Thyroid autoimmunity and early pregnancy loss in Jos, Nigeria

Background: Early pregnancy loss is a challenging experience for both the patient and the physician; it is unfortunately a common complication of human gestation. Early pregnancy loss is defined as the termination of pregnancy before 20 weeks of gestation or with a fetal weight of <500 g. Immunological disorders have been attributed to early pregnancy loss in addition to chromosomal abnormalities. Thyroid autoimmunity is one of the immunological causes of early pregnancy loss that has been poorly studied in sub‑Saharan Africa.Objective: This study was aimed at determining the relationship between early pregnancy loss and thyroid autoimmunity in Jos, North‑Central Nigeria.Patients and Methods: This was a case‑control study involving 44 women with a current history of miscarriage at an average gestational age of 11.57 ± 4.3 weeks (cases) and 44 pregnant women with previous history of delivery with no history of miscarriage(s) at a mean gestational age of 17.9 ± 4.9 weeks (controls). Serum thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) were assayed by Electro‑chemiluminescence immunoassay (ECLIA) using Cobas e411 auto analyzer (by Roche). The data obtained were analyzed using SPSS version 16.0.Results: TgAb was neither present in the cases nor in the control group. The prevalence for TPOAb was 11.4% for the cases and 4.5% for the controls. The difference in proportion was not statistically significant (P = 0.434).Conclusion: There was no statistically significant relationship between thyroid autoimmunity and early pregnancy loss.Keywords: Autoimmunity; pregnancy loss; thyroi

Audit of antenatal services in primary healthcare centres in Jos, Nigeria

Introduction: Maternal mortality remains a big challenge in developing countries including Nigeria where the figures are amongst the highest in the world. The Nigerian government's response in providing primary healthcare centres (PHCs) in all local government areas is commendable but access to quality antenatal care is still poor. The high proportion of maternal deaths resulting from late referrals from PHC's to the Jos University Teaching Hospital (JUTH), prompted this study to audit antenatal services in PHC's in Jos. Methods: Six of the 12 PHC's in Jos were randomly sampled and 425 consecutive antenatal clinic attendees were recruited for the study. In each case, the client's records were scrutinized and a detailed history and physical examination was conducted. Details of personal data and of antenatal care provided were tabulated and analyzed using frequencies. Results: The results showed that 35.5% of pregnant women receiving antenatal care at PHCs in the Jos area were clients with high-risk pregnancies. Over two-thirds of the pregnant women received antenatal care in the PHCs without blood pressure surveillance. Maternal weight was regularly checked in 78.1% (332/425) but height was not recorded in any woman. Sickling test/genotype and VDRL were not done and no client received malaria prophylaxis. Conclusion: The study showed that the standard of antenatal care offered in PHCs in Jos fell short of the required level and represents a missed opportunity to impact on the poor maternal and perinatal health statistics in the area. Keywords: antenatal care, standard of care, audit, Nigeria Tropical Journal of Obstetrics and GynaecologyVol. 22(2) 2005: 147-15

Labour outcome in patients admitted in the second stage of labour at Jos University Teaching Hospital, Jos, Nigeria

Context: Unsupervised or poorly monitored labour is associated with increased maternal and neonatal complications. Late presentation in labour is common place in this part of the world. Objective: To determine the reasons for coming in second stage of labour and compare the labour outcome with those admitted in the first stage of labour. Materials and Methods: This was a case control study conducted at the Jos University Teaching Hospital between September and November 2012. Results: Of the 617 total deliveries, 156 (25.3%) were admitted in second stage of labour. Majority of women (38.57%), (10.00%), (8.57%) stated transportation difficulties, fast progress of labour and husband not around respectively as the reason for coming in second stage of labour. Maternal complications like lower genital laceration (25.7% vs 8.6%), postpartum haemorrhage (7.1% vs 2.1%), and ruptured uterus (2.1%) were more common amongst the cases than the control. The total mean blood loss was similar in both groups. Complications of sickle cell crises, eclampsia, and anaemia including chorioamnionitis were found only among the cases. There were more spontaneous vagina deliveries amongst the cases while caesarean section and use of episiotomy were more amongst the control (P < 0.01). Instrumental delivery was similar in the two groups. Perinatal complications like fresh stillbirths (5.0%), early neonatal deaths (2.10%), birth asphyxia (5.4% vs 3.6%) and the need for admissions in special care baby unit (3.4% vs 0.7%) were more amongst the cases than the control. Conclusions: This study identified transportation problems, fast progress of labour, absence of husband at home when labour starts as major reasons for presenting in second stage of labour. Presenting in second stage of labour was associated with worse labour outcome

COVID-19 Convalescent Plasma Therapy: Long Term Implications

Abstract Background The long-term effect of Coronavirus Disease 2019 (COVID-19) acute treatments on post-acute sequelae of SARS-CoV-2 infection (PASC) is unknown. The CONTAIN-Extend study explores the long-term impact of COVID-19 convalescent plasma (CCP) therapy on Post-Acute Sequelae of SARS-CoV-2 infection (PASC) symptoms and general health 18 months following hospitalization. Methods The CONTAIN-Extend study examined 281 participants from the original CONTAIN COVID-19 trial (CONTAIN-RCT, NCT04364737) at 18 months post-hospitalization for acute COVID-19. Symptom surveys, global health assessments, and biospecimen collection was performed from November 2021 to October 2022. Multivariable logistic and linear regression estimated associations between the randomization arms and self-reported symptoms and PROMIS scores, adjusted for covariables, including age, sex, race/ethnicity, disease severity, and CONTAIN enrollment quarter and sites. Results There were no differences in symptoms or PROMIS scores between CCP and placebo (adjusted odds ratio of general symptoms, 0.95; 95% confidence intervals, 0.54, 1.67). However, females (3.01; 1.73, 5.34), those 45-64 years (2.55; 1.14, 6.23), and April-June 2020 enrollees (2.39; 1.10, 5.19) were more likely to report general symptoms and have poorer PROMIS physical health scores than their respective reference groups. Hispanic participants (difference, -3.05; 95% CI, -5.82, -0.27) and Black participants (-4.48; -7.94, -1.02) had poorer PROMIS physical health than White participants. Conclusions CCP demonstrated no lasting effect on PASC symptoms or overall health in comparison to the placebo. This study underscores the significance of demographic factors, including sex, age, and the timing of acute infection, in influencing symptom reporting 18 months after acute hypoxic COVID-19 hospitalization