Prevalence of gastrointestinal symptoms and related drug use among pregnant women of South-Western Nigeria

Background: Gastrointestinal (GI) symptoms are quite common in pregnancy but there is paucity of data in regard to their frequencies in the south-western part of Nigeria. This study was conducted to determine the prevalence of various gastrointestinal symptoms and related drug use among south-western Nigerian women.Methods: A cross-sectional multicenter study involving three centers in two states of south-western Nigeria from March to August 2014. A composite questionnaire consisting of demographic data, anthropometric indices, obstetrics information, a list of gastrointestinal symptoms and drug usage was administered to 420 consecutive healthy pregnant women at various gestational ages. Data were analysed and presented as means ±S.D, frequencies and percentages.  Relationships between categorical variables were explored with chi-square test. A 5% significance level (p < 0.05) was considered significant.Results: Respondents had age range of 18-43years and a mean of 27.26 (±4.98). The commonest gastrointestinal symptom was nausea (46.9%), followed by vomiting (45.0%) and then anorexia (36.2%). Excessive salivation, heart burn, constipation, regurgitation, and bloating had frequencies of 35.5%, 28.3%, 20.7%, 19.0% and 18.3% respectively. Epigastric pain was the least frequent among the symptoms (16.9%).The association between the parity of respondents and each of the GI symptoms was not statistically significant. But associations between educational status and excessive salivation and anorexia were statistically significant (P-value of 0.018 and 0.023 respectively). Subjects with heartburn had the highest drug usage (23.5%), followed by those with vomiting (22.8%). Subjects with excessive salivation (2%) had the least drug intake.Conclusions: Gastrointestinal symptoms are common among pregnant women of south-western Nigeria. There is need for the physician to be abreast with the prevalence of the common pregnancy related GI problems in the particular locality of practice and the appropriate way to manage them.

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

A comparison between the prevalence of gastroesophageal reflux disease among South-Western Nigerian pregnant women to that of the non-pregnant ones

Gastroesophageal reflux disease (GERD) is common in the general population. Pregnancy is known to be associated with high incidence of GERD symptoms. Although, there are previously conducted studies involving both genders to determine the prevalence of GERD in different population groups in Nigeria, our preliminary literature search showed that there is a dearth of data on the prevalence of GERD among Nigerian pregnant women. The aim of this study is to determine the prevalence of GERD using the GerdQ questionnaire and to test the association between pregnancy and GERD among women of south-western Nigeria. The study was a descriptive hospital based cross-sectional survey involving three medical facilities in two states of south-western Nigeria. A total of 796 women consisting of 413 (51.9%) healthy pregnant women at various gestational ages and 383 (48.1%) nonpregnant women were interviewed. A predesigned questionnaire consisting of sociodemographic data, obstetrics information, the GerdQ questionnaire and previous history of GERD symptoms was administered to each of the participants. Of the 796 women interviewed, 413 (51.9%) were pregnant women with a mean of 27.42 (±5.00) years and 383 (48.1%) non-pregnant women of child bearing age with a mean of 26.72 (±6.46) years. The prevalence of GERD among the pregnant women was 14.5% while that among the nonpregnant group was 9.7%. This difference was statistically significant (P=0.036). Following adjustment for potential confounders, pregnancy maintained a positive statistically significant relationship with GERD [OR=1.67 (95% CI=1.07, -2.61), P=0.023]. GERD has a moderate prevalence in pregnancy in southwestern Nigeria. Pregnancy has a significant association with GERD, independent of the other risk factors

Pattern of biography usage by the students of Nigerian tertiary institutions

The role of the library has been to develop and maintain collections of materials in all formats in order to serve the information needs of its users. Biographies reveal scintillating story of great men and women who by determination, rose to a pride of place in their various endeavours. Most biographical accounts disclose exemplary acts of boldness and bravery, scholastic endeavours, exhibit considerate leadership qualities, gives firm authentic history of one’s birth, growth, career and so on. Descriptive research design using survey method was adopted for this study. Questionnaire was used as the survey instrument. The study sample comprised 500 randomly selected students from three universities in Ogun State, Nigeria. The study finds that the students preferred reading autobiographies to biographies. In case of biographies, they preferred biographies of the living to the dead. The study concludes that the biographies of notable personalities impact positively on younger generations

Pattern of biography usage by the students of Nigerian tertiary institutions

215-221The role of the library has been to develop and maintain collections of materials in all formats in order to serve the information needs of its users. Biographies reveal scintillating story of great men and women who by determination, rose to a pride of place in their various endeavours. Most biographical accounts disclose exemplary acts of boldness and bravery, scholastic endeavours, exhibit considerate leadership qualities, gives firm authentic history of one’s birth, growth, career and so on. Descriptive research design using survey method was adopted for this study. Questionnaire was used as the survey instrument. The study sample comprised 500 randomly selected students from three universities in Ogun State, Nigeria. The study finds that the students preferred reading autobiographies to biographies. In case of biographies, they preferred biographies of the living to the dead. The study concludes that the biographies of notable personalities impact positively on younger generations

Case Report Triplet Delivery following Unilateral Twin Salpingocyesis

We present the case of a 36-year-old woman with primary infertility of six-year duration who had IVF/ICSI on account of male factor infertility. Transvaginal scanning done on the 30th day following embryo transfer revealed an empty uterine cavity with two gestational sacs containing active fetal echoes in the right adnexum. Patient reluctantly had right salpingectomy via open laparatomy. The patient had repeat embryo transfer eleven months afterwards that culminated in the delivery of living twins with a fetal papyraceous

Triplet Delivery following Unilateral Twin Salpingocyesis

We present the case of a 36-year-old woman with primary infertility of six-year duration who had IVF/ICSI on account of male factor infertility. Transvaginal scanning done on the 30th day following embryo transfer revealed an empty uterine cavity with two gestational sacs containing active fetal echoes in the right adnexum. Patient reluctantly had right salpingectomy via open laparatomy. The patient had repeat embryo transfer eleven months afterwards that culminated in the delivery of living twins with a fetal papyraceous