Catatonia is an acutely evolving and severe medical emergency. It occurs in several medical and psychiatric disorders but is often missed or misdiagnosed. There are majorly three different categories; the retarded, excited and malignant types. The latter is the most severe due to the associated autonomic instability. Much is unknown about the pathophysiology, but dysfunction of cortico-cortical modulation and a "top-down modulation" of the basal ganglia resulting from a deficiency of GABA in the cerebral cortex, resulting in motor dysfunction and glutamate hyperactivity and dopamine hypoactivity at the D2 receptor have been proposed. Benzodiazepines, especially Lorazepam, are reportedly effective, but reports of other benzodiazepines, Zopiclone and trials of mood stabilisers are documented. Electroconvulsive therapy is the suggested next line of action in case benzodiazepine fail, while the use of antipsychotic in catatonia is inconclusive. We present a case series of catatonia in 1) acute on chronic renal failure, complicated with uraemic encephalopathy and 2) severe depressive disorder with psychotic features. Physicians are encouraged to have a high index of suspicion to forestall the lethal complications.

Background: Birth weight is a commonly used indicator of newborn maturity and health and a reliable predictor of postnatal survival. There is a need to determine the birth weight pattern and maternal factors that influence the birth weight in babies delivered at term. Objective: To determine the birth weight pattern and maternal factors influencing the birth weight of babies delivered at term. Methods: In this retrospective, descriptive study, the hospital records of all pregnant women who had childbirth at term in Bowen University Teaching Hospital (BUTH), Ogbomoso, Nigeria, from 01 January 2018 to 31 December 2020, were retrieved. Data on birth weight and maternal obstetric factors were retrieved for analysis. Results: The mean age of the mothers was 30.52 ± 5.23 years. A total of 1072 deliveries were recorded during the study period. These consisted of 580 (54.1%) males and 492 (45.9%) females, with a male-to-female ratio of 1.18:1. The caesarean section rate was 37.7%. The mean birth weight was 3.15±0.56 kg, and male babies had a higher mean weight (3.186±0.535kg vs 3.14±0.493kg). Normal birth weight (NBW) was recorded among 90.3%, while low birth weight (LBW) and high birth weight (HBW) were 6.7% and 3.0%, respectively. Only maternal comorbidities (p = 0.0001) and number of gestation (p = 0.0001) were significantly associated with birth weight. Conclusion: Maternal and foetal factors influenced the birth weights of the babies. Implementing measures to minimise the risk of delivering babies with abnormal birth weights is essential to improve newborn survival.

Background: Health-seeking behaviour is defined as the behaviour of people who malfunction or feel sick to find a suitable treatment. One of the critical factors influencing health-seeking behaviour is the satisfaction obtained from healthcare services, which is often linked to the quality of the service received. Objective: To assess university students' health-seeking behaviour and perception of healthcare services provided at the Babcock University Teaching Hospital, Ilishan-Remo, Nigeria. Methods: A descriptive, cross-sectional study of 425 undergraduate students of Babcock University was conducted using a validated structured questionnaire. The socio-demographic characteristics, health-seeking behaviour and perception of available services were analysed using descriptive statistics. Results: About half of the respondents (50.6%) had poor health-seeking behaviour, and most (68.5%) had a positive perception of the healthcare services rendered by the institution’s healthcare facility. Some factors that affected healthcare-seeking behaviour included the non-availability of medications (37.2%), the attitude of healthcare workers (32.5%), and the cost of care (13.6%). Conclusion: The study demonstrated good health-seeking behaviour and a positive perception of the available healthcare services. However, the factors associated with poor health-seeking behaviour included unavailable medications and the poor attitude of healthcare workers. Regular appraisal and pharmacy restocking should be done to ensure an up-to-date supply of commonly prescribed medications.

Background: Malaria remains an essential tropical protozoal disease, affecting both young and old. It manifests in complicated and uncomplicated forms with more grave consequences among Under-five children. Objective: To describe malaria's clinical profile and short-term outcomes in Under-five children in a secondary health facility in southwest Nigeria. Methods: This was a hospital-based and cross-sectional study. Five hundred children under the age of five years who presented with fever at the health facility were recruited into the study. The clinical manifestations were documented, and blood samples were examined for malaria parasitaemia. Results: Forty-eight children (9.6%) of the study subjects were neonates, 195 (39%) were infants, and the remaining 257 (51.4%) were aged 12 months to 5 years. One hundred and two (39.1%) of the 261 children positive for malaria presented with uncomplicated malaria, while 159 (60.9%) of this population had various complications. The overall mortality from malaria was 5.0%. Conclusion: More than 60% of the infected children had complications of malaria, and mortality was mainly due to late presentation. Therefore, malaria preventive strategies should be part of ongoing health interventions.

Monkeypox is now a disease of global public health concern, making it cut across boundaries into different countries, continents and spread worldwide. However, it originated in the Democratic Republic of Congo as a human pathogen in 1970, with the first case reported in Nigeria in 1971. The World Health Organization recently declared Nigeria the country with the highest burden of monkeypox-confirmed cases and deaths in Africa for the current outbreak. This study aimed to identify forms, challenges, strengths, and ways to further strengthen the surveillance system of monkeypox in Nigeria. We conducted a rapid narrative review of articles published in English on monkeypox between January 2018 and October 2022. Google Scholar and PubMed were searched with the following terms: "Monkeypox", "Surveillance system", "Strengthening", "Challenges" "Nigeria" and relevant publications were reviewed. The forms of surveillance systems in Nigeria include Indicator-based and Event-based surveillance, contact tracing, laboratory-based surveillance, sero-surveillance, and mortality surveillance. Shortage of highly skilled staff in public health interventions, insufficient testing capacities, power instability, poor healthcare systems and stigmatization from communities with misinformation, and co-epidemic surveillance burden in Nigeria are some of the challenges contributing to weak surveillance in the country. The Nigerian governments must focus on investing in surveillance systems and bolster preparedness to stem the rapid spread of infectious diseases. Strengthening the surveillance system in the country as a response intervention for monkeypox is no longer a matter of option in Nigeria but of necessity to prevent the forecasted effect the incidence portends.

Background: Telemedicine practice is a rapidly evolving aspect of medicine in developed countries, though resource-limited countries like Nigeria are yet to embrace it fully. Moreover, the COVID-19 pandemic has limited patients’ visits to hospitals in addition to the social distancing measures deployed by the government. In addition, with the challenges of a limited number of doctors, among other difficulties, it has become important that a radical approach to patient care and treatment should be explored. Methods: A comprehensive literature review of original articles was done using an internet search. Words such as Telemedicine, COVID-19, Pandemic, Requirements, History, Benefits, and Challenges were searched on Google scholar, EMBASE, PubMed, Medline, Web MD, and Scopus to check for various articles published or any probable link. The references of the relevant articles were searched. Results: The practice of telemedicine has evolved over the years. Also, the global telemedicine market has grown exponentially and is expected to grow even further in the next five years. Unfortunately, this exciting narrative is not obtainable in developing countries like Nigeria. Indeed, some healthcare providers in Nigeria need to prepare for this new technological advancement, and consequently, they struggle to evolve their practice to adopt this new technology. Furthermore, there is disinterest from most of the end users, particularly the patients. Conclusion: Modifications must involve telemedicine services with a view of getting ready and well-organized in the event of any future pandemic such as COVID-19, in addition to harnessing the benefits of this service in the future.

Background: Overnutrition has been documented at epidemic levels in children and adults. The associated risk factors may include poor dietary habits, sedentary behaviour, inadequate sleep and low parental education.
 Objective: To describe dietary habits, physical activity and sleep patterns among secondary school adolescents.
 Methods: A cross-sectional study of 1,120 adolescents recruited from public and private secondary schools in Lagos, Nigeria, was carried out to study the dietary habits, sleep patterns and physical activity in relation to nutritional status.
 Results: Ten per cent of the adolescents skipped breakfast, while 28% had fruits on up to five days of the week. Eleven per cent had a sweetened drink every day, while 20 % had a sweetened drink on most days of the week. One out of four (26%) adolescents had more than two hours of screen time daily, and only 5% engaged in sporting activities up to five times weekly. One-third of the students slept for less than six hours daily and experienced sleeping difficulties. Multivariate analysis showed that females were twice as likely not to participate in sports (OR = 2.38, CI = 1.3-4.37, p = 0.002 and to have a higher intake of confectionaries (OR = 1.47, CI = 1.07-2.04, p = 0.01.
 Conclusion: Poor dietary habits, inadequate physical activity and insufficient sleep were observed among secondary school adolescents. A multi-pronged approach to improve these behaviours is recommended.

Spindle cell sarcomatoid carcinoma of the lung is a very rare but highly aggressive tumour. The presentation is usually non-specific and can be confused with bronchogenic carcinoma, even on imaging. Tissue biopsy, with histology and immunohistochemistry, is very helpful in diagnosing and differentiating sarcomatoid cell cancer from bronchogenic carcinoma. Surgical resection is the treatment of choice, and if it is not possible, palliative chemotherapy may be an option. This report is about a rare case of spindle cell sarcomatoid sarcoma of the left lung in a flight attendant who presented with left-sided, dull aching chest pain, associated shortness of breath, and cough that was occasionally productive, haemoptysis and weight loss of one-month duration. The tissue biopsy with histology and immunohistochemistry supported the clinical diagnosis of the tumour. Although rare, spindle cell sarcomas may occur in very few patients. The clinical history, imaging and pathologic findings are essential in preventing misdiagnosis of these patients.

Background: Osteonecrosis of the femoral head is likely to be a complex of diseases rather than a single entity. In sub-Saharan Africa, epidemiological studies on the subject are uncommon.
 Objectives: To determine hip function, radiographic severity and other characteristics of patients with osteonecrosis of the femoral head (ONFH) at presentation in a sub-Saharan Africa population
 Methods: A combined prospective clinical survey and retrospective chart review of patients was done.
 Results: Fifty hips in 44 patients were studied (29 retrospectively and 15 prospectively). The prevalence of ONFH was 1.6%. The mean age was 24.8±13.2 years. The lesion was unilateral in 86.4% and bilateral in 13.6% of the hips. Sickle Cell Disease (SCD) occurred in 43.2%, sickle cell trait in 13.6%, and 20.5% of cases were idiopathic. Overall, 12% of affected hips were presented early, and all the hips were painful at presentation. Of the 18 hips studied prospectively, 72.2% had necrosis >30% and >30% subchondral collapse in 61.1%. The mean combined necrotic angle was moderate size, 197o±29.7o and 177.2o±69.4o for the right and left hips, respectively (p = 0.8). The mean WOMAC scores were 37.2 ±17.4 for function, 10.2±4.3 for pain and 4.2±2.7 for stiffness.
 Conclusion: Patients with osteonecrosis of the femoral head tended to be young adults and those with SCD. The majority present with large-sized osteonecrosis and subchondral collapse but moderate hip pain and stiffness.