Screening for Cervical Cancer: Experience from a University Hospital in North Western Nigeria (2007‑2009)

Background: Cervical cancer is the most common gynecological cancer among women in Nigeria. The incidence is on the increase and poses a public health problem. The etiological agent is the human papilloma virus that is sexual transmitted. The cervical cancer incidence is related to lifestyle, poverty and sexual practices. Fortunately, it is a preventable disease as it is preceded by a pre‑invasive phase that can be detected and treated. There is paucity of report in literature on cervical cancer screening in Sokoto North‑West Nigeria.Aim: To determine the uptake, indications and results of cervical cancer screening in Usmanu Dan‑fodiyo University Teaching Hospital (UDUTH), Sokoto.Materials and Methods: A 3‑year descriptive study of the results of cervical cytology among women who attended the gynaecological out‑patient clinic of UDUTH, Sokoto.Results: During the period of study, 126 cervical smears were taken and 96% (121/126) of them were considered adequate for cytological evaluation thus constituting the subjects of the study. The average annual uptake of cervical smear was 1.29%. The main indications for cytologic smears were abnormal uterine bleeding 33.9% (41/121) and suspected carcinoma of the cervix 28.1% (34/121). Cytologic study was positive for dysplastic cells in 7% (25/121) of cases. Ten percent (12/121) of them were high grade squamous intra‑epithelial lesions while invasive carcinoma was seen in 3.3% (4/121) of the smears. Conclusion: Presence of abnormal cervical smear in 20% of the study subjects underscores the need for routine screening for cervical cancer. While organized national screening policy is awaited, opportunistic screening should be maximized. Keywords: Cervical cancer, cervical cytology, north‑west Nigeri

Pregnancy outcome in women involved in road traffic accidents in Sokoto

Background: Road traffic accidents (RTA) are common in Nigeria. Pregnant mothers could be involved in such accidents and this might affect pregnancy outcome.Method: A retrospective analysis of pregnant mothers admitted at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria because of road traffic accidents between January 1998 and December, 2002, was undertaken to determine the incidence, type of injury and pregnancy outcome.Results: One hundred and forty nine women admitted because of major injuries sustained after road traffic accidents. Twelve (8%) of these women were pregnant at the time of the accident. Gestational age ranged from 16 to 38 weeks. Fall from commercial motorcycles was the most common accident with deep lacerations and long bone fractures. Obstetric complication included abruptio placentae and premature uterine contractions. There was normal delivery in 9 patients, 2 stillbirths and one moth with head injury died undelivered.Conclusion: Early consult with appropriate obstetric intervention was associated with good foetal and maternal outcome. The emergency duty doctor should always think of the possibility of a co-existing pregnancy whenever managing any woman within the reproductive age group involved in RTAs

An Appraisal of Retained Placenta in Sokoto: a five-year review

Background: Retained placenta is one of the major causes of primary and secondary postpartum haemorrhage associated with increased risk of maternal morbidity and mortality.Objective: To determine the incidence, method of treatment and maternal outcome of patients with retained placenta.Methodology: This is a retrospective study covering a period of 5years, January 1st, 2007 to December 31st, 2011, in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto.Results: During the 5-year period, there were 144 cases of retained placenta out of 8569 total deliveries, giving an incidence of 1.7%. However, only 118 patients’ case records were available for analysis. Majority of the patients 88 (74.6%) were unbooked for antenatal care in UDUTH and 104 (88.1%) patients had home delivery. The identified risk factors included previous history of retained placenta 32 (27.1%) and previous uterine surgery 13 (11.0%). Fifty per cent of the patients were in hypovolaemic shock at presentation. Manual removal of the placenta was the most common mode of treatment 91 (77.1%). There were 7 maternal deaths giving a case fatality rate of 5.9%.Conclusion: Retained placenta is a significant cause of maternal mortality and morbidity due to the associated haemorrhage and other complications related to its removal. Antenatal care, skilled birth attendant at delivery and provision of emergency obstetrics care services will help to reduce the incidence and severity.Keywords: Morbidity, mortality, post-partum haemorrhage, Sokot

Mechanical Sun-Tracking Technique Implemented for Maximum Power Point Tracking of a PV System for Effective Energy Supply

This paper elucidates a single axis solar tracker system that automatically searches the optimum PV panel position with respect to the sun by means of a DC motor controlled by an intelligent drive unit that receives input signals from light dependent sensors. A prototype of the mechanical maximum power point tracker (MMPPT) was implemented with a motor size of 48W. The power supply unit consists of only supply source which is the AC mains. The sensor unit consists of six sensors. While five are fixed and adjacently aligned at 36o to each other (tracking sensors), the sixth one is movable as it is attached to the surface of the PV panel (feedback sensor). The control unit is divided into two parts: A priority voltage selector and a movement controller. The priority voltage selector comprises of cascaded comparators which compares the five voltage outputs from the sensors and selects the highest voltage (priority voltage).The movement controller compares the feedback voltage with the priority voltage and logically decides whether to move the motor clockwise or anti-clockwise. The solar panel is allowed to move from east to west and back forth with a maximum allowable angle of 180o. Its movement is in only one axis. The prototype built carries the panel from eastward to westward tracking the sun movement from sun rise to sun set and then reset to face eastward as darkness sets in. The results obtained from the prototype MMPPT were used to compare with the results obtained from fixed panel under the same environmental conditions and at the same time interval of 30 minutes using the same type of PV panel. The result from MMPPT has a gain of 5.77% over its counterpart which is fixed panel.http://dx.doi.org/10.4314/njt.v33i2.1

Personalizing health care: feasibility and future implications

Considerable variety in how patients respond to treatments, driven by differences in their geno- and/ or phenotypes, calls for a more tailored approach. This is already happening, and will accelerate with developments in personalized medicine. However, its promise has not always translated into improvements in patient care due to the complexities involved. There are also concerns that advice for tests has been reversed, current tests can be costly, there is fragmentation of funding of care, and companies may seek high prices for new targeted drugs. There is a need to integrate current knowledge from a payer’s perspective to provide future guidance. Multiple findings including general considerations; influence of pharmacogenomics on response and toxicity of drug therapies; value of biomarker tests; limitations and costs of tests; and potentially high acquisition costs of new targeted therapies help to give guidance on potential ways forward for all stakeholder groups. Overall, personalized medicine has the potential to revolutionize care. However, current challenges and concerns need to be addressed to enhance its uptake and funding to benefit patients

Personalized medicine in psychiatry: problems and promises

The central theme of personalized medicine is the premise that an individual’s unique physiologic characteristics play a significant role in both disease vulnerability and in response to specific therapies. The major goals of personalized medicine are therefore to predict an individual’s susceptibility to developing an illness, achieve accurate diagnosis, and optimize the most efficient and favorable response to treatment. The goal of achieving personalized medicine in psychiatry is a laudable one, because its attainment should be associated with a marked reduction in morbidity and mortality. In this review, we summarize an illustrative selection of studies that are laying the foundation towards personalizing medicine in major depressive disorder, bipolar disorder, and schizophrenia. In addition, we present emerging applications that are likely to advance personalized medicine in psychiatry, with an emphasis on novel biomarkers and neuroimaging