Preconception Care and Sickle Cell Anemia in Pregnancy

Background: Pregnancy in women with sickle cell anemia is associated with adverse outcome for mother and child, but with improvements in medical care, the outcome has greatly improved in developed countries. Despite being the most prevalent genetic disease in Africa, sickle‑cell disease, along with its serious health problems in pregnancy, is largely neglected.Objective: To determine the effects of preconceptual care on pregnancy outcome among booked patients with homozygous sickle cell disease at Aminu Kano Teaching Hospital, Kano, Nigeria.Materials and Methods: A cohort study of the pregnancy outcome, among booked 39 pregnant women with homozygous sickle cell disease (Hbss), who had preconception care, and an equal number of booked pregnant women with homozygous sickle cell disease (Hbss), who did not have preconception care (controls), at Aminu Kano Teaching Hospital, between January 2000 and December 2006.Results: There was no statistically significant difference in the occurrence of complications between the two groups, but complications occurred with less frequency among the cases compared to the controls.Conclusion: This study suggest that preconception care and effective prenatal care by a multidisciplinary team, and delivery in a hospital which is accustomed to management of sickle cell disease and its complications, is associated with good pregnancy outcome in women with sickle cell anemia in pregnancy. Keywords: Multidisciplinary team management, preconception care, pregnancy outcome, sickle cell anemi

Grand multiparity: Obstetric performance in Aminu Kano Teaching Hospital, Kano, Nigeria

No Abstract

Obstructed Labour – A Six Year Review in Aminu Kano Teaching Hospital, Kano, Nigeria

The prevalence of obstructed labour in Aminu Kano Teaching Hospital (AKTH) was 0.8%. Obstructed labour is still a common feature of our obstetric practice. The highest frequency was found among unbooked primigravid teenagers, who lack Western education. The commonest cause was cephalopelvic disproportion (75.5%). Perinatal outcome was poor with perinatal mortality rate of 52.9%. Among the women 39.2% presented with intrauterine fetal death, and 70% of them were delivered by destructive operations. Regional anaesthesia was used in 58% of the cases of Lower segment caesarean section (LSCS), while it was used for all cases of destructive operation. The risk of complications did not show a statistically significant difference (P < 0.05) between those who had LSCS and destructive operation. Maternal mortality was 1.0%. Approach to the management of obstructed labour by either destructive operation or LSCS should be individualized, because either method has a favorable outcome in our centre. Keywords: Obstructed Labour, Kano, feto-maternal outcome. The Nigerian Medical Practitioner Vol. 51 (4) 2007: pp. 59-6

Caesarean Section in Kano, North-West Nigeria

A prospective study of all Caesarean sections (C/S) that were performed at Aminu Kano Teaching Hospital, Kano, Nigeria, between January 2001 and December 2006 was carried out to determine the incidence, age, parity, indications, types and feto-maternal outcome. The caesarean section rate in this review was 13.7%. Emergency C/S accounted for 87.9%, while12.1% were done electively. Among them 52.4% were booked while 47.6% were unbooked, giving a C/S rate of 9.2% for booked and 29.2% for unbooked patients. The leading indications for emergency C/S were cephalo-pelvic disproportion (CPD)/obstructed labour and preeclampsia/eclampsia, while for elective C/S it was two or more previous C/S and breech presentation. Feto-maternal morbidity and mortality were significantly higher among unbooked patients because of late presentation in the hospital. We recommend that Traditional Birth Attendants should be trained to refer patients early. Antenatal care should be free or subsidizedand made more accessible. In a predominantly Islamic society like ours where early marriage and teenage pregnancies are common, campaign for antenatal care and hospital delivery, should include education of the husbands and community about the importance of antenatal care. Involvement of religious and community leaders will go a long way to achieve this goal, as well as the aims of Millennium Development Goals- 4 and 5.Key Words: Caesarean section, booking status, feto-maternal outcom

Ruptured uterus in Kano, Nigeria - study of risk factors

This is a comparative prospective study of the risk factors for ruptured uterus in Aminu Kano Teaching Hospital, Kano, Nigeria, between 1st January 2000 and 31st December 2005. Forty six women with ruptured uterus (cases) were compared with two hundred and thirty women who delivered without ruptured uterus (control). Chi-square (x2) test was used for comparison of the data for statistical significance. The incidence of ruptured uterus was 1 in 278 deliveries (0.36%). The significant risk factors found were unbooked status (OR = 36.70, CI = 12.85 – 112.94), low socioeconomic status (OR = 11.51, CI = 5.34 – 25.10), 30-39 years of age (OR = 2.23, CI = 1.10 – 4.50), grandmultiparity (OR = 8.25, CI = 3.88 – 17.64). Prolonged obstructed labour (OR = 5.92, CI = 2.57 – 13.66).Poor supervision in labour (unbooked status) was found to be the commonest cause of ruptured uterus. In a predominantly Islamic community like ours where early marriage is common, female western education and employment, as well as education of their husbands, community and religious leaders on the importance of antenatal care and hospital delivery, will go a long way to improve its utilization and reduce the prevalence of ruptured uterus in our community. Keywords: Ruptured uterus, risk factors, KanoNigerian Hospital Practice Vol. 2 (3) 2008: pp. 65-6

A Review of Family Planning Methods Used in Kano, Nigeria

Objective To review the acceptance pattern and the influence of age and parity on the choice of Family Planning Methods at the Family Planning Clinic, Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Method All records of the clients that attended the Family Planning Clinic from January 2003 to December 2007 were analyzed Results New clients were 22% while revisits were 78%, with a steady increase in the number of new clients from 4% in 2003 to 26% in 2007. Injectable contraceptives were the most commonly used (40.63%), followed by the intrauterine contraceptive device (IUCD) (34.53%). Most women of low parity used the injectable contraceptive method (36.2%) and oral contraceptive pills (30.7%), while those in the early reproductive age group (37.1%) used oral contraceptive pills and injectable contraceptive method (32.5%) than any other method. Women of high parity (47.1%) and those in the late reproductive age group (51.2%) used injectable contraceptives more, followed by IUCD (43.0% and 46.1% respectively). There was very low acceptance of Implants (0.54%) and voluntary surgical contraception (0.36%). Majority of the clients (67.5%) were informed about voluntary family planning by Health workers. Conclusion There is an increasing trend in the yearly number of new clients in our centre. Contraceptive methods that do involve surgery or the exposure of the women were preferred, and these should be promoted in a conservative society like ours. The influence of husbands, community and religious leaders and female education are important, if the acceptance of voluntary family planning is to increase in societies like ours, where women marry early and are not socioeconomically empowered. Efforts should be made to step up campaign for voluntary surgical contraception, especially among women who have completed their families, as its utilization is very low in our community. Keywords: Voluntary family planning methods, age, parity, acceptance, Kano

Trends of multiple birth at federal medical centre bida, Northcentral Nigeria

Background: Multiple pregnancy remains a significant determinant of perinatal outcome and a contributor to neonatal morbidity and mortality. Aim: To determine the prevalence, trend, and fetomaternal outcome of multiple births at Federal Medical Centre, Bida. Materials and Methods: This was a retrospective study of multiple births at Federal Medical Centre, Bida, Nigeria from 1st January 2010 to 31st December 2013. Data was collected using a pro-forma and then analyzed. Results: The period prevalence of multiple births was 28.4/1000 births and it ranged from 28.6/1000 births in 2010 to 27.4/1000 births in 2013. Associated with multiple births were prematurity, low birth weight, birth asphyxia, high perinatal mortality, and caesarean section. There was correlation between multiple births and increased maternal age which reached its peak at 25–29 years as well as maternal hypertensive disorders. There was no associated maternal death. Conclusion: The prevalence of multiple births was 28.4/1000 births and it was associated with prematurity, low birth weight, birth asphyxia, and admission to special care baby unit as well as increased cesarean section rate and maternal hypertensive disorders

Knowledge of Zika virus disease among reproductive-age women attending a general outpatient clinic in Northern Nigeria

Background: Nigeria is not insulated from the global threat of Zika virus disease (ZVD) because of international travel and the presence of Zika-virus-carrying mosquitoes in the country. A paucity of studies exists concerning knowledge of ZVD among atrisk populations. Thus, the necessity for assessment of knowledge of ZVD among reproductive-age women in general outpatient setting. Materials and methods: A cross-sectional study was conducted on 377 reproductive-age women attending a Nigerian tertiary hospital’s general outpatient clinic. Their knowledge of ZVD was assessed using a structured questionnaire. A chi-square test was used to assess the relationship between participants’ sociodemographics and ZVD knowledge. Results: The participants’ median age was 27.0 ± 7.19 years. Though 68.97% of participants were aware of ZVD, only 23.85% of those had good knowledge of ZVD. Their median knowledge score was 57.14%. Participants’ age (< 27 years) (p = 0.00399), tribe (Hausa) (p = 0.0174) and monogamous family type (p = 0.0108) were associated with good knowledge of ZVD. Only 5% knew that ZVD is transmitted through both mosquito bites and a sexual route. Some 80% were unaware that everybody was at risk of ZVD but 80.77% knew it could cause microcephaly. Insecticide-treated nets (80.77%), environmental sanitation (78.08%) and indoor insecticide spraying (58.85%) were preventive measures reported by most participants; a minority reported mosquito repellents (28.46%), wearing of protective clothing (36.15%), and traditional medicines (20.00%) as preventive measures. They lacked knowledge of prevention of sexual transmission. Conclusion: Participants’ knowledge of ZVD was inadequate despite the high awareness rate. Stakeholders may need to address existing knowledge gaps through effective public enlightenment. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.131348

CHEMICAL COMPOSITION AND SENSORY QUALITY OF SWEETPOTATO CRISPS AS AFFECTED BY VARIETY AND FRYING CONDITIONS

The effect of frying temperatures ranging from 150-180 °C and frying time of 3-12 mins on the compo-sition and sensory quality of sweetpotato crisps from white-fleshed and yellow-fleshed varieties were investigated in this study. Chemical composition, sensory properties and overall acceptability of the crisps were determined using standard methods. Results obtained showed moisture content (2.37-7.50%), fat (9.77-16.22%), total sugar (1.52-4.44%), carotenoids (31.65-55.29 μg/100 g), free fatty acid (0.11-0.44%) and peroxide values (2.95-12.30 mEq/kg). Each of the chemical components and sensory attributes of the crisps were significantly (p&lt;0.001) affected by the individual and combined effects of variety, frying temperatures and frying duration (time) in minutes. The highest overall accept-ability scores were 8.46 for yellow-fleshed crisps fried at 170 °C/5 min and 7.84 for white-fleshed crisps fried at 180 °C/5 min