teachers regarding the SHP and determine their level of implementation. Methods: A survey was conducted of head teachers of privately owned primary and secondary schools in Ilorin. A pretested questionnaire with information on knowledge of SHP and current facilities and practices in their schools was given to head teachers at a training workshop to improve their awareness regarding hygiene and disease prevention in schools. Results: A total of 100 questionnaires were distributed with 84 head teachers returning their completed questionnaires. The mean (standard deviation) age of the head teachers was 43.3 (9.9) years with a female:male ratio of 1.9:1. Thirty-eight (47.5%) of the head teachers had good/adequate knowledge, and female head teachers were statistically more likely to have adequate knowledge Thirty-nine of the schools delivered school health services, most commonly by a health assistant (79.5%). Fifty-nine (73.8%) of the schools had a first aid box. The most common source of water was well water (46.3%). Refuse and sewage disposal was largely by incineration and water closet system, respectively. Conclusion: School head teachers had a poor knowledge of SHP and inadequate school health services in their school.

Background: The mutagenic and teratogenic effects of chemotherapeutic agents from repeated exposure during care are well documented. Nurses are among the healthcare professionals who constantly handle these agents, therefore their knowledge and pattern of occupational safety is a concern. This study sought to determine knowledge of chemotherapy and occupational safety measures of nurses in oncology units in the University College hospital, Ibadan. Materials and Methods: A cross sectional descriptive study design, based on Protection Motivation theory was conducted among 100 purposively selected nurses from oncology unit of the hospital. Data were collected using a 54-item validated questionnaire. Descriptive and inferential statistics at 0.05 level of significance was used. Results: Respondents were within 35.4 ± 5.1 years. More than half of the respondents had over 3 years practice in the oncology unit (mean 2.62, ± 1.1). Knowledge of chemotherapy among the cohort was high; mean 13.9 ± 2.2, 70 % understood the use of gloves and gowns as part of safety guidelines. On handling patients' clothes, only 57% understood that such should not be washed by hand or with other clothes. Cumulatively, 79.2% of the respondents knew about the safety guidelines, 4.7% had no knowledge while 16.1% were not sure of the correct guidelines for administering chemotherapy. Respondents' level of education was significantly associated with knowledge of chemotherapy, P<0.05; practice score was also significantly associated with respondents' cadre; P<0.05. Conclusion: Periodic and consistent update of nurses' knowledge supported by policies to enforce guidelines implementation is recommended.

Background: Postoperative pain has a negative effect on the process of recovery. There is paucity of literature on the postoperative pain management practice in children in developing countries. We sought to determine the current practice of postoperative pain management in children among pediatric surgeons in Nigeria. Methods: A cohort of 43 pediatric surgeons/trainees attending two annual meetings of Association of Paediatric Surgeons of Nigeria (2011 and 2013) were surveyed with a questionnaire enquiring about the practice of postoperative pain management in children and their perceptions. Results: Thirty-seven respondents had completed the survey (86% response rate). Of these respondents, 27 (73.0%) were consultants and 10 (27.0%) were trainees. Only 2 (5.4%) respondents used any guidelines, and 8 (21.6%) respondents had an established institutional protocol for the pediatric postoperative pain management. Almost half of the respondents (18, 48.6%) used clinical judgments for assessing postoperative pain, followed by crying, requires oxygen to maintain saturation > 95%, increased vital signs, expressions, and sleeplessness scale (13, 35.1%); alertness, calmness, respiratory response/crying, physical movement, muscle tone, and facial tension behavioral scale (11, 29.7%); and verbal rating (10, 27.0%). In neonates, 89% of the respondents used paracetamol and 32% used pentazocine for routine postoperative analgesia. None of the respondents used morphine for neonatal postoperative analgesia. In older children, commonly used analgesics include paracetamol (35, 94.6%), pentazocine (30, 81.1%), and nonsteroidal anti-inflammatory drugs (28, 75.7%). More than half of the respondents (20, 54.1%) were not satisfied with their current practice of postoperative pain management. Conclusion: Pain was infrequently assessed, and analgesic therapy though multimodal was largely not protocol based and therefore subject to inadequate pain relief. Postoperative pain should be more visible in our hospitals, and efforts should be made to improve its assessment and management.

Hepatic hemangioendothelioma is the most common benign vascular tumor of the liver in infancy and it is the most likely of all hepatic tumors to present with symptoms early in life, presenting in the first 6 months of life. It may present with life-threatening complications such as congestive cardiac failure and thrombocytopenia. As a way of creating awareness to the existence of this rare condition in our environment, we report a case of symptomatic hemangioendothelioma in a newborn and challenges that can be encountered during management in a resource poor-setting. Baby OA is a 22-day-old female neonate who presented with an abdominal mass noted at birth. Diagnosis was made based on clinical findings and results of abdominal ultrasound scan and computerized tomography scan which were in keeping with a hepatic hemangioendothelioma. She was treated with oral prednisolone, propranolol, and aggressive supportive treatment with blood and platelet concentrate transfusions. Her management was hampered by challenges in obtaining a histologic diagnosis, financial constraints, and unavailability of wider therapeutic options. She has been discharged and is being followed-up at the out-patient clinics. Hemangioendothelioma should be considered in the differential diagnosis of infants presenting with an abdominal mass in the newborn period as it could be associated with significant morbidity and mortality requiring aggressive treatment and meticulous supportive care.

Tapia's syndrome consists of concurrent injury to the recurrent laryngeal and hypoglossal nerves. Trauma as a result of direct pressure from inflated cuff of the tracheal anesthetic tube and/or overextension of the neck during surgery have been reported to be possible causes of this syndrome. Here, we report a case of Tapia's syndrome following surgical excision of a very large recurrent parotid tumor. The aim of this report is to draw the attention of head and neck surgeons and anesthetists to this often unexpected condition. A 30-year-old female presented to the surgical outpatient clinic of the Lagos University Teaching Hospital with a massive, multinodular, right facial swelling. There was no sensory or motor nerve paresis on presentation. The patient underwent surgical excision of the swelling under general anesthesia. Two hours after extubation, the patient had difficulty moving the entire tongue and had difficulty with phonation. A working diagnosis of Tapia's syndrome was made based on clinical presentation and assessment. The patient was reassured and placed on tablets neurobion three times daily and tablets prednisolone 20 mg daily. Fourteen days after surgery, hoarseness of voice had resolved completely and full tongue control returned after 2 months. Tapia's syndrome must be considered, especially by all head and neck surgeons and anesthetists even though it is usually a rare complication of surgery.

Low-grade myofibroblastic sarcoma (LGMS) is a rare malignant tumor of soft tissue that commonly presents as a painless enlarging mass of the affected site. There are several reported cases of malignant cancers among sickle cell disease (SCD) patients, and to the best of our knowledge, there was no previously reported case of LGMS occurring in a known SCD patient in our environment. We report a 16-year- old patient with sickle cell anemia who presented with the left knee swelling that was initially managed as a benign infection, but a later histological examination revealed a diagnosis of LGMS.