Gossypiboma: Spontaneous trans-urethral migration of a forgotten surgical gauze sponge 5 years post hysterectomy in grand multiparous post-menopausal woman.

INTRODUCTION: Gossypiboma denotes a mass of cotton retained in the body following surgery. Migration of gossypiboma from initial site is a rare entity and could pose some diagnostic difficulties. Migration of gauze sponge has been reported to occur in several organs of the body. There have been few reported cases but the true incidence may be much higher due to under reporting for fear of litigation. PRESENTATION OF CASE: We present an unusual case of a 58-year-old grand multiparous woman who had gauze retention for 5 years following a hysterectomy and presented with acute urinary symptoms. The gauze sponge transmigrated from the peritoneal cavity to the bladder and was partially extruded through the external urethral meatus. She had laparotomy for the removal of gauze sponge with good outcome. DISCUSSION: Retained foreign body especially surgical sponges (gossypiboma) infrequently occurs and can be a source of great concern to the surgeon and patient. Foreign bodies inside the body cavities and organs can present with several non-specific clinical features that can make diagnosis difficult. Migration of surgical sponge (gauze, mops) into the urinary bladder is uncommon when compared to other abdominal and pelvic viscus. A gossypiboma in the peritoneal cavity creates a fistulous tract through the thick wall of the urinary bladder from long period of chronic inflammation as seen in the index case where the previous surgery was performed 5 years prior to onset of symptoms. Due to the non-specific presentations of gossypiboma, especially those in the bladder, several investigative modalities need to be employed to help make a prompt diagnosis. Most long-standing cases would require laparotomy due to the dense adhesions that occur around the site of the gossypiboma. Lack of appropriate diagnosis leaves the patient with recurrence of distressful symptoms and the consequent morbidities. CONCLUSION: Transmigration of a gauze sponge over 5 years from the peritoneal cavity into the urinary bladder and through the external urethral meatus following a hysterectomy is a rare occurrence and can present diagnostic difficulties. High index of suspicion, prompt diagnosis and management will help reduce the high morbidity that is associated with the condition as in the case reported.

Prevalence of Premenstrual Syndrome and Changes in Blood Pressure with Menstrual Cycle Among University Students.

We aimed to investigate prospectively the prevalence of premenstrual symptoms (PSM), changes in bloodpressure with menstrual cycles and to investigate the relative severity of each symptoms and to cluster these symptoms intofactors, and the relative contributions of each factor in a sample of undergraduate students of Ahmadu Bello University,Zaria and Bingham University, Karu. A total of 370 female undergraduate students reported on the severity of 23 PMS in afull cycle. Their blood pressures (BP) were measured during follicular and luteal phases. Paired sample student t-test wasused to investigate difference in mean of blood pressures based on menstrual phases. We fitted PCA to cluster the symptoms.Backache, wish to be alone, joint or muscle pain, fatigue, and pain in the thigh were the five most frequently reportedsymptoms. About 89% of the participants reported experiencing at least one symptom during each cycle. Mean arterial bloodpressure, systolic, and diastolic blood pressures were significantly (P <0.001) higher at the luteal phase than at the follicularphase while, pulse rate was significantly higher (P <0.001) at the follicular phase than the luteal phase. The 23 symptomswere reduced into four clusters; affective, physical, somatic, and GIT/physical symptoms. In conclusion, our findings indicatea high prevalence of PMS with majority indicating that the symptoms as mild to severe. Blood pressure significantlyincreased at luteal phase than follicular phase. The 23 symptoms were reduced into four clusters.

Effect of aerobic exercise training on cardiovascular parameters and CD4 cell count of people living with human immunodeficiency virus/acquired immune deficiency syndrome: a randomized controlled trial.

OBJECTIVE: Despite the significant positive effect of Highly Active Antiretroviral Therapy on physical and psychosocial well-being of people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) (PLWHA); decreased physical activity and its associated cardiovascular risk still pose some consequences for health and general well-being. This study investigated the effect of an 8 week aerobic exercise training on cardiovascular parameters and CD4 cell (T-cells) count of PLWHA. MATERIALS AND METHODS: This randomized controlled trial recruited 30 age matched PLWHA who were randomly assigned into exercise group (EG) ( n = 15) and control group (CG) ( n = 15) respectively. The PLWHA were patients receiving treatment in President's Emergency Plan for AIDS relief at the HIV clinic of the University of Nigeria Teaching Hospital, Nigeria. The EG in addition to conventional therapy received moderate intensity continuous exercise training (60-79% of the maximum heart rate [max]) of between 45 and 60 min, 3 times/week for 8 weeks, while the CG received conventional therapy involving antiretroviral therapy and counseling only. Systolic blood pressure (SBP), diastolic blood pressure (DBP), maximum oxygen uptake (VO2 max) and CD4 cell count were assessed at baseline (week 1) and week 8 respectively. Analysis of co-variance and Pearson correlation tests were used in data analysis. RESULTS: Findings of the study revealed a significant effect (ANCOVA test) of moderate intensity continuous exercise training program on, SBP, DBP, VO2 max and CD4 cell count at P < 0.05. Changes in VO2 max significantly correlated (Pearson correlation test) with changes in CD4 cell count ( r = 0.528) at P < 0.05. CONCLUSION: Moderate intensity aerobic exercise is an effective complementary therapy in lowering blood pressure and increasing CD4 cell count in PLWHA.

Large supralevator puerperal haematoma following a normal delivery.

BACKGROUND: Puerperal Haematomas are not very common and supralevator haematomas following normal vaginal deliveries are quite rare. METHOD: We report a case of supralevator haematoma following a normal spontaneous vertex delivery, necessitating laparotomy. RESULTS: A 29 year old multiparous woman who had a normal pregnancy and normal labour, developed a large supralevetor haematoma. She had a laparotomy and her recovery was uneventful. CONCLUSION: Supralevator haematomas should be considered in patients presenting with lower abdominal pains and absence of vaginal bleeding following normal delivery. Ultrasound scan is helpful, but not conclusive in the diagnosis of supralevator haematomas.

Perceived body image and weight: discrepancies and gender differences among University undergraduates.

BACKGROUND: Body image (BI) is a multidimensional construct that includes perceptual, attitudinal, behavioural components, and feedback from other people's perception of oneself. The feedback from others and the degree to which one accepts or rejects it can determine self evaluation and perception. Body weight perception is a strong determinant of nutritional habits and weight management among adolescents. One of the barriers to reducing rise in obesity prevalence could be its cultural acceptability in some developing countries. OBJECTIVE: To explore the gender influences on perception of self- and opposite-sex body images (BI), perceived body weight and the actual body weight categories at which discrepancies occur among the perceived BIs in undergraduates. METHODS: This was a survey of perceptual dimension of BI, perceived body weight and actual body weight carried out in 121 undergraduates aged 21-29 years. RESULTS: Discrepancies occurred between self-perceived BI and each of actual body weight (p= 0.00 at 0.00-0.02 confidence interval (CI)), perceived body weight (p= 0.01 at 0.000-0.02 CI) and self-ideal BI (p= 0.03 at 0.000-0.05 CI) of normal-weight males. Self-perceived BI and perceived body weight also differed in normal-weight females (p= 0.02 at 0.000-0.04 CI). Discrepancies (p= 0.02 at 0.00-0.04 CI) occurred between self-perceived BI and self-ideal BI, and between self-perceived BI and desired BI (p= 0.02 at 0.00-0.04 CI) in overweight females. Gender differences occurred for self-ideal BI (p= 0.00 at 0.00-0.02 CI), ideal image for the opposite sex (IBIOS) (p= 0.02 at 0.00-0.04 CI) and desired BI (p= 0.00 at 0.00-0.02 CI). CONCLUSION: Normal-weight males perceived their BI differently from their actual body weight, perceived body weight and self-ideal BI whereas normal-weight females perceived their BI differently from only their perceived body weight. Discrepancies occur between self-ideal BI and self-perceived BI, and between self-perceived BI and desired BI in overweight females. There are differential perceptions of self-ideal BI, IBIOS and desired BI between males and females.

Quality of life and its correlates in caregivers of stroke survivors from a Nigerian population.

PURPOSE: The study aimed at determining the quality of life (QOL) of caregivers of stroke survivors in a Nigeria population and some patient and caregiver-related variables that may be associated with it. METHOD: A survey of the QOL of volunteering informal caregivers of stroke survivors in purposively selected tertiary health centres from South-Eastern Nigeria was done using the SF-12 questionnaire. RESULT: Caregivers rated their QOL fairly well. Older age, female gender and closeness in relationship to survivor were caregivers' variables that were significantly related to poorer QOL scores. Being a woman close relative is associated with lower mental health scores while being an older close relative contributed to lower physical health score (P < 0.05). Caregivers' scores on the physical and mental health domains correlated moderately with each other (r = 0.52) and highly with their overall QOL scores (r = 0.81 and 0.88). CONCLUSION: Caring for stroke survivors in Nigeria seems to have adverse effects on the QOL of closer relatives who are either women or older. There is a need for clinicians to help those caregivers at risk find ways of improving and optimizing their QOL.

The Knowledge and Attitude Towards Seeking Medical Care in Case of Exposure to Sexual Violence amongst University of Benin Female Students

Background - There has been increased concern on human sexuality; especially with respect to contraception and the control of sexually transmissible infections. There is need to identify the sociodemographic characteristics that influence sexual behaviour and contraceptive use among young women. Methods - A descriptive cross sectional study that focused on the socio-demographic characteristics; sexuality; knowledge and use of modern contraceptive technology as well as interventions taken in the event of inadvertent pregnancy was conducted. A structured; close- ended questionnaire was randomly administered to 195 female nursing students with 60; 65 and 70 of them in their first; second and third year respectively. Results - Majority (76.7) of the students were in the age bracket of 20 - 24years. While 65.6of them were sexually active; only 54.9had knowledge of family planning. Condom was the commonest contraceptive used (37.4) and the main reasons were that of effectiveness (31.8) and safety (30.3). There was a significant relationship between respondents with multiple sexual partners and incidence of unwanted pregnancies (p=0.003). The majority (51.2) of those with unwanted pregnancies resorted to induced abortion

A standard protocol for blood pressure measurement in the newborn.

OBJECTIVES: Improvements in neonatal care have resulted in increasing survival of extremely premature infants whose hospital course often runs into weeks or months. Some interventions during the acute care of these neonates, such as umbilical catheterization and use of steroids, not infrequently result in elevation of blood pressure (BP). It is, therefore, essential that these infants be monitored accurately for possible hypertension during their convalescence. Unfortunately, normative data on BP in this population are scant and comparison of data from various studies is hampered by methodologic differences in design. Studies in adults address the necessity for a restful state, adopting a comfortable position, and attempts to reduce the startle response to initial cuff inflation. Studies in the newborn using the oscillometric technique have not addressed these concerns. A standard BP measurement protocol was studied to determine the effect of ensuring a restful state, startle response to cuff inflation, and infant position on BP in clinically stable low birth weight infants after the first week of life. STUDY DESIGN: The Dianamap oscillometer was used to measure BP in infants with a birth weight <2500 g between 7 and 42 days postnatal age. Each infant was studied only once when they were clinically stable. BP was measured in two positions, prone and supine, in random order. Infants were studied at least 11/2 hours after their last feeding or medical intervention. An appropriate sized cuff was applied to the right upper arm and the infant was positioned according to randomization. The infant was then left undisturbed for at least 15 minutes or until the infant was sleeping or in a quiet awake state. Three successive BP recordings were taken at 2-minute intervals. The infant's position was then reversed and another 15 minutes of quiet time was allowed. Thereafter, a second set of three successive BP recordings were obtained. The most recent routine nursing BP measurement was also recorded. Data were analyzed using analysis of variance and are presented as means and standard errors of the mean. RESULTS: Sixty-four infants were studied. Birth weights ranged from 901 to 2423 g and gestational ages from 26 to 37 weeks. Overall, mean BP was significantly lower in the prone than supine positions (45.7 +/- 0.7 vs 47.8 +/- 0.8 mm Hg, P < .002). In either position, the first measurement was significantly higher than the third (average difference was 3 mm Hg, P < .003). In general, the relationships among position and order of measurement were similar for systolic and diastolic BP. Mean BPs obtained by routine nurse measurements were significantly higher than those in either position using our standard protocol (54.4 vs 47.0 or 49.1 mm Hg, P < .003). Moreover, the routine nurse measurements varied more widely than did those obtained using the standard protocol. The standard deviation for the routine mean BP measurements by nurses was 11.4 compared with 6.8 and 8.2 for the first measurements in the prone and supine positions, respectively, with the standard protocol. The mean BP measurements made in the supine position (the highest measurements obtained) using the standard protocol were also significantly lower than published values: 57 of 64 measurements were less than the average mean BP for age described by Tan (J Pediatr. 1988; 112:266-270). CONCLUSION: The statistically significant difference between the prone and supine position and among successive measurements in each position are not clinically relevant. The clinically significant differences between measurements obtained with this standard protocol and routine nursing measurements or published data are the result of ensuring a restful state after cuff application. We believe that measurements thus obtained are more representative of true resting BPs in these infants. (ABSTRACT TRUNCATED)

Respiratory syncytial virus infections in malnourished children.

The prevalence of respiratory syncytial virus (RSV) infection among severely malnourished children was studied at the University of Benin Teaching Hospital, Benin City, Nigeria at a time when the infection was known to be prevalent in the community. Nasopharyngeal washings were obtained from subjects on admission and thereafter every 4 days until discharge. RSV was detected by ELISA technique. Of 20 well nourished children who served as controls, 11 were ELISA-positive for RSV (55%). Eight (16%) of the 51 patients who were malnourished were ELISA-positive, four of whom (8%) had nosocomial infection. Fever and rhinitis were the most common presenting features in the RSV-infected malnourished children. None of the children showed any clinical or radiological signs of lower respiratory tract infection. Malnourished children appear not to be at increased risk of RSV infection, and those who contract the infection usually do not manifest severe disease.

Obesity, body fat distribution, and blood pressure in Nigerian and African-American men and women.

This article describes a study that assesses body fat distribution patterns in Nigerian and African-American males and females and determines the association between body fat distribution patterns and blood pressure in young adults of differing geographical and ethnic backgrounds. The study population was comprised of 275 African Americans (92 males and 183 females) and 282 Nigerians (219 males and 63 females). The mean ages for the African-American males and females were 18.7 and 18.9 years, respectively, compared with 21 and 19.2 years for the Nigerian males and females. African Americans were more likely to be obese and overweight compared with their Nigerian counterparts. However, there were no significant differences between the two ethnic groups within gender for body fat distribution patterns based on waist-to-hip ratio. Despite being leaner, the Nigerians had higher diastolic blood pressures than the African Americans. There were no significant associations observed between blood pressure and waist-to-hip ratio for either the Nigerian or the African-American males or females, and body mass index was associated consistently with blood pressure only among the African Americans. These findings suggest that body mass index, a general indicator of obesity, is a better correlate of blood pressure than the waist-to-hip ratio among African Americans.

Sex and ethnic differences associated with urinary sodium and potassium in African-American US white and Nigerian college students.

BP and urinary sodium and potassium were assessed in 183 African-American, 113 US white and 72 Nigerian college students. SBP was higher in African-American males compared with Nigerian and US white males (123.1, 117.6 and 115.7 mmHg, respectively, P < 0.05). There were no significant differences observed between African-American and white male students in overnight urinary excretion rates of sodium and potassium. In contrast, African-American females excreted more sodium (41.0 vs. 31.3 mEq per 8 hours, P < 0.01) and potassium (12.0 vs. 8.9 mEq per 8 hours, P < 0.05) compared with white females. Only among the white students was a significant sex difference observed in urinary electrolyte excretion rates, where males excreted at higher rates than females. Multiple regression models for the African-Americans revealed that potassium explained only 4% of the SBP variance. Among the US whites and Nigerians, sodium explained 4.9% and 6.8%, respectively, of the DBP variance.

Hemopexin: a unique genetic polymorphism in populations of African ancestry.

Using isoelectric focusing and immunoblotting techniques, we have screened 937 plasma or serum samples from Nigerian blacks (N = 380), Papua New Guineans (N = 110), Aleuts (N = 62), Mayans (N = 139), Dogrib Indians (N = 45), and Eskimos from Kodiak and St. Lawrence islands (N = 201) for the hemopexin (HPX) polymorphism. We compared these data with our previously published data for US whites (N = 267) and US blacks (N = 194). Except for Nigerian blacks and US blacks, HPX was found to be monomorphic for the common HPX*1 allele in all populations tested. In addition to the commonly occurring HPX*1 allele, two other less common alleles, HPX*2 and HPX*3, were observed with respective frequencies of 1.8% and 4.6% in US blacks and 1.7% and 9.0% in Nigerian blacks. These data strongly suggest that the HPX*2 and HPX*3 alleles are unique alleles restricted to the black gene pool and are of potential significance in microevolutionary studies and in defining African admixture in hybrid populations. In addition to their importance in anthropogenetic studies, these unique HPX mutations also have potential biological significance in hemolytic disorders.

Nutritional status of urban Nigerian school children relative to the NCHS reference population.

The present study assessed the growth problems in an indigenous African population of Nigerian urban public school children. The study population consisted of 1390 Nigerian children (predominantly Igbo), 718 boys and 672 girls, ages 4-10 years. Compared to the National Center for Health Statistics (NCHS) reference population, the Nigerian children had an excess prevalence of both short stature and underweight. The prevalence of short stature was 14.2% for the boys and 17.4% for the girls. Approximately 20% of the children were underweight whereas less than 1% were considered overweight. These data demonstrate an excess of both acute and chronic malnutrition relative to the NCHS reference population.

PIP: In 2 urban primary schools in Benin City, Nigeria, over a 3-month period, research assistants came to the classrooms of 1390 children aged 4-10 years to take anthropometric measurements so researchers could compare the nutritional status of these school children with that of a US reference population. The Nigerian school children were much shorter than the US reference population. Specifically, boys were at the 32.4 percentile and girls were at the 31.5 percentile. Further, more than 66% of the children fell in percentiles lower than the 40th percentile for height for age. 19.9 and 19.7 were the mean weight for age percentiles for boys and girls. Almost 85% of the children were below the 40th percentile of the US reference population for weight for age. More than 80% were below the 40th percentile for weight for height. 14.2% of boys and 17.4% of girls were short for their age. 19.5% of boys and 21.1% of girls were undernourished (i.e., underweight). Just less than 1% were overweight. The researchers called for further research to learn more about interpretation of growth patterns and problems between developing and developed countries, since a US reference may not be suitable for all populations.

The sickle gene: a marker for blood pressure?

Blood pressure patterns were studied in 224 Nigerians comprising 22 families with at least one child with sickle cell anemia (SS) and 18 families without sickle cell anemia (AA) in a community with a high frequency of the sickle trait (AS). Among the offspring (n = 162; mean age: 10.1 years), systolic blood pressure did not differ between the SS, AS, or AA groups. However, the SS group had significantly lower diastolic blood pressure than the AS or AA groups (60.6 versus 66.5 and 65.4 mm Hg, respectively; P < .01). After controlling for genotype, age, body mass index, and sex, regression analysis revealed that age was the only independent correlate of blood pressure.

Pattern of bacteraemia in febrile children with sickle cell anaemia.

A total of 166 episodes of fever in 162 children with sickle cell anaemia (SCA) aged between 6 months and 16 years who presented with rectal temperatures > or = 38.3 degrees C were studied for bacteraemia. Non-sicklers of similar ages and with similar temperatures were also studied as controls. Bacteraemia occurred in 32.5% (54) of children with SCA and in 26% (39) of controls. Gram-negative bacteria were the predominant organisms (70.4%) in SCA. The commonest organisms isolated were Salmonella (25.9%), Klebsiella (25.9%) and Staphylococcus aureus (22.2%). Gram-positive bacteria were the predominant organisms (51.3%) in controls, with Staphylococcus aureus accounting for 41% of all organisms isolated. In both groups, the incidence of bacteraemia decreased in children after the age of 10 years. Use of antibiotics prior to presentation in hospital was commoner among children with SCA (47.6%) than controls (14.7%). Antimicrobial agents were detected in the urine of 12 children with SCA and four controls whose parents denied prior antibiotic usage. The predominant organisms isolated were sensitive to gentamicin and 3rd-generation cephalosporins.

Factors associated with hypertension in Nigerian civil servants.

BACKGROUND: Study of hypertension in segments of West African populations in transition toward Westernization may lead to better understanding of the high risk for hypertension among Westernized blacks. METHODS: Five hundred fifty-nine urban civil servants, ages 25-54, were recruited from six ministries of Bendel State, Nigeria. Blood pressure, physical measurements, urinary protein and glucose, fasting blood glucose, and demographic data were collected at the workplace. Subjects were classified as senior staff (professionals or administrators) or junior staff (non-administrators). RESULTS: Among 172 male senior staff, the age-adjusted rate of hypertension (diastolic blood pressure > or = 90 mm Hg, systolic blood pressure > or = 140 mm Hg, or on an antihypertensive medication) was 43% and occurrence rose dramatically from 21 to 63% across age groups 25-34 to 45-54, respectively. Among 266 male junior staff, the age-adjusted rate of hypertension was 23%, and occurrence did not rise with age. Logistic regression showed that body mass index (kg/m2), age, alcohol drinking, and being senior staff were all independently related to hypertension in men. On the other hand, the age-adjusted rate of hypertension in 121 women was 20% and was significantly related only to body mass index. CONCLUSION: Male urban civil servants appeared to have a risk for hypertension similar to that of U.S. black males. Age, body mass index, alcohol drinking, and other unidentified factors related to higher socioeconomic status were strong determinants of hypertension in this population.

Malarial parasitaemia in febrile children with sickle cell anaemia.

One-hundred-and-sixty-six episodes of fever in 162 children with sickle cell anaemia (SCA) aged 6 months to 16 years, presenting to the children emergency room of the University of Benin Teaching Hospital, Nigeria with rectal temperature greater than or equal to 38.3 degrees C were studied for malarial parasitaemia. Non-sicklers of similar ages and with similar temperatures were also studied as controls. Malarial parasitaemia was documented in 9 per cent of children with sickle cell anaemia, and 29 per cent of controls (P less than 0.0001). Bacteraemia occurred in 33 per cent of children with SCA and 26 per cent of controls (P greater than 0.10). Bacteraemia was, therefore, the commonest cause of pyrexia in febrile children with sickle cell anaemia on antimalarial prophylaxis. It is suggested that children with SCA on regular anti-malarial prophylaxis who present with significant pyrexia should be carefully screened for bacterial infection and appropriate anti-microbial therapy instituted.

Tracking of blood pressure and anthropometric measures in Nigerian children.

Persistence in ranks (tracking) for blood pressure and anthropometric measures over a one year period was examined in 208 Nigerian children (age 6-17 years). Systolic blood pressure tracked better than diastolic blood pressure (r = 0.52 to 0.72) and r = 0.25 to 0.55, respectively). For systolic blood pressure, 56.5%-70.6% of the Nigerian children remained in the top tertile after one year compared with 45.5%-69.2% for diastolic blood pressure. Weight showed the strongest correlation over the one year period (r = 0.88 to 0.97), whereas skinfolds demonstrated the weakest association (r = 0.54 to 0.82). The association between anthropometric measures at baseline and blood pressure one year later revealed for both males and females that height and weight were positively and significantly correlated with blood pressure.

Caucasian genes in American blacks: new data.

Data on 15 polymorphic protein-coding loci are used to estimate the proportion of Caucasian genes in U.S. blacks from the greater-metropolitan area of Pittsburgh. Allele frequencies from U.S. whites of the same region and from a sample of Nigerians are used as representatives of the genetic contributions of the source populations between which admixture has occurred. These materials provide 18 unique variants that occur exclusively in the blacks and 5 variants that are restricted to the Caucasians only. As a result, when all segregating alleles (52) at these 15 loci are considered, the proportion (mean +/- SE) of Caucasian genes in U.S. blacks (25.2% +/- 2.7%) is estimated with a precision much better than that of all other previous estimates. The estimate based on the frequencies of these 18 unique variants of African origin (24.8% +/- 6.2%) is also consistent with the pooled estimate obtained from the 15 loci by the weighted least-square method. The homogeneity of locus-specific estimates of admixture indicates that these loci are appropriate for studying the proportion of black genes in any admixed population involving African admixture. The advantages of employing such loci for genetic-epidemiologic studies in U.S. blacks is discussed in the context of the availability of these large number of unique African variants at these protein loci.

Nosocomial respiratory syncytial virus infection in a newborn nursery.

The nosocomial spread of respiratory syncytial virus (RSV) was studied in a newborn nursery in Benin City, Nigeria at a time the virus was known to be highly prevalent in the community. Nasopharyngeal washings were obtained from babies on admission and, thereafter, every 4 days until discharged. Questionnaires were administered to medical personnel with upper respiratory tract infection (URTI). RSV was detected by an ELISA technique. A total of 56 babies were studied, made up of 33 preterm and 23 full term babies. Fourteen of the 56 babies (25%) developed RSV infection. Eleven babies (20.8%) acquired the infection nosocomially. The infected babies were all symptomatic and some had significant morbidity. One preterm baby died following acquisition of RSV. The study demonstrated that medical personnel working in our newborn nursery were a major contributor to the spread of nosocomial RSV infection. Babies hospitalized for more than 4 weeks were more likely to acquire RSV infection. Control measures are outlined for the reduction of nosocomial spread of RSV infection in our newborn nursery.