A review of gestational trophoblastic diseases in a tertiary hospital

Background: Gestational trophoblastic diseases (GTD) result from abnormal proliferation of trophoblastic tissue and although rare, are a recognizable cause of maternal morbidity and mortality worldwide. However, prognosis is good when diagnosed and treated early.Objectives: To describe the prevalence, pattern of presentation, management practices and outcome of Gestational Trophoblastic Diseases at the University of Abuja Teaching Hospital, Abuja, Nigeria.Materials and Methods: Case notes of women with a diagnosis of Gestational Trophoblastic Disease from 1st January 2009 and 31st December 2016 were retrospectively reviewed. Relevant information was extracted and entered into structured proformas. The data processing and analysis was done with the aid of SPSS for windows version 20.0. Results were expressed as percentages, means and range.Results: A total of 51 cases of Gestational Trophoblastic Diseases were reviewed, giving a prevalence rate of 4.4/1000 deliveries. The prevalence of molar pregnancy and choriocarcinoma were 2.4 and 1.6 per thousand deliveries respectively. The age group with the highest frequency of occurrence was the 25-29 years {18(35.3%)} and 25(49%) were para 1-4. The commonest antecedent pregnancy event was a miscarriage in 74.5% of cases while the commonest symptoms were amenorrhoea 46(90.2%) and vaginal bleeding 45(88.2%). These were complicated by anaemia in 18(35.5%) of cases. Thirty (58.8%) women had suction evacuation, 16(31.4%) had chemotherapy and 3(5.9%) had hysterectomy. Loss to follow up was 33(64.7%) and case fatality rate was 19.6%.Conclusion: Morbidity and mortality resulting from Gestational Trophoblastic Diseases is still high in University of Abuja Teaching Hospital, Abuja. Significant contributing factors were late presentation and poor compliance. Efforts have to be made to reeducate patients and health workers so as to address challenges related to early diagnosis and compliance.Keywords: Gestational Trophoblastic diseases, Hydatidiform mole, choriocarcinoma, Abuja, Nigeria. Short Title: Gestational trophoblastic diseases in Abuja

A five‑year survey of cesarean delivery at a Nigerian tertiary hospital

Background: Caesarean section is one of the most commonly performed surgical procedures in obstetrics and certainly one of the oldest operations in surgery; the incidence of caesarean section is steadily rising. The increasing use of CS as a mode of delivery is due to improved safety of the procedure because of increasing use of antibiotics, blood availability, and improved anesthetic techniques. Despite all these, problems of safety and cost still pose some concern, particularly in resource‑poor countries.Objective: To evaluate the incidence, indications, and outcomes of caesarean section in this hospital during the period under review.Materials and Methods: This is a retrospective descriptive analysis of all the caesarean sections carried out at the University of Abuja Teaching Hospital, Gwagwalada from 1st January 2012 to 31st December 2016. The labor ward delivery register and theatre operation register were also reviewed. The nature and indications for the procedure were analyzed. Other parameters reviewed included booking status of the patient, parity, and fetal outcome. Results were presented using simple percentages and ratios.Results: Out of 9,604 deliveries during the study period, 2,053 cases were by caesarean section, giving a caesarean section rate of 21.4%. Most cases 1647 (80.2%) were by emergency caesarean sections and elective caesarean section accounted for 406 (19.8%) cases. The rate of caesarean section was higher among unbooked patients 1304 (63.5%) than booked patients 749 (36.5%). Cephalopelvic disproportion was the most common indication 633 (30.8%) followed by fetal distress 484 (23.6%) and severe pre‑eclampsia/eclampsia 224 (10.9%). Anemia was the most common postpartum morbidity and there were 17 maternal deaths and the maternal case fatality rate was 0.8%, and there were 62 (2.9%) perinatal deaths due to birth asphyxia following emergency caesarean section.Conclusion: The rate of caesarean section has been increasing gradually and is associated with maternal and perinatal morbidity and mortality. There is need for education of the  populace to reduce late presentation.Keywords: Cesarean section; incidence; indications; outcome

Vegetative propagation of Adansonia digitata (L.) using juvenile stem cuttings, various rooting media and hormone concentrations

Adansonia digitata is an important economic tree species which provides varieties of goods and services but despite this importance, the species is threatened with extinction due to its inability to regenerate under natural condition as a result of dormancy, drought, increased human pressure and other environmental factors. As such, some ex-situ conservation methods are necessary in order to preserve and conserve the productivity of the species. This prompted an investigation into the possibility of vegetative propagation of A. digitata as influenced by rooting media and hormone concentrations using juvenile stem cuttings. Double node stem cuttings were obtained from four months old seedlings and treated with indole-3-butyric acid and indole-acetic acid at 0, 50, 100 and 150mg/L. The treated cuttings were planted into three different sets of rooting media (Top soil, River sand and Saw dust) in a completely randomized design and replicated three times. The cuttings were watered twice a day (morning and evening) with knap sac sprayer. Data was collected on percentage survival, number of roots, length of longest root, total root length and number of leaves. Data was analyzed using descriptive statistics and Analysis of Variance. Significantly different means were separated with Duncan multiple Range Tests (P<0.05). The result indicated significant growth differences in the various rooting media and hormone concentrations for the variables assessed. Cuttings dipped in Indole-3-butylic Acid (with a concentration  of 150mg/L) planted in sawdust media (SD/IBA/150mg/L) had the best result of all the variables assessed and therefore recommended for vegetative propagation of A. digitata.Key word: Vegetative propagation, Growth hormone, Rooting medi

Growth Response of Upland Rice (Oryza Sativa L.) Varieties to Nitrogen and Seed Rates in the Northern Guinea Savahah.

Field experiments were carried out at the Institute for Agricultural Research (IAR) farm at Samaru during 2011 and 2012 rainy season. The treatments evaluated were two rice varieties (NERICA 4 and 8), three rates of nitrogen (0, 65 and 130 kg N ha-1) and three seed rates (30, 60 and 90kgha-1). The treatments were factorially combined and laid out in a Randomized Complete Block Design (RCBD) replicated three times. Results obtained shows that NERICA 4 produced taller plants than NERICA 8. Application of nitrogen up to 65 kg N ha-1significantly increased plant height, and leaf area index, however, crop growth rate and relative growth rate responded to applied 130 kg N ha-1. Plant height was not significantly increased beyond seed rate of 60 kg ha-1. Based on this study it can be concluded that both NERICA varieties can be sown at the rate of 60 kg ha-1 with application of 65 kg N ha-1. Key words: NERICA, Nitrogen, Seed rate, Northern guinea savanna

Pyridoxine responsive megaloblastic anaemia in pregnancy: a case report of two patients

In pregnancy megaloblastic anaemia commonly results from folic acid deficiency partly due to placenta transfer to fetus, but mainly because of increased folate catabolism due to cleavage of folate coenzymes in rapidly proliferating tissues. Cobalamin deficiency causing megaloblastic anaemia has been described in infants born to severely cobalamin deficient mothers, but its deficiency is very rare. Similarly Pyridoxine deficiency is also rare but if it does occur, it is often in association with deficiency in several B- Complex vitamins. We report a case of megaloblastic anaemia in pregnancy which was responsive to pyridoxine with a view to increasing the awareness of pyridoxine deficiency complicating megalobastic anaemia.Keywords: Megaloblastic Anaemia, Pyridoxine Deficiency, Pregnanc