Incidence of breech presentation and its association with fetal/myometrial lesions in Kano

The entrance of the fetal buttocks or lower extremities into the maternal pelvic inlet is defined as breech presentation. It complicates 3-4% of all pregnancies. The occurrence of breech presentation decreases with advancing gestational age. Both myometrial and fetal lesions have been linked with persistence of breech presentation Methodology: It was a prospective study conducted at Aminu Kano Teaching Hospital. Ethical approval was obtained from the hospital ethics committee. Information on socio-demographic characteristics was sought and obtained on a questionnaire after obtaining informed consent. using 3.5 MHz linear transducer connected to Mindray Digital Ultrasound Imaging System (Model DC6; Shenzhen Mindray Biomed Electronics, Shenzhen, China). Obstetric correlates that were determined and recorded on the questionnaire were the lie, presentation, estimated gestational age, myometrial and fetal lesions. The data were analyzed using SPSS Electronic Software Version 19 (SPSS Inc,IL,Chicago, USA). Chi-squared test was used for categorical data and P-Value of <0.05 was considered statistically significant. Results: A total of 300 pregnant women were recruited for the study. The mean age± SD was 27.3±5.20. The incidence of breech presentation was highest below the gestational age of 28 weeks (14.3%); the least (1.6%) was above the gestational age of 36 weeks. There was no statistically significant association between breech presentation and myometrial or fetal lesion (P=0.213; P=0.787 respectively). Conclusion: There was low incidence of breech presentation at term (1.6%). The incidence of breech presentation has an inverse relation with an increasing gestational age. Myometrial and fetal lesions were not statistically associated with occurrence of breech presentation

Effect of Camel Milk’s Supplementation on Serum Glucose Levels, Lipid Profile and Body Weight of Alloxan-Induced Diabetic Rats

Cases of diabetes are on the rise in almost every population and epidemiological studies suggest that without proper prevention and control measures, prevalence of the disease will continue to increase globally. The aim of the current study was to investigate the effect of camel milk supplementation on serum glucose, lipid profile and body weight of alloxan-induced diabetic rats. Rats were rendered diabetic by intravenous injection of alloxan (80mg/kg body weight). Diabetic rats showed significantly higer blood glucose levels (9.68±1.36 mmol/L). Treatment with camel milk significantly decreases blood glucose levels (5.33±0.46) p<0.05 compared to control. There was a significant increase (p<0.05) in serum total cholesterol, triglyceride, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, and a significant decrease (p<0.05) in high density lipoprotein cholesterol in diabetic untreated rats as compared with control group. However, a significant decrease (p<0.05) in total cholesterol, triglyceride, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, and a significant increase (p<0.05) in high density lipoprotein cholesterol was observed in diabetic treated with camel milk group as compared with diabetic untreated group. No significant change in body weights were observed in all experimental groups during the period of the experiment. The current study demonstrates the efficacy of camel milk in management of diabetes in alloxan induced diabetic rats. This suggests that camel milk may have important implication in the management of diabetes. Further studies are required to elucidate the safety as well as the mechanism of action.Keywords: Camel Milk, Serum glucose, Lipid profile, Diabete

Audit of gynaecological laparoscopies in national hospital Abuja, Nogeria

No Abstract

Pattern of gynaecological admissions in Aminu Kano Teaching Hospital: A three year review

Concept: Gynaecological admissions form a large proportion of the number of admissions in any Obstetrics and Gynaecological department of our hospitals.Aims and Objectives:This study was conducted in gynaecology ward of AKTH, Kano to review the gynaecological admissions, mortality and efficiency of hospital facility utilization over a period of 36 months (January 2006 to December 2008).Methodology: This is a retrospective review of all patients admitted into the gynecology ward between January, 2006 and December, 2008. Information obtained on socio-dermographic characteristics, diagnosis, hospital stay, bed occupancy, etc were collated and analysed.Results: There were 1717 admissions over the study period, out of which 1225 (71.3%) were emergencies and 494(28.7%) were elective admission for surgery giving an emergency/elective ratio of about 2.5:1. There were 50.5 patients per bed per year with bed occupancy of 13.8%. The commonest diseases responsible for gynaecological admission were abortions (23.1%), followed by medical complications of early pregnancy (19%), gynaeclogical malignancy (11.4%), ectopic pregnancy(6.7%), infertility (5.2%) and pelvic inflammatory disease (3.5%).All the deaths occurred in the emergency group (2.4%). The highest fatality was contributed by gynaecological malignancies, which accounted for 71.4 % of all gynaecological deaths with carcinoma of the cervix as theleading cause (33.2%), followed by ovarian cancer (28.6%). Postabortal sepsis was the third most common cause, contributing 16.7% fatality.Conclusion: Management should improve admission policy, understanding of patient needs in order to increase acceptance of our services.Key Words: Bed occupancy, gynaecological admissions, AKTH, Kano

Sero-prevalence of Hepatitis B Virus Infection and its Risk factors among Pregnant Women Attending Antenatal Clinic at Aminu Kano Teaching Hospital, Kano, Nigeria

Background: Pregnant women infected with hepatitis B virus (HBV) can transmit the infection to their fetuses and newborns. Neonates who contract the HBV have about 90% risk of developing chronic HBsAg carriage (HBsAg: hepatitis B surface antigen) and chronic liver disease. Neonatal immunization interrupts this vertical and perinatal transmission.Objectives: To determine the seroprevalence of HBsAg among pregnant women attending the antenatal clinic at Aminu Kano Teaching Hospital (AKTH) and to identify potential risk factors associated with HBV infection.Materials and Methods: A case control study was conducted involving a total of 303 pregnant women attending the antenatal clinic at AKTH and 303 nonpregnant women of childbearing age. Blood sample was collected from each woman and the serum tested for the presence of HBsAg using latex rapid agglutination slide test kit (Cal-Tech Diagnostic Inc., USA) in the laboratory of the hospital. Reactive samples were stored at -20ºC and further confirmed for HBsAg using enzyme-linked immunosorbent assay (ELISA) kits (Bio-Rad, France). HBsAg-positive samples were tested for hepatitis B e antigen (HBeAg) using ELISA kits (Orgenics, Israel). A pretested, structured questionnaire was used for the collection of sociodemographic data and possible risk factors. Results: The prevalence of HBsAg among pregnant women and nonpregnant women were 7.9 and 7.6%, respectively. There was no statistically significant difference in the prevalence of HBsAg in pregnant and nonpregnant women. The presence of HBeAg was statistically significant among both pregnant and nonpregnant women who tested positive for HBsAg. The risk factors associated with HBV infection were blood transfusion, ear piercing, history of an affected sibling with HBV infection, tattooing, and abortion among pregnant women.Conclusion: The prevalence of HBsAg in this study was not statistically different in pregnant and nonpregnant women. There was a high level of HBeAg infection among pregnant women who tested positive for HBsAg. History of an affected sibling with HBV infection, tattoo, and abortion were significant risk factors for HBV infection. Keywords: Africa, hepatitis B, pregnancy, risk factor

Necrotic enteritis and its management in 13-week old commercial pullets in Katsina, Nigeria

Necrotic enteritis is rarely reported because it is often misdiagnosed as coccidiosis due to similarity in clinical and pathological features. A field outbreak of necrotic enteritis in a flock of 13 weeks old 4,500 commercial pullets was investigated, the onset of the disease, morbidity and mortality rates were recorded. Post mortem examinations were conducted and gross lesions were documented. Tissues were collected and fixed in 10 % neutral buffered formalin and processed for histopathological examinations. Clinical signs observed were ruffled feathers, weakness, somnolence, loss of weight and diarrhoea; while the gross lesions observed were emaciated carcasses, lean abdominal fat, enlarged, pale and haemorrhagic liver; enlarged, mottled and congested spleen; mucus and diphtheritic membrane on the jejunal mucosa and enlarged kidneys. The histopathological findings of the intestine were diffused necrotic epithelial cells with marked mononuclear cells infiltration in the mucosa with severe oedema fluid. The necrotic enteritis was diagnosed based on clinical signs, pathology as well as isolation and identification of Clostridium perfringes. Triplesulfa® (sulfadimidine sodium, sulfadiazine sodium and sulfamerazine sodium); Tridox® L.A (20% Oxytetracycline long acting) and Enterocillin® (Amoxycillintrihydrate and Colistin sulphate) were ineffective, while copper sulphate at 1g/5L of drinking water was found to be effective for the treatment of the disease. The haematological values indicated lymphocytosis due to damage of the tissue caused by C. perfringes and the toxins produced. Keywords: Necrotic enteritis, Commercial pullets, Copper sulphate, Clostridium perfringen

Oxidative stress among subjects with metabolic syndrome in Sokoto, North.Western Nigeria

Background: Oxidative stress is known to play a role in the pathophysiology of metabolic syndrome and its components. Racial differences may exist in the level of markers of oxidative stress and antioxidants in patients with metabolic syndrome.Aim: The aim of this study was to determine the oxidative stress and antioxidants status in subjects with metabolic syndrome in Sokoto, North.Western Nigeria.Methods: A cross.sectional community.based study was carried out. Two hundred subjects (96 males and 104 females) were recruited for the study using a multi.stage sampling technique. Demographic data were obtained from the participants. Evaluation of anthropometric variables, blood pressure, blood  glucose levels, lipid profiles, plasma insulin levels, total antioxidant status, and oxidative stress markers was performed.Results: The subjects with metabolic syndrome had significantly higher malondialdehyde as compared to those without metabolic syndrome (236.4 [92.2] vs. 184 [63.2] nmol/l). The antioxidant enzymes  (superoxide dismutase, glutathione peroxidase and catalase) were significantly lower in subjects with metabolic syndrome than in those without metabolic syndrome (11.3 [4.2] vs. 13.9 [4.1] U/ml, 160[42] vs. 220[32] U/ml, and 2.12 [0.2] vs. 2.42 [0.2] U/ml, respectively). Similarly, the antioxidant Vitamins (A, C, and E) levels were significantly lower in subjects with metabolic syndrome than in those withoutmetabolic syndrome (7.1 [4.1] vs. 7.7 [4.2] µmol/L, 225 [55.3] vs. 227.6 [62.3] µmol/L, and 75.9 [13.9] vs. 82.8 [18.6] mg/dl, respectively). There was a positive correlation between components of metabolic syndrome and free radicals.Conclusion: Significantly increased oxidative stress and diminished antioxidant defenses were found among Nigerians with metabolic syndrome.Key words: Antioxidants, metabolic syndrome, oxidative stres

Relationship between admission serum C-reactive protein and short term outcome following acute ischaemic stroke at a tertiary health institution in Nigeria

Background: There is evidence of an association between mediators of inflammation, particularly C-reactive protein (CRP), and outcome of acute ischaemic stroke. This provides a potential opportunity for interventions aimed at improving outcome. There is sparse data exploring the role of inflammatory markers such as CRP and stroke outcome in Africans. The study objective was to determine the association between admission serum CRP levels and short-term outcome in the Nigerian patient presenting with acute ischaemic stroke.Materials and Methods: Consecutive patients hospitalized for first-ever acute ischaemic stroke at the Lagos University Teaching Hospital, Lagos, Nigeria, were prospectively enrolled between October 2007 and June 2008. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). Serum CRP was determined on samples obtained within 7 days of stroke onset. All stroke patients were followed up till day 30 post-stroke. Outcome measures were 30 day Glasgow outcome scale score and functional impairment on the modified Rankin Scale (mRS). An age- and gender-matched healthy control group had serum CRP determined at inclusion. Elevated CRP was defined as any level above the cutoff (mean +2 x standard deviation of CRP level of controls).Results: Eighty patients with acute ischaemic stroke (47 men and 33 women) and 40 controls (27 male and 13 female) (P = 0.47) were studied. Mean age in cases was 59.1 ± 15.0 years. Mean CRP was significantly higher in stroke cases than controls (17.7 ± 14.4 mg/L versus 1.1 ± 1.7 mg/L respectively) (P < 0.00001). The frequency of elevated CRP (>4.5 mg/L) was 76.3% in stroke (N = 61) and 5% (N = 2) in controls (P < 0.0001). The case fatality rate in stroke with elevated CRP (32.8%) was significantly higher than stroke with normal admission CRP (0%; P= 0.015). The association of higher admission CRP with fatality () was statistically significant (P < 0.0001). Amongst survivors, mean CRP levels were markedly higher in the patients with unfavorable motor outcome (moderate/severe disability; n = 22; 21.5 ± 11.1) compared to those with favorable outcome (mild disability; n = 38; 6.5 ± 6.2) (P < 0.00001). In multivariate regression analysis, only high NIHSS score (P = 0.004) and admission CRP (P = 0.008) were independently associated with case fatality.Conclusions: Elevated admission CRP and high NIHSS score are independent predictors of short-term case fatality and adverse functional outcome following acute ischaemic stroke in Nigerians.Key words: C-reactive protein, ischaemic stroke, outcom

Effect of Mobile Phone Radiofrequency Electromagnetic Fields on Cardiovascular Parameters in Apparently Healthy Individuals

Summary: Since cell phones emit radiofrequency electromagnetic fields (EMFs), this study tested the hypothesis that cell phones placed near the heart may interfere with the electrical rhythm of the heart or affect the blood pressure. Following informed consent, eighteen randomly selected apparently healthy male volunteers aged 21.44 ± 0.53 years had their blood pressure, pulse rates and ECG measured before and after acute exposure to a cell phone. The ECG parameters obtained were: heart rate (HR), QRS complex duration (QRS), PR interval (PR) and Corrected QT interval (QTc). Results are presented as mean ± SEM. Statistical analyses were done using two-tailed paired t test for blood pressure and pulse rate data and one way ANOVA with a post hoc Tukey test for the ECG data. P<0.05 was considered statistically significant. The blood pressure and pulse rates before and after exposure to the cell phone showed no significant difference. The ECG parameters (HR: beats/min, QRS:ms, PR:ms and QTc respectively) did not differ before (66.33 ± 2.50, 91.78 ± 1.36, 151.67 ± 5.39 and 395.44 ± 4.96), during (66.33 ± 2.40, 91.11 ± 1.61, 153.67 ± 5.06 and 394.33 ± 4.05) and after calls (67.22 ± 2.77, 91.11 ± 1.67, 157.44 ± 4.46 and 396.56 ± 4.93) compared to baseline (67.17 ± 2.19, 94.33 ± 1.57, 150.56 ± 4.93 and 399.56 ± 3.88). These results suggest that acute exposure to EMFs from cell phones placed near the heart may not interfere with the electrical activity of the heart or blood pressure in healthy individuals.Keywords: Cell phone radio waves, Blood pressure, Electrocardiogramme

Prenatal skull radiography and calvaria histogenesis in Uda and Yankasa breeds of sheep

The anterior fontanelle was opened and radiolucent in the second trimester; at the third trimester, the fontanelle began to shrink and finally closed at birth and became radiopaque. The borders of the orbit and the teeth were both radiolucent and undifferentiated at the second trimester and at the third trimester, and these regions became radiopaque at the second and third trimester, respectively. The histomorphology of the calvarium in the first-trimester foetus had three layers consisting of the mesenchymal and osteoblast cells; as the foetus ages within the second trimester, the mesenchymal cells were transformed into osteoblast, colonies, primitive bone spicules, matured bone spicules, and primitive trabeculae respective, in the third trimester, the primitive trabeculae developed into a matured trabeculae, in the day old, the matured trabeculae transforms into a primitive spongy bone. However, this process occurs earlier in Yankasa than in Uda. The histomorphology of the calvarium during foetal life is similar in the Uda and Yankasa. However, the stages of calvarium development occur earlier and faster in Yankasa than Uda of the same ages. This implies that foetal development and time of parturition could occur earlier in the Yankasa compared to the Uda breeds