Intractable Haematuria in Pregnancy: Challenges of Management Case Report and Review of Literature

Background: Intractable haematuria is a life threatening and challenging urological emergency. It is more so when it occurs in pregnancy as the lives of both mother and baby are at risk. The safety in pregnancy of most agents or methods used in treatment of this condition is unknown.Materials & methods: A 24 years old pregnant woman at 29 weeks gestation complained of total painless haematuria for days. Ultrasound scan revealed a bladder mass and a viable intrauterine gestation. She was admitted and managed with continuous saline irrigation of the bladder, and repeated blood transfusions as well as fetal monitoring. After 4 weeks, absent fetal heart tone was noticed. She went into spontaneous labour and was delivered of a fresh still born. She then had bladder irrigation with 1% alum solution. The bleeding stopped within 48 hours of treatment and she was discharged 72 hours later.Conclusion: Intravesical alum irrigation is an effective method of treatment, its safety profile in pregnancy is unknown thus more studies in this regard are needed to prevent adverse maternal or perinatal outcomes

Environmental Management Education for Sustainable Development in Nigeria

A major challenge that has faced the human race the world over, especially since the 1970s, is the myriad of environmental problems arising from man's quest for rapid economic development. Countries worldwide have been developing their national policies on the environment to ensure, among others, that environmental concerns are integrated into the major economic decision-making process. Nigeria's document identifies 21 strategies, including Education, for the implementation of the policy. Environmental management is practically multi-disciplinary in scope and requires the training of professionals that will be equipped with critical and analytical skills to provide both preventive and corrective measures to address all types of environmental problems. Unfortunately, only 31 out of 141 Universities and other 52 degree/HND/NCE awarding tertiary institutions in Nigeria offer environmental management programs. This extremely too low and poor record, partly explains why Nigeria's environmental problems seem difficult to tackle. To effectively implement the policy applying the education strategy, through environmental management education is key. This paper therefore recommends that an appropriate and potent educational curriculum at all levels (i.e. from the primary, through secondary to the tertiary level) would lead to sustainable capacity building through environmental management education for sustainable national development

Intractable Haematuria in Pregnancy: Challenges of Management Case Report and Review of Literature

Background: Intractable haematuria is a life threatening and challenging urological emergency. It is more so when it occurs in pregnancy as the lives of both mother and baby are at risk. The safety in pregnancy of most agents or methods used in treatment of this condition is unknown.Materials & methods: A 24 years old pregnant woman at 29 weeks gestation complained of total painless haematuria for days. Ultrasound scan revealed a bladder mass and a viable intrauterine gestation. She was admitted and managed with continuous saline irrigation of the bladder, and repeated blood transfusions as well as fetal monitoring. After 4 weeks, absent fetal heart tone was noticed. She went into spontaneous labour and was delivered of a fresh still born. She then had bladder irrigation with 1% alum solution. The bleeding stopped within 48 hours of treatment and she was discharged 72 hours later.Conclusion: Intravesical alum irrigation is an effective method of treatment, its safety profile in pregnancy is unknown thus more studies in this regard are needed to prevent adverse maternal or perinatal outcomes

P WAVE ANANYSIS IN ASYMPTOMATIC HEALTHY ADULT NIGERIAN STUDENTS: A PRELIMINARY STUDY

The P wave amplitude and duration were measured and analyzed in the 12-lead ECG in a hundred and nine subjects aged between 19 and 30 years. The mean P wave duration was 0.07 ± 0.02 sec. Significant correlation was found between P wave duration and amplitude and various anthropometric measurements. Prediction equation was derived for the mean P wave voltage and the systolic blood pressure. The study has demonstrated the normal range for the P wave duration and amplitude. It thus provides a reference guide for the quantitative interpretations of the P waves of healthy adult Nigerians in Jos

Reasons for cancellations of urologic day care surgery

Objective: The numerous economic and social benefits associated with the practice of day care surgery could be eroded by frequent cancellations. We therefore determined the reasons for such cancellations in a tertiary care centre in Nigeria. Patients and Methods: This was a prospective study of all consecutive urologic day cases seen at Jos University Teaching hospital, Nigeria from January 2003 to December 2004. Results: A total of 270 patients were seen during the study period with ages from 2 weeks to 100 years (median 55 years) and male to female ratio of 14:1. The procedures carried out were mainly urethroscopy /urethrocystoscopy in 103 (38.2%) patients, visual internal urethrotomy in 48 (17.8%) and trucut prostatic biopsy in 33 (12.2%) patients. Sixteen (5.9%), 16(5.9%), 9(3.3%) and 8(3.0%) patients had examination under anaesthesia / bladder biopsy for suspected bladder carcinoma, urethral dilatation, testicular biopsy and total orchidectomy for carcinoma of the prostate respectively. There was a cancellation rate of 15.6% (n=42) mainly due to the inability of the patients to come (24 patients, 57.1%), inadequate materials in the theatre (9 patients, 21.4%), power failure (4 patients, 9.5%), strike action (3 patients, 7.1%) and financial difficulties (2 patients, 4.8%). Conclusion: We are still faced with a high cancellation rate of urologic day cases and these are mainly due to avoidable reasons. Patient as well as physician education and provision of adequate materials and infrastructural development are recommended to reduce these; so as to gain maximally from urologic day surgery practice