Background Phototherapy is paramount in the management of high total serum bilirubin (TSB). Whether its effectiveness can be improved with ursodeoxycholic acid (UDCA) has not been evaluated among newborns of African descent. Methods A double-blind-controlled study was used to evaluate the effect of UDCA on the management of high TSB in neonates. Recruited neonates were categorized into the experimental group (given UDCA plus phototherapy) and the control group (phototherapy and plain syrup), and their TSB and conjugated bilirubin levels were measured. The data were analyzed using SPSS version 20. Statistical significance was set at a p -value of <0.05. Results The mean (SD) percentage reductions in TSB after 24 hrs were 40.73% (18.1) and 10.21% (7.1) in the experimental and control groups, respectively, and the difference was statistically significant ( p =0.001). The mean (SD) durations on therapy were 3.0 days (0.58) in the experimental group and 5.5 days (1.35) in the control group ( p =0.001). Conclusions Phototherapy is still effective in the management of neonatal hyperbilirubinemia, but inclusion of UDCA accentuates the reductive effect of phototherapy on the TSB in neonates, reducing the duration of treatment and in-patient care.

Background: The health of people living with HIV/AIDS becomes progressively worse when co-infected with hepatitis B virus (HBV) and hepatitis C virus (HCV), resulting in shortened life span. The modes of transmission of HIV, HBV and HCV are similar. Objective: To determine the prevalence of HBV and HCV co-infection in HIV patients. Method: This was a retrospective study of serology test results for hepatitis B surface antigen (HBsAg) and antibodies to HCV (anti-HCV) of HIV positive patients registered from 2008-2013 (6years) at the University of Nigeria Teaching Hospi- tal. Adult patients with confirmed HIV seropositivity were included. Ethical approval was obtained and confidentiality of the patient information was maintained. Laboratory records were reviewed to obtain HBsAg, anti-HCV, and CD4 T-lymphocyte results. Prevalence was determined by the number of positive results over total number of patients tested. Chi-square test was used to determine relationships and p<0.05 was considered to be statistically significant. Results: 4663 HIV patient records were included comprising 3024 (65%) females and 1639 (35%) males. Serology results showed 365/4663 (7.8%) tested HBsAg-positive only; 219/4663 (4.7%) tested anti-HCV-positive only; and 27/4663 (0.58%) tested both HBsAg and anti-HCV-positive. Correlation of age and sex were statistically significant with HBV and HCV (p<0.05) but not CD4 count (p>0.05). Conclusion: HBV co-infection was more prevalent than HCV, and triple infection was also observed. Screening for these viral infections in the HIV population is necessary for early identification to enable appropriate, holistic management of these patients. Keywords: Hepatitis B virus; Hepatitis C virus; HIV; co-infection.

Introduction: An estimated 6.3 million Nigerians were reported to have prediabetes in 2015 placing Nigeria in the 9th position in world ranking. This number is projected to become 12.9 million by 2040. One way of reversing this trend is early identification of individuals at risk. This study was carried out to assess the knowledge, attitudes and practice of health care providers toward prediabetes diagnosis and management. Methods: This was an observational-based cross-sectional study involving the use of self administered questionnaire to doctors from the departments of internal medicine, paediatrics, obstetrics and gynaecology, family medicine and others. Results: In all, 358 questionnaires out of 410 were selected. All 10 risk factors for prediabetes were correctly identified by 82/358 (22.9%) participants with 300/358 (83.8%) able to identify at least 5 risk factors. Laboratory reference interval of 5.6 – 6.9 mmol/L for diagnosing prediabetes using fasting plasma glucose were correctly identified by 70/358 (19.6%) (lower value) and 14.5% (upper value) respectively. American Diabetes Association guidelines for prediabetes screening was the most familiar to 272(76.0%) respondents even though 144/358(40.2%) do not consider prediabetes as a condition that requires specific management. Over half 186/358(52%) of respondents agreed that metformin use can reduce the risk of diabetes in individuals with prediabetes but only 6/358(1.7%) have ever discussed starting metformin with their patients. Conclusion: There is need to educate medical doctors about risk factors for prediabetes and its management to curb the rising diabetes epidemic in Nigeria.

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Background: Elderly people have increased risk factors for low serum vitamin D levels, which is worsened among the black race. Therefore, elderly Africans constitute a reference population for vitamin D study. Aim: The aim of this study was to establish the reference interval of serum 25-hydroxyvitamin D (25(OH)D) among an African elderly population. Methodology: This was a cross-sectional study of rural community dwellers in Enugu, south-eastern Nigeria aged 50 years and above, that satisfied the criteria of the reference population. Ethical approval and informed consent were obtained. Venous blood was collected from reference individuals and serum 25(OH)D was determined by enzyme-linked immunosorbent assay.Data were analysed using a non-parametric, bootstrap method to obtain the central 95% reference limits and 90% confidence intervals of the lower and upper limits of the reference interval respectively. Results: One hundred and twenty-four (62 males and 62 females) participants were recruited. The median (25th -75th percentile) of serum 25(OH)D was 56 (35 – 71) ng/ml. The 2.5th percentile defined the lower reference limit and it was 21 ng/ml with 90% confidence interval (20 – 23) ng/ml; while the 97.5th percentile defined the upper reference limit and it was 93 ng/ml with 90% confidence interval (90 – 98) ng/ml. Conclusion: The reference interval for serum 25(OH)D for the selected African elderly population in Enugu, Nigeria was determined to be 21 to 93 ng/ml. Keywords: Bootstrap method; elderly; reference interval; vitamin D.