Thrombogenic indices in an evaluation of pregnant Nigerian women with pregnancy loss

Background: Pregnancy losses (PLs) are usually a source of pain and psychological stress to the expectant couples. The association between ABO blood groups and some thrombogenic markers with PL among Nigerian women is mostly unknown. Aim: This study investigates the association between ABO blood group, deficiencies of protein C (PC), and protein S (PS) and PL. Patients and Methods: A cross‑sectional study involving 170 pregnant women grouped into two, those with or without a history of clinically‑ or ultrasonographically recognizable PL. ABO blood groups using the tile method, plasma concentrations of free protein S (fPS) antigen, protein C antigen (PCAg) by the enzyme‑linked immunosorbent assay‑based method, and PC activity (PCAc) by PROTAC method was determined.Results: There was no difference in mean values between the two groups for PCAg, PCAc, FPS, and blood group (P > 0.05). The chances of PL were; non‑O blood group (AOR 1.29; 95% CI 0.65‑‑2.54), deficient PCAg (AOR 1.75; 95% CI 0.87‑‑3.54), and deficient PCAc (AOR 1.05;95%CI 0.25‑‑4.13). There was a very poor correlation of miscarriage with FPS (rho 0.04), PCAg (rho 0.09), and PCAc (rho = 0.05).Conclusion: There was no significant association between PLs and ABO blood group phenotypes, PCAg, PCAc, fPS.Key words: Free protein S; Nigerian women; pregnancy loss; protein C antigen; thrombogenic markers

Stroke prevalence amongst sickle cell disease patients in Nigeria: a multi-centre study

Background: Stroke is a life-changing, debilitating complication of sickle cell disease (SCD). Previous studies had recorded high stroke prevalence amongst this group of patients. Nigeria has a large population of people affected by this condition and this study aims to assess the stroke prevalence in this large population.Methodology: Stroke prevalence data from 14 physicians working in 11 tertiary health centres across the country was collated by doctors using the sickle cell registers and patient case notes. This data was then collated and used to obtain the overall stroke prevalence in adult and children.Results: The stroke prevalence in sickle cell disease patients in Nigeria was observed to be 12.4 per 1000 patients. Prevalence in the adult patients was 17.7 per 1000 patients and 7.4 per 1000 patients in children. Twenty three percent of the affected patients had more than stroke episode.Conclusion: The stroke prevalence in Nigeria is lower than previously recorded rates and further studies will be required to investigate other factors which may play a role.Keywords: sickle cell, stroke, Nigeria, prevalenc

The Influence Of Parity On The Gestational Age At Booking Among Pregnant Women In Enugu, South East Nigeria

Antenatal care utilization is influenced by several factors. Due to our peculiar socioeconomic and cultural circumstances, gestational age at booking may be affected by certain variables. The aim of this study was to determine the influence of parity and other socio demographic factors on gestational age at booking amongst pregnant women in Enugu, South Eastern Nigeria. This is a prospective multicenter survey of randomly selected 928 pregnant women attending antenatal care for the first time in three hospitals in Enugu between January1 2006 to December 31, 2007. The average age was 30.22 ± 5.2 yrs. The average age of the primigravidae at booking was 29.16 ±5.6yrs. The average gestational age at booking for all the pregnant women studied was 26.12± 7.6 weeks. Parity significantly (P<0.05) influenced the gestational age at booking (24.00 ±7.9weeks versus 27.16 ±7.5weeks versus 26.12±7.6weeks for the primigravidae, multigravidae and grandmultiparous women respectively. 856 (92.24%) booked late for antenatal care after the first trimester. Occupation did not have significant influence on gestational age at booking. It is concluded that parity significantly influenced the gestational age at booking in Enugu

Thrombogenic indices in an evaluation of pregnant Nigerian women with pregnancy loss

Background: Pregnancy losses (PLs) are usually a source of pain and psychological stress to the expectant couples. The association between ABO blood groups and some thrombogenic markers with PL among Nigerian women is mostly unknown. Aim: This study investigates the association between ABO blood group, deficiencies of protein C (PC), and protein S (PS) and PL. Patients and Methods: A cross-sectional study involving 170 pregnant women grouped into two, those with or without a history of clinically- or ultrasonographically recognizable PL. ABO blood groups using the tile method, plasma concentrations of free protein S (fPS) antigen, protein C antigen (PCAg) by the enzyme-linked immunosorbent assay-based method, and PC activity (PCAc) by PROTAC method was determined. Results: There was no difference in mean values between the two groups for PCAg, PCAc, FPS, and blood group (P > 0.05). The chances of PL were; non-O blood group (AOR 1.29; 95% CI 0.65--2.54), deficient PCAg (AOR 1.75; 95% CI 0.87--3.54), and deficient PCAc (AOR 1.05;95%CI 0.25--4.13). There was a very poor correlation of miscarriage with FPS (rho 0.04), PCAg (rho 0.09), and PCAc (rho = 0.05). Conclusion: There was no significant association between PLs and ABO blood group phenotypes, PCAg, PCAc, fPS

Malaria parasitaemia among pregnant women in a rural community of eastern Nigeria; Need for combined measures

Malaria in pregnancy is a major contributor to adverse maternal and perinatal outcome. In hyper endemic areas like ours, it is a common cause of anaemia in pregnancy in both immune and non-immune individuals and is aggravated by poor socioeconomic circumstances. The aim of this study is to assess the prevalence of asymptomatic malaria parasitaemia among pregnant women in a rural setting. 272 pregnant women, aged between 18 and 40 years in some remote rural areas of Ebonyi State, Nigeria were recruited between January 2007 and March 2008.Their blood samples were collected and examined for malaria parasite, haemoglobin and packed cell volume using standard methods. Our results showed 59.9% prevalence of parasitaemia with the highest prevalence occurring in the first trimester (84.1%).Among the positive cases, mild parasitaemia was recorded in 47.2% moderate parasitaemia in 37.4% while severe parasitaemia was recorded in 15.3% of cases. These differences were statistically significant (P<0.016). Furthermore the distribution of malaria densities in different gravidity groups showed an inverse relationship, 45.4% in primigravidae, (31.9%) in secundigravidae and (10.4%) among people with more than five pregnancies. These findings were statistically significant (P< 0.0001). The prevalence of anaemia in pregnancy in this study was 62.4%. Apart from the use of nets, drugs and vector control, the prevention of malaria in pregnancy in very poor socioeconomic settings should make provision for nutritional support

Impact of some low.cost interventions on students' performance in a Nigerian medical school

Background: Studentsf poor performance in physiology examinations has been worrisome to the university community. Reported preference of peer.tutoring to didactic lectures at the University of Nigeria Medical School has not been investigated.Aim: The aim of this work is to design/implement low.cost interventions to improve teaching and learning of physiology.Materials and Methods: This is a postintervention retrospective review of medical Student's performance in 2nd Bachelor of Medicine and Bachelor of Surgery examinations physiology. Data were collected and analyzed by descriptive and inferential statistics using the MedCalc Statistical software (Turkey). The odds ratio (OR) was used to determine the chances of passing before and after the intervention. The level of significance was set at P &lt; 0.05.Results: A total of 2152 students sat for the professional examination over the study period, and 1485 students passed the examination at first attempt giving an overall pass rate of 69%. The pass rate from 2008 when our interventions started was significantly higher than the pass rate before this reform (OR: 0.53; 95% confidence interval: 0.43-0.64; P &lt; 0.0001).Conclusion: Results support the engagement of teachers with strong translational interests and clinicians to augment existing faculty in basic sciences, innovative alternatives to passive lecture formats and students involvement in program evaluation.Key words: Learning, low.cost innovation, medical school, Nigeri

A review of current and future prospects in cancer prevention and chemotherapy

The worldwide burden of non-communicable diseases, including cancers, continues to increase. There has been an increasing pace of research and progress globally in the development of treatments, cures and preventive strategies against cancers. The modalities employed include chemotherapy, radiotherapy, immunotherapy, hormonal agents and dietary interventions. This update and review will discuss these modalities, their mode of action, safety and efficacy, as well as strategies to reduce toxicities arising from their use, such as personalized immuno-targeting. Optimizing immune functionality by addressing the gene - environment interaction will become an important preventive strategy. This review is based on references from online searches conducted on the following databases: Google Scholar, PubMed, Biomed Central and SciELO, using “cancer chemotherapy” as keywords

Uptake of hepatitis B vaccination and its determinants among health care workers in a tertiary health facility in Enugu, South-East, Nigeria

Abstract Background Hepatitis B vaccination is the most effective method of prevention for hepatitis B virus infection. It is a major public health problem in Nigeria, and health workers are at increased risk. This study determined the uptake of hepatitis B vaccination and assessed its determinants among health care workers (HCWs). Methods A hospital-based cross-sectional study was conducted between July and August, 2016 using self-administered structured questionnaires among 3132 HCWs in University of Nigeria Teaching Hospital, Enugu, South-East, Nigeria. Data was analysed using SPSS version 22. Binary logistic regression analysis was used to identify factors that influenced uptake of vaccination. Ethical clearance was obtained from the Research Ethics Committee of the health facility. Results The uptake of hepatitis B vaccination was 14.2% (n = 445). The number of doses received were: 3 doses (218/3132, 48.9%), 2 doses (71/3132, 16.0%), and one dose (156/3132, 35.1%). The reasons for non-uptake of vaccination included: cost of vaccine 48 (10.8%), ‘did not believe they could be infected’ 28 (6.6%), long vaccination schedule, and lack of time 150 (35.1%). The Odds for uptake of hepatitis B vaccination were 22% lower among nurses compared to doctors (AOR = 0.78, 95% CI = 0.54–0.98, P = 0.037). It increased with increasing age (AOR = 1.30, 95% CI = 1.08–1.59, P <  0.001), increasing duration of work in the hospital (AOR = 1.19, 95% CI = 1.09–1.32, P = 0.032), and was about twice higher among those that had tertiary education than others that had less education (AOR = 1.96, 95 CI = 0.76–5.07, P = 0.164). Conclusions The uptake of hepatitis B vaccination was low among HCWs in Enugu, Nigeria. Age, staff category, and duration of work in the hospital, were independently associated with hepatitis B vaccination. Provision of adequate hepatitis B surface antigen screening facilities and vaccination sites where the cost of vaccination is subsidized for all HCWs is recommended