BACKGROUND: Complementary and alternative medicine (CAM), an emerging aspect of the management of chronic diseases worldwide is not widely studied in Nigerian patients with diabetes mellitus (DM). OBJECTIVE: To assess the frequency and pattern of CAM utilization in people with DM . METHODS: This was a cross-sectional question-naire survey involving 263 patients with DM. Biodata, duration of DM, type and pattern of CAM utilization and adherence to prescribed medications were documented. The prevalence and possible determinants of CAM utilization were evaluated by determining the odds ratio for independent variables. RESULTS: There were 263 respondents with a mean age of 60 (10.7) years and with ages ranging from 28-80 years. The prevalence of CAM usage was 46% and the female: male ratio was 2:1. Generally, CAM users were older than non-CAM users, (p= 0.006). The main forms of CAM used were biological based therapies and these included bitter leaf (Vernonia amygdalina), aloe vera, garlic, ginger, and "local herbs". Adherence to prescribed medications was observed by 94% of respondents. CONCLUSION: We found that CAM usage is an important facet of management of DM among our patients with biological based therapies being the prevalent forms of CAM utilized. Despite CAM usage, adherence to prescribed medications was high. Further evaluation of the impact of CAM on glycaemia is needed. WAJM 2010; 29(3): 158-162.

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Objectives: To determine the prevalence, aetiology and predisposing factors in patients presenting with hoarseness to Usmanu Danfodiyo University Teaching Hospital, Sokoto. Methods: The study was a prospective, hospital-based study involving patients with hoarseness ≥7 years. Demographic characteristics and information on voice abuse, smoking, alcohol ingestion and gastroesophageal reflux disease (GERD) were taken. Participants had laryngeal endoscopy using a flexible nasopharyngolaryngoscopy to determine the cause of hoarseness. Results: A prevalence of 2.97% was obtained in the study, and the age range of participants was 7 to 78 years, with a male:female ratio of 1.3:1. The most common cause of hoarseness was laryngeal inflammation 38 (40.0%), followed by benign neoplasm 24 (25.3%), malignancy 20 (21.1%) and trauma 10 (10.5%). Voice abuse, GERD and smoking were significant predisposing factors for benign neoplasm (χ2 = 8.73; P = 0.0031), inflammation (χ2 = 19.79; P < 0.0001) and malignancy of the larynx (χ2 = 10.66; P = 0.0011), respectively. Conclusion: The study showed that acute and chronic laryngeal infection and neoplasms (benign and malignant) of the larynx were the most common causes of hoarseness. Voice abuse, smoking and GERD were the commonest predisposing factors.

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Mucoceles of the paranasal sinuses are expansile, benign mucus filled epithelial lined cystic-like lesion resulting from chronic obstruction to sinus ostia. They erode bony walls by pressure and bony resorption with the frontal and ethmoid sinuses predominately affected. The expansile lesion can involve surrounding structures like the orbit, intracranium or nasopharynx. Diagnosis is based on history, examination and radiological assessment with Computerized tomography scan   being the imaging of choice. Surgery is the mainstay of treatment and would require collaboration with the neurosurgeons or the ophthalmologist when it extends to the brain or orbit respectively. It can be done via an external approach, endoscopic approach or a combination of both.  If left without intervention, it may cause morbidity and potential mortality due to its proximity to the brain and orbit.  We report a rare case in our setting of a 65-year-old male farmer with a painless huge left sided cystic fronto-orbital swelling of 8 years that mimicked a benign orbital tumor. The mass was non-tender and not pulsatile measuring about 20×18 cm with normal visual acuity. Computed tomography (CT) scans of the brain and paranasal sinus revealed a large well-defined non-contrast enhancing homogenous lesion involving the left fronto-ethmoidal sinuses with orbital and intracranial extension as well as inferolateral displacement of the left eye globe. He was reviewed by the ENT surgeons, neurosurgeons and ophthalmologists and subsequently had frontoethmoidectomy via an external approach.