IntroductionSpontaneous bacterial peritonitis (SBP) is a common bacterial infection in patients with cirrhosis and ascites requiring prompt recognition and treatment. The aim of this study was to determine the prevalence, and characteristics of SBP among in-patients with cirrhosis and ascites seen at our facility.MethodsThirty one patients with liver cirrhosis and ascites who were admitted into the Medical ward of the Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Nigeria from August 2009 to July 2010 were retrospectively studied. All the patients had abdominal paracentesis done within 48 hours of admission under aseptic condition and the data obtained were analyzed.ResultsThe mean age of the studied population was 62±9 years (age range 43-78 years). Of the 21 that developed SPB, culture positive SBP was present in 66.7% (14/21) while CNNA was found in 33.3% (7/21). The prevalence of MNB was 26% (8/31) in this study. Of those with SBP, 93% had monomicrobial infection with aerobic Gram negative bacilli being responsible in 66.7% of the cases with E.coli (70%) being the predominant organism followed by Klebsiella species. Gram positive organisms accounted for 33.3% with Streptococcal species (60%) being the predominant organism followed by Staphylococcus aureus (40%). Patients with SBP had significantly lower platelet count when compared with those without SBP, p < 0.05. Also, international normalization ratio (INR) was significantly higher in those patients with SBP compared with those without SBP, p < 0.05. The poor prognostic indicators found in this study were; low ascitic protein, hepatic encephalopathy, coagulopathy, renal dysfunction (creatinine >2mg/dl) and leukocytosis (p < 0.05).ConclusionIt is therefore imperative to do diagnostic abdominal paracentesis for cell count and culture in any patient with onset of ascites or cirrhotic patients with ascites and suggestive symptoms compatible or suggestive of SBP.

CKD is very common among patients with HIV/AIDS in Ilorin. Screening and early intervention for CKD should be part of the protocols in the management of these patients.

Universally, Body Mass Index (BMI) is used to diagnose obesity, and is associated with cardiovascular disease, as well as significant morbidity and mortality. Because the effect of obesity on health risk is influenced by ethnic background, age, and gender, using a universal BMI cut-off has been questioned by some authorities or workers. Reports on appropriate BMI for Nigerians are scanty. Results of a cross-sectional study involving residents of Ado Ekiti, Nigeria, and neighboring towns and villages who participated in a health screening were analyzed. BMI cut-off which identifies the presence of hypertension and hypercholesterolemia was determined with Receiver Operating Characteristics curve. Five hundred and fifty-two (552) participants comprise of 230 (41.7%) men aged 38.8±15.6 years and 322 (58.3%) women aged 40.7±15.4 years. More women (27.7%) than men (8.8%) had obesity (p<0.001). Hypercholesterolemia was more prevalent in women (7.1%) than men (3.9%), p=0.014. Prevalence of hypertension was 24.8 and 22.0% in men and women, respectively. Overall, the prevalence of overweight/obesity and hypertension increases with age (p<0.001). The optimal BMI cut-off for men and women were 24.1kg/m 2 (AUC= 0.

Testicular infarction/gangrene is most commonly secondary to testicular torsion. Testicular infarction complicating a strangulated inguinal hernia has been well documented in pediatric literature but found to be rare in adults as it has only been reported in only 2 cases and none of which required orchidectomy for treatment. We report a rare case of strangulated inguinoscrotal hernia with testicular gangrene following a delayed presentation in a 25 year old boy with neglected groin hernia. The patient had orchidectomy in addition to primary bowel resection and anastomosis.

BACKGROUND፡ Perforated peptic ulcer is a life-threatening complication with a high morbidity and mortality. It is the most common indication for emergency operation in peptic ulcer disease (PUD) patients. This study aimed to describe the pattern of presentation, management and early outcome in patients with perforated PUD.METHODS: This was a prospective study of patients who had operation for perforated PUD at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Southwestern Nigeria from June 2015 to May 2020.RESULTS: Forty-six patients were studied with their ages ranging from 21-85 years. Their mean age was 49.9±16.3 years while the median was 54 years. Males outnumbered females by a ratio of 5.5:1. Majority (56.5%) of the patients were farmers and artisans. Duration of symptoms was 6 hours to 9 days (mean 2.7±1.9 days). Non-steroidal anti-inflammatory drugs use, herbal concoction, alcohol and smoking was found in 54.3%, 52.2%, 30.4% and 21.7% respectively. More duodenal perforations (63.0%) were recorded. Graham’s patch closure was done for 27 (58.7%) while the remaining (41.3%) had primary closure with omentoplasty. Sixteen (34.8%) had postoperative complications with wound infection predominating. Overall postoperative mortality was 17.4%. Age ≥ 60 years (p=0.04), premorbid illness (p=0.01), delayed presentation ≥ 48 hours (p=0.01), shock (p=0.01) and intraperitoneal effluent ≥ 2000ml (p=0.03) were associated with mortalities.CONCLUSION: Perforated PUD accounts for high morbidities and mortalities in our setting. Abuse of NSAIDs and herbal concoction ranked highest among the risk factors. Efforts at curtailing indiscriminate sales of NSAIDs and herbal concoction will reduce the menace.