Nigerian Journal of Medical and Dental Education

Open Distal Radioulnar Shaft Fractures from Camel Bite: A Case Report from Northeast of Nigeria

2026-02-10T07:29:04+00:00

Camel bite injuries occur world-wide and it is well documented. In the North-Eastern region of Nigeria, injuries from camel bite are rarely reported. Severe injuries from camel attack require multidisciplinary management approach as it can result in limb or life-threatening conditions. To mitigate against these types of severe injuries from camel bites, there is need to report the incidents of camel attacks in order to provide enlightenment about the nature of the camels and their mechanism of causing injuries. Hence, we report a case of Gustilo-Anderson type 3B (GA type 3B) distal radioulnar shaft fractures in a young male camel rearer.

, fracture, soft tissue loss, wound injection, flap.

Bilateral Transverse Facial Cleft with Unilateral Complete Cleft Lip and Palate: A Case Report.

2026-02-10T07:43:21+00:00

Background: The simultaneous occurrence of a bilateral transverse facial cleft with unilateral complete cleft lip and palate is extremely rare especially where no syndromic association can be established. This has hardly ever been reported in African population. The management thus, poses a challenge as the sequence and timing of different aspects of care is not fully established.

Case description: We report the clinical and radiographic (craniofacial computed tomographic scan) findings and surgical management of a rare case of bilateral transverse facial cleft with unilateral complete cleft lip and palate highlighting the challenges of providing care.

Treatment: patient had lip repair, lateral cleft repair and palatal repair in that sequence using Millard’s rotational advancement, straight line and the Bardach’s two flap palatoplasty techniques respectively.

Conclusion: Obvious challenges have been documented however; conscious efforts are required to document treatment protocols that can help in diagnosis and treatment of rare facial clefts presentations.

Spontaneous rupture of Tuberculous epididymo-orchitis; a rare urological emergency

2026-02-10T13:57:20+00:00

Background: Tuberculosis (TB) remains a significant global health problem, with genitourinary involvement accounting for up to 40% of extrapulmonary cases. Spontaneous rupture of tuberculous epididymo-orchitis is extremely rare and often misdiagnosed.

Case Description: A 32-year-old HIV-positive man presented with painful left scrotal swelling and spontaneous rupture of a tuberculous orchitis. He underwent emergency orchidectomy. Histology confirmed necrotizing granulomatous inflammation consistent with TB.

Conclusion: The spontaneous rupture of tuberculous epididymo-orchitis is an uncommon and severe manifestation of genitourinary TB. Early recognition and multidisciplinary management are critical for a good outcome, especially in immuno-compromised patients.

Pan Pneumosinus Dilatans Presenting with Chronic Headache in a Young African Patient

2026-02-10T14:27:12+00:00

Background: The facial bones are normally aerated in adulthood, thus reducing the weight of the skull bones. Pneumosinus dilatans (PSD) is a rare condition of unknown aetiology in which there is over aeration and enlargement of one or more paranasal sinuses. PSD may be primary or secondary

Case description: A 16-year-old male presented with recurrent headaches of 4 years’ duration. There was no history or examination findings to suggest recurrent sinusitis. Computed tomography revealed enlargement of all paranasal sinuses without evidence of sinus obstruction. There was no facial asymmetry, and intracranial structures appeared normal. The patient was managed conservatively and is doing well.

A review of the literature highlights the importance of radiologic investigations in the evaluation of PSD, especially in defining the extent and diagnosing associated conditions.

Conclusion: PSD is a benign condition which can be managed conservatively. Surgical intervention may be reserved symptomatic sinus obstruction or disfiguring changes.

A Rare Diagnosis in a Tertiary Institution: First Ever Case Report and Literature Review of Giant Cystadenoma of the Prostate at the University of Benin Teaching Hospital, Benin City, Edo state, Nigeria

2026-02-10T14:43:39+00:00

Background: Giant multilocular cystadenoma of the prostate (GMCP) is an extremely rare Benign tumour of the prostate gland. An extremely high index of suspicion is required to make a clinical diagnosis, however, in most cases, the diagnosis is made following radiologic investigations and histologic examination of resected specimen. We report the first case of GMCP seen at our institution and ever reported in Nigeria.

Case Description: Our patient was a 64-year-old man who presented to our facility, with painless lower abdominal swelling, storage and voiding lower urinary tract symptoms. He had several episodes of acute urinary retention relieved by a urethral catheterisation and had been catheter dependent. Abdominopelvic ultrasound scan (USS), abdominopelvic computed tomography (CT) scan and magnetic resonance imaging (MRI) done revealed a huge cystic pelvic mass of uncertain origin. Prostate specific antigen (PSA) done on several occasions ranged from 27ng/ml- >100ng/ml. He had transrectal ultrasound (TRUS) guided prostate biopsy on 2 different occasions that revealed prostatic hyperplasia with no evidence of malignancy. He had an initial pelvic exploration which revealed a retroperitoneal mass with an abscess cavity. The mass was resected at that time, but reoccurred about 1 year after. He also had transrectal aspiration of the haemorrhagic cysts on 2 occasions due to pain, with cytology revealing haemorrhagic smear and no malignant cells. He subsequently had joint exploratory laparotomy with R2 resection of a huge cystic mass originating from the pelvis and infiltrating the bladder and surrounding abdominal viscera. Histology of the resected mass revealed the diagnosis of GMCP.

Conclusion: With no reported case of GMCP in Nigeria, we present our diagnostic dilemma of GMCP. A consideration should therefore be made for this entity in male patients presenting with huge cystic masses arising from the pelvis.

The Effect of Vitamin B-Complex Supplement on Salivary Flow Rate, Salivary Viscosity and PH among Post-Menopausal Women: Randomised Trial

2026-02-10T15:22:14+00:00

Background: Vitamin B Supplementation could be a promising and affordable treatment option for adverse hormonal manifestations in the oral cavity for post-menopausal women in Nigeria. This study aimed to determine the effect of vitamin B-complex supplementation in improving salivary flow indices of Unstimulated Salivary Flow rate (USFR), Salivary Viscosity (SRV), and Salivary pH, among postmenopausal women.

Methods: A total of 70 postmenopausal women attending outpatient clinics of the University of Benin Teaching Hospital (UBTH) were recruited into the study and were randomized into two arms: Treatment (35) and Placebo (35). The treatment group received a vitamin B-complex supplement (370mg twice daily) and the control group received a placebo. The respondents were followed up for 4 weeks on a weekly basis. Data was analyzed using IBM SPSS version 24.0 with statistical significance set at p<0.05.

Results: At the end of 4 weeks; there was a significant difference in unstimulated whole salivary flow rate (UWSFR) between the groups (p=0.041) with regression analysis indicating that Vitamin B supplementation and baseline UWSFR were significant predictors of UWSFR. The unstandardized B coefficient indicated a 0.08 gm/min increase in UWSFR in the treatment group (p = 0.023) compared to the placebo group at recall. There was no significant effect of Vitamin B complex in improving SRV. (B=0.014, p=0.865) and salivary pH (p = 0.365).

Conclusion: Vitamin B-complex supplements over 4 weeks significantly improved USFR but did not significantly improve SRV and pH.

Personal Pre-Posting Preview by Clinical Students

2026-02-10T15:34:01+00:00

Background: Clinical posting is integral in medical schools. Preparations made prior to commencement of posting directly influence outcome. Hence, the need to study the effects of personal pre-posting preview (PPP) by clinical students.

Methods: Questionnaires were administered to senior surgery posting students at commencement, mid-way and completion of the posting to assess their knowledge, practice and outcome of PPP. The questionnaire administered at the end of the study had an additional section for objective assessment of the general outcome of the posting. Data collected were analysed as frequencies and proportions. Some results were presented as charts where applicable.

Results: Forty-nine students were involved, 7 (14.3%) had formal knowledge of PPP but only 2 (4.1%) practised it. Albeit, 25 (51.0%) had outlined personal objectives prior to previous posting but only 10 of them (40%) were up to standard. For the previous clinical posting, 2 (4.1%) indicated very satisfactory, 10 (20.4%) indicated satisfactory, 15 (30.6%) indicated average and 22 (44.9%) indicated not significant regarding the basic knowledge and skills expected to acquire in the posting.

Assessment midway into the surgery posting, after adequate enlightenment on PPP, showed 36 (73.5%) very satisfactory, 6 (12.2%) satisfactory, 5 (10.2%) average and 2 (4.1%) not significant responses regarding the effectiveness of completed posting in meeting pre-set objectives. Also, 22 (44.9%) had a full understanding of basic knowledge and skills expected to acquire in their next posting unit.

General outcome at the end of the surgery posting showed 17 (34.7%) very good, 12 (24.5%) good, 12 (24.5%) average and 8 (16.3%) poor.

Conclusion: The improvement in clinical posting observed in the study demands that PPP be popularized among clinical students.

The Role of Pre-Operative Spirometry and Chest Radiography in Predicting Post-Operative Pulmonary Complications After Abdominal Surgery

2026-02-10T15:39:52+00:00

Background: Post-operative pulmonary complications (POPCs) are a major cause of morbidity and prolonged hospital stay following abdominal surgery. In low-resource settings, the predictive utility of routine pre-operative tests like spirometry and chest radiography remains underexplored. This study evaluated the role of these investigations in predicting POPCs in a Nigerian tertiary hospital.

Methods: A prospective observational study was conducted with 100 patients scheduled for elective abdominal surgery. Participants underwent pre-operative spirometry and chest radiography. They were followed for seven days post-operatively for the occurrence of POPCs, defined by standard clinical and radiological criteria.

Results: Over half of the patients (56, 56.0%) had abnormal spirometry, primarily a restrictive pattern (46, 46.0%). Pre-operative chest radiographs were abnormal in 34 (34.0%) of patients. Radiographic findings of fibrosis and hyperinflation were significantly associated with the development of POPCs. Among patients with fibrosis, 6 (75.0%) developed POPCs compared to 33 (35.8%) without (p=0.033). Similarly, 5 (83.3%) patients with hyperinflation developed POPCs versus 34 (36.1%) without (p=0.028). Patients with fibrosis most frequently developed hypoxemia with infiltrates and pneumonia, while those with hyperinflation commonly had non-productive cough and pneumonia.

Conclusion: Pre-operative spirometry and chest radiography are valuable tools for identifying patients at high risk for POPCs. A restrictive pattern on spirometry, along with radiographic evidence of fibrosis or hyperinflation, are significant predictors. Their routine use in pre-operative assessment can facilitate early risk stratification and guide preventive care, potentially improving surgical outcomes in resource-limited settings.

Substance Use Disorders: Its Influence on the Self-Perceived and Normative Oral Healthcare Needs in Adolescents and Young Adults Attending the University of Benin Teaching Hospital

2026-02-10T15:57:35+00:00

Background: Substance use disorders (SUDs) significantly impact general and oral health, particularly among adolescents and young adults. While SUDs are associated with increased oral disease burden, there is limited data assessing both perceived and professionally evaluated (normative) oral healthcare needs in this population. The objective was to evaluate the influence of substance use disorders (SUD) on the perceived and normative needs for oral healthcare among adolescents and young adults receiving treatment for SUDs at the University of Benin Teaching Hospital, Benin City, Nigeria.

Methods: A hospital-based cross-sectional study was conducted among 51 participants aged 10–25 years diagnosed with SUDs using DSM-5 criteria. Data were collected using a semi-structured interviewer-administered questionnaire and clinical oral examinations assessing oral hygiene (OHI-S), periodontal status (CPITN), dental caries (DMFT), and mucosal lesions. Associations between substance use patterns, perceived oral health, and normative needs were analyzed using SPSS v23 with significance set at p<0.05.

Results: The majority were males (86.3%) aged 20–25 years (94.1%), with cannabis being the most used substance (74.5%). While over half rated their oral health as good (56.9%) and felt they needed dental care (54.9%), 70.6% had never visited a dentist. Clinically, most had fair oral hygiene (51.0%), moderate periodontal treatment needs (88.2%), and 56.9% had no caries. A significant association was found between cannabis use and self-rated good oral health (p=0.019).

Conclusion: Most adolescents and young adults diagnosed with substance use disorders perceived their oral health needs as good, whereas their normative oral healthcare needs were mostly fair. Those in need of oral healthcare, such as scaling and polishing, and dental caries treatment had no perception of the need for treatment, especially those who had a recent history of substance use.

Herbal Medicine among Women Attending Antenatal Clinic in Health Facility in Rural Nigeria

2026-02-10T16:09:45+00:00

Objective: This study aimed to determine the prevalence and factors associated with the use of herbal medicine by pregnant women.

Methods: A descriptive cross-sectional study of six healthcare facilities in Okada town, Edo State, Nigeria, involving 370 women attending antenatal clinics. Data were collected using an interviewer-administered questionnaire on the use of herbal medications in pregnancy. Data were analysed using a statistical package for the social sciences (SPSS) version 25.0, and P-values of less than 0.05 were considered statistically significant. Univariate and multivariate logistic regression analyses were performed to determine the prevalence, types of herbal medications used, and factors associated with the use of herbal medicine among the women.

Results: The mean age of respondents in this study was 30.64 ± 8.33 years. About 72.7% knew about herbal medicine intake during pregnancy. and the prevalence of herbal medicine use was 44.1%. Age, level of education, religion, marital status, parity and number of antenatal visits were significantly associated with herbal medicine use (p ˂ 0.05). The odds of using herbal medicine were 2.44 times higher in respondents with higher incomes.

Conclusion: The use of herbal medicine by pregnant women was seen to be quite high in this study. This is because many patients have confidence in the efficacy of herbal remedies and find them helpful with limited reported side effects. There is a need for further investigation of these herbal medicines, their potency, efficacy and safety in pregnancy.

Risk of Obstructive Sleep Apnoea and its Association with Perceived Quality of Life among Hospital Workers in Southern Nigeria

2026-02-10T16:16:16+00:00

Background: Obstructive sleep apnoea (OSA) is a prevalent yet underdiagnosed sleep breathing disorder associated with fatigue, poor quality of life and cardiometabolic complications. Despite growing awareness, data on the risk of OSA, health workers notwithstanding, remains sparse even in light of the knowledge of its health significance. This study aimed to assess the risk of OSA and its relationship with perceived health-related quality of life among hospital workers in Benin City, Nigeria, while also exploring potential sociodemographic and environmental influences.

Methods: A cross-sectional study was conducted among 93 non-clinical staff at the University of Benin Teaching Hospital. Participants were recruited through direct engagement and screened using a structured questionnaire incorporating the STOP BANG and WHOQOL BREF instruments. Data on stove type, cooking location and fuel source were collected to assess indoor exposure risks. Descriptive statistics, Chi-square tests and t-tests were used to analyze associations between OSA risk, sociodemographic variables and perceived quality of life.

Results: Most participants were at low risk for OSA (87.1%), while 5.4% and 7.5% were at intermediate and high risk respectively. All high-risk individuals were male and had significantly higher mean age (43.6 ± 10.0 years vs. 31.8 ± 7.4 years; p < 0.001). A significant inverse relationship was found between education level and OSA risk (Chi-square for trend = 6.831; p = 0.009). Classic symptoms such as loud snoring (85.7%) and daytime fatigue (100%) were prevalent in the high-risk group. BMI was higher among high-risk individuals but not statistically significant. Most respondents rated their quality of life as good or very good (88.2%), although symptom burden among those at high OSA risk suggests possible impaired well-being. Nearly 41 percent of participants used open fire stoves without chimneys, indicating possible exposure to indoor air pollution.

Conclusion: A measurable proportion of hospital workers in this study were at increased risk of OSA, especially among older males and those with lower educational attainment. Despite overall positive self-reported quality of life, high-risk individuals exhibited a cluster of classic OSA symptoms that may compromise daily functioning and productivity. Routine workplace screening using validated tools like STOP-BANG, coupled with awareness campaigns and clean cooking interventions, is recommended to reduce the burden of undiagnosed OSA among workers in healthcare settings.

Haematological and Urinalysis Parameters among Anaemic Patients with Gynaecological and Surgical Cancers at a Tertiary Hospital in Nigeria

2026-02-10T16:25:02+00:00

Background: Anaemia is a common complication of cancer, yet the major causes of cancer-related anaemia particularly in our setting remains unclear. This study assessed haematological and urinalysis parameters among anaemic patients with gynaecological and surgical cancers to better understand the aetiology of cancer- related anaemias.

Methods: This hospital-based descriptive cross-sectional study was conducted at the University of Benin Teaching Hospital between March 2016 and May 2017. Ninety-four anaemic patients (49 with surgical cancers, 45 with gynaecological cancers) were consecutively recruited. Laboratory assessments included full blood count, reticulocyte count, peripheral blood film, bilirubin assay, urinalysis and antibody screening via direct and indirect antiglobulin (Coombs) tests.

Results: The mean age of participants was 52.3 ± 1.4 years while the mean haemoglobin ± SEM of all participants was 9.76±0.15 g/dl. The majority of anaemia cases were mild or moderate, with no statistically significant difference between cancer types. Antibody screening revealed no positive cases (0.0%) for either direct or indirect Coombs tests. Burr cells, suggesting renal dysfunction, were found in 11(23.5%) participants. Most anaemias were microcytic-hypochromic. Urinalysis findings showed a subset of patients had proteinuria (23 (24.5%) participants) or haematuria (20 (11.3%) participants), particularly those with burr cells—supporting possible renal impairment.

Conclusion: Cancer related anaemias (CRA) are a leading cause of hospitalization amongst cancer patients and the use of basic haematological and urinalysis parameters can serve as a cheap and effective screening tool to determine the aetiology of CRAs. The inappropriate reticulocyte response, the red cell morphologic findings on PBF examination, evidence of proteinuria and haematuria on urine analysis, and the absence of red cell autoantibodies all suggest that diverse mechanisms, such as chronic inflammation, nutritional deficiencies, bone marrow infiltration, or renal dysfunction, are more likely to underlie anaemia in these patients. It also almost rules out an autoimmune basis to CRAs in solid tumours.

The Effect of Pulmonary Hypertension on Mortality of Heart Failure Patients in a Nigerian Population

2026-02-10T16:34:07+00:00

Background: Pulmonary hypertension has become increasingly recognized as a contributory cause of death in patients with heart failure. This study examines the effect of pulmonary hypertension on the survival of heart failure patients, both intra-hospital and follow-up for one year.

Methods: A descriptive cross-sectional study in which one hundred and fifty patients admitted for heart failure were recruited.

Results: A total of 31 (22.67%) patients admitted for heart failure died within one year of presentation. Among those that died, 22 (71%) had pulmonary hypertension, while 9 (29%) did not have pulmonary hypertension. The one-year mortality rate was 27.2% and 13.0% in heart failure patients with and without pulmonary hypertension respectively. Also, the intra-hospital mortality was 12.3% and 5.8% in heart failure patients with and without pulmonary hypertension respectively.

Conclusion: This study shows a high one-year mortality rate among patients with heart failure; with intra-hospital mortality rate of 10%. There is therefore need for better management strategies to help reduce mortality in heart failure patients.

Investigation of the Effect of Carica Papaya Seed Extract on Some Haematological Parameters in Adult Wistar Rats

2026-02-11T14:21:33+00:00

Background: Haematological disorders, including anaemia and leukemia, are a significant public health issue globally, particularly in developing nations. Carica papaya L. seeds are known for their bioactive compounds, which have demonstrated antioxidant, antimicrobial, and anti-inflammatory activities, but their effects on haematological parameters remain underexplored.

This study aimed to evaluate the dose-dependent effects of aqueous Carica papaya seed extract on haematological parameters in adult Wistar rats. Twenty-five rats were divided into five groups and administered varying doses of the extract (250, 500, 750, and 850 mg/kg) for 14 days, with a control group receiving normal saline. Blood samples were analyzed for red blood cell (RBC) count, white blood cell (WBC) count, haemoglobin (HGB) concentration, packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), platelet count, and differential leukocyte counts.

The results showed that RBC count ranged from 6.06 × 10¹²/L to 7.50 × 10¹²/L across groups, while WBC count ranged from 4.80 × 10¹²/L to 5.33 × 10¹²/L, and PCV ranged from 40.33% to 43.33%. There were no statistically significant changes in RBC, WBC, HGB, PCV, MCV, MCH, or MCHC when compared to the control group. However, significant dose-dependent changes were observed in minor leukocyte populations: eosinophil percentages increased at 250 and 500 mg/kg, basophil counts decreased at 250, 750 and 850 mg/kg, and monocyte levels rose at 500, 750 and 850 mg/kg.

Conclusion: Aqueous Carica papaya seed extract demonstrated potential immunomodulatory effects on specific leukocyte populations without significantly affecting major haematological parameters. Further studies with longer durations, and disease models are recommended to fully explore its therapeutic potential in haematological and immune system regulation

Prevalence and Associated Risk Factors for Prediabetes and Diabetes in Udo, Edo State, South-South Nigeria

2026-02-11T14:34:40+00:00

Background: Diabetes is a chronic condition that can lead to serious illness and death if not detected early and managed effectively. Prediabetes is the crucial period to promote, prevent, or delay the development of Diabetes mellitus (DM). It describes a metabolic state that signals the potential progression to type 2 DM. Individuals with prediabetes have a higher risk of developing Type 2 diabetes. This study aimed to evaluate the prevalence and risk factors associated with prediabetes and diabetes among residents of Udo, a rural community in Edo State, South-South Nigeria.

Methods: A community-based descriptive cross-sectional study was conducted. Adults aged 18 years and older living in the rural community who attended a free medical outreach program as part of the World Diabetes Day Celebration were screened for prediabetes and diabetes mellitus. Data were collected using a structured, interviewer-administered questionnaire. Fasting plasma glucose (FPG) was measured with calibrated glucometers and classified as follows: normal (<or equal to 6mmol/L), prediabetes (6.1-6.9 mmol/L), and diabetes (≥7 mmol/L). Data were analyzed using descriptive statistics, the chi-square test, and binary logistic regression.

Results: The mean (standard deviation) age of the participants was 48.8 ± 18.3 years. The prevalence of prediabetes and diabetes was 23.6% and 18.2%, respectively. Of the 78 diabetic patients, 75.6% (59) were undiagnosed, and 24.4% (19) were diagnosed diabetics. Hypertension was significantly associated with prediabetes. A positive family history of DM and increasing age were the main predictors of diabetes.

Conclusion: This study demonstrated a high prevalence of prediabetes and diabetes in the study population in a rural setting, reducing the rural-urban disparity in DM prevalence. There is a need for targeted routine screening for diabetes and hypertension, especially for at-risk individuals, along with intervention programs aimed at reducing the risk of diabetes and prediabetes and the associated risk factors, thereby alleviating the burden of DM in Nigeria.

Flap Fixation; Post-Mastectomy Seroma Prevention in University of Benin Teaching Hospital, Nigeria

2026-02-11T14:49:24+00:00

Background: Post mastectomy seroma is the accumulation of serous fluid under the skin flap or axilla following mastectomy. It is a common complication post mastectomy. Several techniques have been attempted in preventing seroma following mastectomy including flap fixation. Flap fixation involves fixing the skin flaps to underlying pectoralis major muscle. The objective was to determine the efficacy of flap fixation in addition to conventional flap closure in the prevention of seroma formation post mastectomy at the University of Benin Teaching Hospital (UBTH).

Methods: This was a prospective comparative randomized study done over 12 months in UBTH. Sixty-four (64) breast cancer patients who had Auchincloss modified radical mastectomy (MRM) were randomized into two (2) groups in this study. Group A patients had flap fixation to the pectoralis major muscle with vicryl 2/0 suture followed by simple interrupted flap closure with prolene 0 while group B had simple interrupted flap closure with prolene 0 suture. Both Groups were followed up for one (1) month, examining for seroma, number of times seroma was aspirated and volume of seroma aspirated. The results were presented in tables and figures. P-value was set at < 0.05.

Results: The incidence of seroma was lower in group A (15.6%) compared to group B (28.1%), (p = 0.365). Most patients who had seroma (80%) in group A were aspirated once while most patients (55.6%) in group B had multiple aspirations (p = 0.001). The mean volume of seroma aspirated was lower in group A (32.33 ± 12.01mls) compared to group B (249.50 ± 207.04mls), (p=0.028). The mean duration of surgery in group A was prolonged (p=0.008). Patient’s satisfaction with scar outcome was not statistically significant in both groups (p = 0.676).

Conclusion: Flap fixation reduced the incidence of seroma formation. Flap fixation significantly reduced the volume of seroma and the number of times seroma was aspirated. However, it significantly prolonged the duration of operation.

Enhancing Medical Practice While Mitigating Medico-Legal Risks in Nigeria’s Healthcare System

2026-02-10T15:05:53+00:00

Medical practice in Nigeria exists within a fragile ecosystem that blends clinical expertise with systemic weaknesses. Rising patient awareness, growing litigation, and heightened expectations—particularly in the private sector—make the alignment of clinical excellence with medico-legal safeguards indispensable. This paper examines the structure of medical practice in Nigeria, explores the ethical and legal frameworks that guide it, identifies common medico-legal risks, and proposes strategies for reducing liability. It highlights the importance of communication, informed consent, documentation, confidentiality, and governance in strengthening patient trust while minimizing risks. For sustainable healthcare delivery, Nigerian practitioners must integrate professionalism with medico-legal awareness to ensure safe, ethical, and accountable practice.