Desire for obstetric analgesia among women in northern Nigeria

Background: Obstetric analgesia is now routinely provided in most developed countries. However, in developing countries including Nigeria, childbirth is still a painful natural process for most women without choice. This study determined labour pain perception, awareness and desire for obstetric analgesia among antenatal clients of Aminu Kano Teaching Hospital (AKTH) in northern Nigeria.Methods: A hospital based cross sectional study was conducted in the Antenatal clinic of AKTH from March to April 2010. Questionnaires were filled by verbal interviews conducted on 400 antenatal clients.Results: Of those that have delivered at least once previously (n=284), majority (194, 68.3%) scored labour pain as severe 66(23.2%) said it was moderate while 24 (8.5%) claimed it was mild. Only 15% (n=59) of therespondents were aware of at least one method of obstetric analgesia. The methods mentioned include Epidural (57.6%, n=34), injections (18.6%, n=11), breathing and relaxation (6.8%, n=4), social support (6.8%, n=4) and all the above methods mentioned (10.2%, n=6). Their main sources of information were friends (62.7%, n=37), books (17.0%, n=10), health worker (13.6%, n=8) and the Internet (6.8%, n=4). None have been offered any analgesia during labour. Majority 317 (79.3%) were desirous of pain relief during the delivery of their current pregnancy. On multivariate logistic regression analysis, educational attainment, ethnicity and awareness of methods of obstetric analgesia remained significant predictors of desire for obstetric analgesia.Conclusion: There is a gross unawareness regarding pain relief in labour, but there is strong desire for same. Reforms in labour pain management are recommended offering parturients a range of safe methods to choose from.Keywords: Labour pain, obstetric analgesia, awareness, desire, antenatal clients, Nigeri

Post-Operative Evaluation of Anterior Pituitary Function in a Nigerian with Hyperprolactinaemia: A Case Report and Review of Literature

Prolactinoma is an endocrine abnormality associated with hyperprolactinaemia of which there is paucity of data in this environment probably due to under-reporting, under diagnosis and inadequate skill for management. This is a report of a 42 year old Nigerian who underwent surgery for pituitary prolactinoma in Western Germany and was referred to our hospital for assessment of anterior pituitary reserve on return to Nigeria. Basal values of glucose, cortisol, T3, T4, TSH, LH, FSH, and prolactin were measured following which a triple function test was conducted by intravenous administration of a bolus consisting of 250ug of ACTH, 200ug TRH and 100ug GnRH. Basal values demonstrated normoglycaemia and euthyroidism while responses to TRH and GnRH indicated restoration of anterior pituitary capacity for synthesis and control of TSH, LH, FSH and prolactin post-operatively. (Key words: Hyperprolactinaemia, Hypophysectomy, Triple function test, Immunoassay). Sahel Medical Journal Vol.7(1) 2004: 41-4

Total Glycated Serum Protein Levels in Hyperbilirubinaemic and Normobilirubinaemic Non Diabetic Nigerians

Serum glycated protein concentrations as fructosamine were estimated in 30 non- diabetic patients with hyperbilirubinaemia and 20 controls using the colorimetric nitroblue tetrazolium reduction technique. This was aimed at assessing the effect of hyperbilirubinaemia on serum total glycated protein concentrations (fructosamine levels) in Nigerians. The mean serum fructosamine concentration was significantly higher (p0.05). Conjugated bilirubin correlated significantly with serum fructosamine levels (r = 0.37; p0.05). These observations show that hyperbilirubinaemia, especially conjugated bilirubin fraction positively affects the concentrations of fructosamine at level probably greater than 100 umol/L. A correction factor is thus suggested. (Key words: Fructosamine, hyperbilirubinaemia, glycated protein Sahel Med. J. Vol.6(3) 2003: 83-8

Measurement of Serum Total Bilirubin in Jaundiced Newborns by Direct Spectrophotometric Micro-Technique and Diazo Method.

Background : Serum total billirubin (STB) concentrations are measured by Diazo Methods (DMs) in clinical laboratories in third world countries. However, several reports across the world suggest that these methods are associated with numerous problems. There is a need to search for an alternative method specific for neonatal bilirubin analysis. The aim of the present study was to assess a direct Spectrophotometric micro-technique (DSMT) with a view to recommending its application or otherwise for the routine estimation of serum bilirubin (SB).Materials and methods: SB concentrations were estimated by both DM and DSMT in 100 (50 males and 50 females), full – term (n±84) and pre-term (n=16) jaundiced newborns, admitted to the Special Care Baby Unit (SCBU) of ABUTH, Zaria. Capillary and venous blood specimens were obtained for the measurement of STB concentrations by DSMT and DM respectively. The data obtained were analyzed using SPSS 11.0 for Windows (SPSS, Chicago, IL). The results of STB concentrations obtained by DSMT were compared with those obtained by DM using Student’s t- test statistic method. Correlation of the two methods was carried out using Pearson’s linear correlation. A p-value of equal to or less than 0.05 (p< 0.05) was considered as statistically significant.Results: The mean values of STB concentrations obtained using DSMT and DM were 242 ± 85 and 215 ± 90 μmol/L respectively. The difference between these values was statistically significant (

Alpha-Fetoprotein in Asymptomatic Hepatitis B Virus Infected Subjects

The prevalence of hepatitis B virus (HBV) infection is high in sub-Saharan Africa. A great number of the infected individuals are asymptomatic and are commonly diagnosed by chance. Alpha-fetoprotein and liver functiontests were evaluated in asymptomatic hepatitis B surface antigen (HBsAg) positive subjects to ascertain those that are at immediate risk of hepatocellular disease. Fifty subjects (37 males and 13 females), were recruited from among blood donors and general Outpatient clinics of Aminu Kano Teaching Hospital. They were seropositive for HBsAg but asymptomatic on routine medical check. HBsAg, alpha fetoprotein and liver enzymes activities were analyzed using strip and latex agglutination technique, ELECSYS 1010 and Express Plus auto analyzers respectively. There were no statistically significant changes in the level of alpha fetoprotein and liver function tests in HBsAg positive but asymptomaticsubjects when compared with control subjects, except in one subject who had serum alpha fetoprotein, asparate amino transferase and alanine amino transferase activities twice the value for the control subjects. But alkaline phosphate, bilirubin, total protein and albumin remained unchanged. Only one subject could be regarded to be at risk of developingliver disease at the time the study was carried out. Since hepatocellular pathology takes years to develop, it is therefore suggested that a twice yearly programme of alpha-fetoprotein testing be established in both urban and rural areas. This will help to reduce mortality and morbidity often associated with hepatic diseases due to HBV infection

Relationship between serum heat-stable alkaline phosphatase activity and blood pressure in patients with pre-eclampsia and eclampsia

Background: The objective of this study was to explore the relationship, if any, between the serum heat-stable alkaline phosphatase (HS-ALP) activity and the blood pressure (BP) of patients with pre-eclampsia and eclampsia. Method: The activity of HS-ALP was measured using the 4 – nitrophenyl phosphate (4 – NPP) method after incubation at a high temperature of 65 0C for exactly 30 minutes in one hundred normal pregnant women and in another one hundred with pre-eclampsia/eclampsia. The normal pregnant women were used as controls. The blood pressure (BP), systolic as well as diastolic was measured in each of the studied patient using desktop mercury sphygmomanometer. Results: In the patients with pre-eclampsia/eclampsia, it was found that the higher the systolic and diastolic BP, the higher is the activity of the HS-ALP. Conclusion: It can be concluded that the HS-ALP activity in patients with pre-eclampsia/eclampsia is positively related to the severity of the hypertension and therefore this could help in detecting early complication. Keywords: heat-stable alkaline phosphatase, eclampsia, blood pressure Annals of African Medicine Vol. 5 (1) 2006: 38–4

The Semen of Fertile Men in Jos, Nigeria

Evaluation of male fertility potential involves basic semen analyses. Perhaps semen concentration is the most widely utilized semen parameter. Decline in sperm count has been described in several reports in both developed and developing countries. The objectives of the study was to assess decline in semen concentration in apparently fertile healthy men in Jos, Nigeria. During the period of the study, semen samples were obtained from men of proven fertility. These consisted 106 men who were male partners of pregnant women drawn from antenatal clinics. Apparently healthy fertile Nigerian men showing sperm count greater than 20 million/ml were considered for the study. The study reported a mean sperm concentration of 46.0 x 106/ml and (20.0 – 97.3 x 106/ml) confidence interval for fertile men. Environmental, life style and dietary factors may be possible causes of decline in sperm production. The present data confirm wide variability in the assessment of sperm concentration. We suggest adherence to recommended methodologies and comprehensive structured training of laboratory personnel performing semen analysis in order to reduce inter-observer variability.Keywords: Male fertility, semen concentration, fertile men, declin

Lipid abnormalities: A case study of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

No Abstract