Background: Back pain is a recognized problem in children globally and it has been shown that many adult sufferers report onset of back pain in early teenage years. In the majority of cases, medical attention was seldom sought. Objectives: To determine the prevalence and effect of back pain among secondary school students from randomly selected secondary schools in a Nigeria population. Methods: The participants for the survey were 1003 secondary school students (males– 466; females– 537) whose ages range from 12 to 18 years. The participants were required to complete a 37-item structured closed ended questionnaire, which collected information on participants' age and physical characteristics, occurrence of back pain, location of back pain, predisposing factors and effects of back pain. Results: The 1-month prevalence of back pain among the participants was 87.50%, with the low back pain being the most common. Factors that predisposed students to back pain were inappropriate school desks and chairs (45.10%), prolonged sitting while playing computer games or watching television, heavy school bags (58.00%) and manner of carrying school bags (34.00%) among others. Conclusion: Back pain, particularly low back pain was a significant problem among the respondents. Long hours of sitting while playing computer games and watching television, heavy school bag (backpack) and the manner in which the school bag were carried ranked highest among the observed predisposing factors. It was recommended that back education should be introduced into the school curriculum.

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Background: This study compared the ease and success of Laryngeal Mask Airway (LMA) insertion in children following halothane or propofol induction. Methods: Sixty children aged 1– 12 years for daycase surgery between January and December 2008 were induced with inhalational 2– 3% halothane or intravenous propofol 3.5mg/kg. The ease, duration, number of attempts at insertion of LMA and any complications were documented Results: The mean induction to insertion time was 3.25±1.17mins in the propofol group and 9.20±2.20mins in the halothane group, (p<0.001). The mean insertion time was similar in both groups (p=0.93). Complications included movement in 11 patients who had propofol (36%) and one (3.33%) who had halothane (P = 0.003) and partial jaw opening in 3 patients (10%) who had propofol (p=0.23). LMA insertion was satisfactory in 93.7% of patients who received propofol and 96.7% who had halothane (p=0.679). Conclusion: Halothane induction produced better conditions for LMA insertion in Nigerian children.

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Objective: To highlight specific neuro-ophthalmological presentations of HIV/AIDS (Human Immunodeficiency Virus/Acquired Immunodeficiency Disease Syndrome) and the challenges in their management. Study Design: Cross-sectional non-randomised convenient study. Subjects: Consecutive adult sero-positive HIV/AIDS patients attending President Emergency Plan Fund for AIDS Relief (PEPFAR) Clinic at the Lagos University Teaching Hospital Idi-Araba between 1ST of February andMarch 15TH 2008 were enrolled into the study. Methods and Materials: Biodata and medical history were recorded on an interviewer administered questionnaire. Participants were examined according to standard protocol comprising of visual acuity, intraocular pressure, and detailed anterior segment examination with slit lamp biomicroscopy and dilated fundoscopy. Fundus photographs were taken where necessary. Results of packed cell volume (PCV), cluster designation four positive (CD4+) T lymphocyte count, viral load at diagnosis, stage of HIV disease according to WHO staging were extracted from patients records. Results: A total of 400 patients were included in this prospective study. The age range was 18– 71 years with a mean of 40 years (S.D. 9.12). There was a female preponderance, with a male: female ratio of 1:1.7. Ocular disorders were seen in 314 (78.5%) of patients, 18 (4.5%) of these had neuroophthalmological presentations. Of these eighteen, fifteen (3.8%) had presumed Herpes Zoster Ophthalmicus, while management challenges were encountered in the remaining three. Deduction of precise diagnosis, conducting relevant investigations and instituting the appropriate therapy were challenges which arose in their management. Conclusion: A high index of suspicion and evaluation at presentation, improved health education of people infected, elimination of the stigma associated with infection and access to diagnostic and therapeutic materials are necessary to improve the quality of holistic care given to individuals living with HIV/AIDS. Social workers and counseling sessions are very important in handling of these patients.

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Background: Client-centered approach to providing high – quality care as a basic human right has emerged as a critical element of family planning and reproductive health programs. Empirically, quality of family planning services has been found to affect clients' usage of methods effectively, continuity of use and adoption of methods. The objective of this study was to assess clients' perception of the quality of family planning services received in health care facilities in a rural LGA. Methodology: A cross sectional descriptive study was carried out among women accessing family planning services in Ikorodu, a rural LGA in Lagos State, using client exit interview. Consecutive recruitment was done until the desired sample size (120) was achieved. Result: The mean age of respondents was 33.6±7.3 years with almost all (97.8 %) currently married. The majority, (93.4 %) reported easy access to the clinic, 91.8 % reported sufficient privacy, and 85 % reported that the clinic was clean. The mean waiting time reported was 32.6±26 minutes, with 18 % reporting dissatisfaction with the waiting time. About two-thirds of the respondents were satisfied with the cost paid for commodities/service. Providers' performance in interpersonal relations was good with 96 % of respondents reporting that they were treated with dignity and respect while 78.3 % were given an appointment for follow up. Conclusion: Respondents' perception of the quality of care received was good. Measures to reduce waiting time to less than 30 minutes may further improve acceptance and uptake.

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Aims/Objectives: To determine the indications for surgery in the newborn and highlight challenges in management. Materials/Methods: In this retrospective study, records of all the neonates who were managed in the Pediatric Surgery Unit of the Lagos University Teaching Hospital between January 2005 and December 2007 were retrieved and information about the age at presentation, sex, surgical diagnosis, surgery performed and mortality and its causes were documented. Results: Records of 63 patients were retrieved for analysis. There were 46 boys and 17 girls with a M:F ratio of 3:1. There were 13 patients diagnosed with Hirschsprung's disease while 9 patients had anorectal malformation with 6 of them having the high type and 3 had low malformations. There were ten patients with intestinal atresia; 5 patients had atresia of the duodenum, 4 had atresia of the jejunum and a patient had atresia of the ileum. Seven patients had esophageal atresia with distal tracheoesophageal fistula (OA with TOF) while there were four patients each with inguinal hernia and exomphalos. Three patients with postcircumcision bleeding and two patients with Gastroschisis also presented within the study period. There were ten patients with other diagnoses. Different surgical procedures were performed according to the diagnosis. There were 10 deaths giving an overall mortality rate of 15.9%. A patient with posterior urethral valves with features of large bowel obstruction and severe sepsis died. One of two patients each with diagnosis of ectopia vesicae and Gastroschisis died (50% mortality). Also, 2 out of 4 patients with jejunal atresia died (50% mortality). There were 3 deaths out of the 7 patients with OA with TOF (42.9% mortality) and there was a patient out of 4 with Duodenal atresia who died (25% mortality). One of the 13 patients with Hirschsprung's disease died (7.7% mortality). Conclusion: Neonatal intestinal obstruction forms the bulk of surgical load in neonates in our center. Presentation seems to follow a pattern in which visible congenital anomalies present to hospital earlier than internal ones. Sepsis and malnutrition are the commonest causes of death and constitute an on-going challenge. Poor prenatal screening programme and lack of Total Parenteral Nutrition (TPN) and Neonatal Intensive Care Unit (NICU) are other challenges that if overcome may improve survival.

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