Background: Arrival of a child with cleft lip or palate is characterized by mixed feelings in the parents. The aim of the study was to determine the magnitude of psychological distress, attributional beliefs on causation, perceived stress symptoms in mothers of infants with cleft lip and palate. Subjects and Methods: Questionnaires about causal beliefs (MCA), the General health questionnaire-version 12 and Perceived stress Scale (PSS) were administered to mothers of babies with cleft lip and palate. Results: Psychological distress was noted in 12 (23.1%) of the cases. On the PSS scale, 9 (17.9%) of the mothers had the perception of more than average stress. A higher proportion of mothers with more than average perceived stress had combined cleft lip and palate (66.7%). Many mothers (n = 43, 82.7%) had no understanding of the cause of their childs deformity. There was a significant relationship between the presence of Psychological distress and the mothers perception of stress (P < 0.005). Thirty-eight (73%) of mothers who had cleft babies admitted to subjective feelings of misery and depression in relation to coping with the deformity and this was significantly associated with the experience of psychological distress (P = 0.016) with 9 (75%) of them having suggestive scores on the GHQ. Also among these mothers those who reported more perceptions of stress also seemed to endorse more subjective feelings of depression (P < 0.05). Conclusion: Mothers of babies with cleft lip and palate can go through difficult emotions that make them perceive their role as being stressful. This has implications on their overall emotional wellbeing. Early maternal mental health screening, health education explaining causation are useful strategies that can be embedded in protocols to help promote both maternal and child mental health in this special population group.

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Background and Objective: Accurate documentation promotes continuity of care and facilitates dissemination of information concerning the patient to all members of the health care team. This study was designed to analyze the pattern of physiotherapy documentation of the patients' records and discharge plans in a tertiary hospital in Lagos, Nigeria. Materials and Methods: A total of 503 case files from the four units of the Physiotherapy Department of the hospital were examined for accuracy of records. The D-Catch instrument was used to quantify the accuracy of record structure, admission data, physiotherapy examination, physiotherapy diagnosis, patients' prognoses based on the plan of care, physiotherapy intervention, progress and outcome evaluation, legibility, and discharge/discontinuation plan. Results: “Accuracy of legibility” domain had the highest accuracy score: 401 (79.72%) case files had an accuracy score of 4. The domain “accuracy of the discharge/discontinuation summary” had the lowest accuracy score: 502 (99.80%) case files had an accuracy score of 1. Conclusion: Documentation of the plan of care made in the hospital for the period of this study did not fully conform to the guidelines of the World Confederation for Physical Therapy (WCPT). The accuracy of physiotherapy documentation needs to be improved in order to promote optimal continuity of care, improve efficiency and quality of care, and recognize patients' needs. Implementation and use of electronically produced documentation might help physiotherapists to organize their notes more accurately.

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Background: Fixed drug eruption (FDE) is common cutaneous drug eruption characterized by the development of one or more annular, oval, erythematous, and hyperpigmented patches as a result of systemic exposure to a drug. Drugs causing FDE vary with prevailing diseases and prescription pattern in different parts of the world. This study is aimed at reviewing cases of FDE seen at the dermatology outpatient clinic of Lagos University Teaching Hospital (LUTH) over a 9-year period, highlighting the spectrum of drugs implicated and the clinical characteristics. Materials and Methods: Data were obtained from the clinic records and patients' case notes. These included the demographic details, duration of presentation, drugs implicated, and clinical characteristics. Results: FDE was diagnosed in 1.8% (295/16,160) of patients seen. There was a slight female preponderance. Antimalarials were the commonest group of medications implicated (51.0%) followed by antibiotics (27.9%); analgesics (10.2%), herbal toothpaste (6.1%), and oral hypoglycemic agents (4.1%). Sulfonamides were the commonest group of drugs found in 78 patients (53.1%) predominantly as sulfadoxine/pyrimethamine antimalarials and trimethoprim/sulfamethoxazole antibiotics (co-trimoxazole). Conclusion: Concerted efforts are needed to discourage over-the-counter sales and purchase of nonprescription sulfonamide-based medications. A change in prescription pattern from sulfonamides to other classes of antimalarials and antibiotics is desirable and/or recommended. Patients should inform their caregivers at any point of care about their reaction to drugs. It is advised that they have a list of common implicating drugs and they wear a medic alert or carry an ID card bearing this information.

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Solid cystic papillary tumor is a rare tumor of the pancreas. These are seen more commonly in young females. Preoperative diagnosis is difficult to make due to its similarity with other cystic pancreatic lesions. These tumors carry a favorable prognosis because of their low malignant potential, and have a good prognostic outcome after surgery. Here we report a case of an 18-year-old female patient who presented with a history of pain and lump in epigastrium for 7 months. Diagnostic laparotomy was done that revealed a well-defined cystic mass attached to the body of pancreas. The mass was excised along with distal pancreatic tissue. Splenectomy was also done in the patient. She had no evidence of recurrence for the last 1 year after complete excision of the tumor.

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Introduction: Health care-seeking behavior of individuals determines how early they present for appropriate care. In patients with chronic kidney disease (CKD), late presentation to the nephrologist is associated with poor outcomes. This study aims to describe the health care-seeking behavior of patients with CKD attending the nephrology outpatient clinic of a teaching hospital located in Lagos, Nigeria. Materials and Methods: This was a cross-sectional survey conducted on 104 consecutive adult patients with CKD, presenting for the first time at the nephrology outpatient clinic of a teaching hospital located in Lagos, South West Nigeria. Information was retrieved from the study participants using a structured interviewer-administered questionnaire, entered into an Excel spreadsheet, and analyzed using Epi Info^® statistical software version 7.0. Results: Overall, 74 (71.2%) patients sought help, first from a trained health care provider, and their health care-seeking behavior was adjudged to be appropriate. Compared to patients with appropriate health care-seeking behavior, those with inappropriate health care-seeking behavior had a lower mean age (40.4 ± 13.7 years vs 47.3 ± 15.6 years;P = 0.03), were less likely to see their illness as a medical problem (46.7% vs 67.6%;P = 0.04), more likely to have a monthly income less than N25,000 ($150) (80.0% vs 59.5%;P = 0.04), and have received below tertiary level education (20.0% vs 48.6%; P < 0.01). They were also more likely to have consulted more than one health care provider before being referred to our clinic. The factors predicting inappropriate health care-seeking behavior were education below the tertiary level and age less than 45 years. Conclusion: Though health care-seeking behavior was appropriate in majority of our patients with CKD, there remains a need for improved public health awareness.

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Objective: This study was conducted to determine the changes in the blood pressure (BP) and the pulse rate (PR) of normotensive patients having dental extraction under the administration of 2% lignocaine local anesthetic with or without adrenaline. Materials and Methods: This prospective study was carried out on 325 consecutive normotensive patients who presented at the exodontia clinic of the Lagos University Teaching Hospital (LUTH), Lagos, Yoruba State, Nigeria from December 2004 to August 2005 for simple tooth extraction. The patients were randomly allocated into two groups according to the type of anesthetic solution employed. Group A had tooth extraction done under the administration of 2% lignocaine with adrenaline (1:80,000) while group B had tooth extraction done under the administration of 2% lignocaine local anesthetic without vasoconstrictor (plain lignocaine). Each patient had single tooth extracted. The following parameters were monitored in each of the surgical interventions: systolic blood pressure (SBP), diastolic blood pressure (DBP), and PR. Measurements were taken in the waiting room before surgery, during the surgery after local anesthesia, during tooth extraction, and 15 min after tooth extraction. Results: The sample consisted of 176 females and 149 males. Age range of the patients was 18-89 years with the mean age of 35.08 ± 15.60 years. The hemodynamic responses to lignocaine with adrenaline (1:80,000) and plain lignocaine essentially follow the same pattern in the study. There was no statistically significant difference between the measured parameters in the two groups after the administration of local anesthetics. Conclusion: This study, therefore, shows that there was no difference in the hemodynamic changes observed with the use of lignocaine with adrenaline or plain lignocaine during a simple tooth extraction in healthy adults.

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