Utilization of family planning services in a Nigerian tertiary hospital: a six year review

Context: Family planning is an integral part of maternal health as its uptake is a significant factor in the reduction of maternal mortality and in ensuring positive child health outcomes.Objectives: To describe prevalence and pattern of contraceptive use, and identify reasons for discontinuation among women accessing family planning facilities.Study design: A six year retrospective review of hospital records of new family planning clinic clients at the teaching hospital was conducted. Data was obtained from the client cards and proportions expressed as simple percentages.Results: A total of 1,284 clients accepted a family planning method during the period. Contraceptive prevalence rate in relation to hospital deliveries was 18·1%. Modal age group of clients was 31–40(50.4%), while modal parity was Para 2-3 (43·4%). A third of the clients sought contraception within 6 months of delivery. Intrauterine contraceptive device was the most common method (65.0%). Information on family planning was mainly from nurses (66.7%). Contraceptive discontinuation rate was 21.2%, mainly due to desire for another pregnancy (62%). Menstrual irregularity and husband's decision were some other reasons.Conclusion: There is an identified need for promotion of uptake of family planning methods. Involvement of men in contraception counselling and services is essential to improve its uptake and continuity.Keywords: Family planning, contraceptives, Ile-Ife, Nigeri

Comparison of Community Reintegration and Selected Stroke Specific Characteristics in Nigerian Male and Female Stroke Survivors

This study investigated the difference between community reintegration of male and female stroke survivors and the association between gender of stroke survivors and some selected stroke specific characteristics (type,side of paresis and occurrence) Fifty-two patients (25 males and 27  females) recruited from hospitals in Nigeria took part in the study. Community reintegration (CR) was assessed three months post-admission discharge using the Reintegration to Normal Living Index (RNLI).  Demographic and stroke-specific characteristics were obtained using a dataform. Data were analysed using descriptive statistics, the Mann-Whitney U test and the chi-square test. Level of significance was set at p = 0.05.The mean age of the participants was 61.21 ± 11.25 years (range 31 – 86 years). There was no significant difference (p = 0.173) between the community reintegration scores of male and female participants. There wasalso no significant association between gender and each of the selected stroke specific characteristics such as type of stroke (p = 0.279); side of paresis (p = 0.250) and occurrence of stroke (p = 0.670). Community reintegration scores of male and female stroke survivors are not  significantly different. There is no significant association between gender and each of the selected stroke specific characteristics.KEYWORDS: community reintegration, stroke, stroke survivors,  participation, gende

Where there is no anaesthetist: the role of obstetrician - administered spinal anaesthesia for emergency caesarean section

Context: Shortage of anaesthetic manpower is a stark reality in developing countries like Nigeria where “waiting for the anaesthetist” has been repeatedly identified as a cause of phase 3 delays. This has led to widespread abuse of ketamine anaesthesia for emergency caesarean section in private hospital settings.Objectives: To determine the effect of single handed obstetrician-anesthetist administered spinal anesthesia for caesarean section on Decision-Delivery Interval (DDI), postoperative hospital stay, fetal and maternal outcome.Materials and Methods: A prospective analytical study comparing caesarean DDI between 42 consecutive emergency caesarean sections (CS) under Obstetrician-administered Spinal anesthesia (OASA) versus 42 women who had locum anesthetist administered spinal anesthesia (LAASA) and an equal number who had ketamine anesthesia.Results: The DDI was about 2.5 fold shorter in the OASA (59.67 ± 9.40 minutes) compared with the LAASA (144.54 ± 28.00 minutes) group (pConclusion: Obstetrician-administered Spinal Anesthesia for emergency caesarean section reduces Decision-Delivery Interval and postoperative hospital stay. It is therefore judicious where there is no anesthetist. Moreover, it is superior to ketamine anesthesia for caesarean section.Keywords: Obstetric anaesthesia, Spinal anaesthesia, Caesarean section, Bupivacaine, KetamineTrop J Obstet Gynaecol, 30 (1), April 201

Premature rupture of membranes at term: immediate induction of labor versus expectant management

Objective: To compare the maternal outcomes of immediate induction of labor with expectant management in women presenting with premature rupture of membranes (PROM) at term.Methods: One hundred and fifty two women with PROM at term were randomized into either immediate induction of labor with oxytocin or expectant management for a period of 12 hours. The primary outcome measure was the incidence of clinical endometritis in each group. Secondary outcomes were the mode of delivery, the neonatal outcome and the proportion of women in the expectant management group that progressed to spontaneous labor.Results: The immediate induction arm had a lower caesarean section rate, (7.9% vs 28.9%, P=0.001), higher spontaneous vaginal delivery rate (92.1% vs 71.1%; P=0.001) and lower incidence of clinical endometritis (0% vs 5.3%, P=0.006), when compared with the expectant management arm. The estimated duration of labor was shorter in the expectant management arm (8.9±2.17hours vs 10.6±2.35hours; P=<0.001). Neonatal morbidity rates were comparable in both groups.Conclusion: Immediate induction of labor in women with PROM at term resulted in significantly lower rate of infectious morbidity without increasing the risk of operative delivery. It is therefore recommended as the management option of choice.Keywords: Premature rupture of membranes, induction of labor, endometriti

Treatment and failure of amalgam restoration analyzed according to class of restoration

Aims: This is a cross sectional; longitudinal retrospective study to find our reasons for placement of amalgam restoration at a Teaching Hospital in Nigeria and the most common classes of amalgam cavity prepared for amalgam restoration.Material &amp; methods: The record of patients also offended the dental centre of hospital in Nigeria was used for this study and all II records were centralized to separate those that attended the Conservation Dental Clinic for placement were recalled for a cross-examination and comparison with the records.Results: Out of the 431 patients recalled, two hundred and seventy seven turned up (64.3%).&nbsp;Two thousand and ninety four restoration were placed in regular attendees with classes I,II &amp; V Accounting for 60.08%, 36.77% and 3.16% of all restorations placed respectively, primary caries accounted for 74.1% of all restoration placed, fractured restoration 16.1 % defective margins 3.7%; secondary caries 2.8% dislodged restoration 1.2 %;overcharging amalgam restoration 0.4% cervical abrasion 1.3 % and other reasons which include attrition, iatrogenic preparation accounted for 0.3%.The reasons given for failure in the pooled study was seen repeating itself in that order in Class I and II.Discussion: Class I restorations was the most commonly placed restoration followed by class II and class V restoration, the most common cause of failure in this study in all the classes of restoration was fractured amalgam restoration and the percentage is much higher for class II restorations. This may be due to the high masticatory load it is subjected to as a result of the cultural diet effect practiced in this environment, whereas in other studies carried out in the Caucasian region and other developed economies, secondary caries form the major reason for placement of restoration.Clinical significance: Amalgam fillings are the most commonly performed restoration when treating caries but data in the developing countries on amalgam is sparse and dearth. It is of importance to know the longevity, the failure pattern, shortcoming of the restoration and to find out if the dates in developed countries tally with developing world for analysis and comparison.Conclusion: Dietary habit may be a major reason in failure of amalgam restoration and it is important to note that cultural background may be a deciding factor in the types of failure seen.The problem of over diagnosis of carious lesion may also play a part in primary caries especially in the Teaching Hospital/Dental College unlike what is seen in General Dental centres or Hospital, because Dental students and resident doctors in training are involved in the clerking and treatment of patients.</p

Variability of soil properties along two toposequences on basement complex in South Western Nigeria

No Abstract. Discovery and Innovation Vol. 18(1) 2006: 44-5

Comparative study of the performance of Jute plant (Corchorus olitorius l.) On home garden soil, farmland and cocoa plantation soils as influenced by varying levels of n- fertilizer

This experiment was carried out in the green house at the College of Agricultural Sciences, Olabisi Onabanjo University, Yewa Campus, to assess the performance of jute plant (Corchorus olitorius L.) on three soil-use types (viz; farmland soil, cocoa plantation soil and residential or home garden soil) treated with five nitrogen (N) levels: 0, 25, 50, 75, and 100 kg/ha respectively. The trial was laid out in a split-plot design arranged in a randomized complete block format with three replications. Data collected were analyzed using Analysis of Variance (ANOVA) and the significant means were compared with Least Significant Difference (LSD) and Duncan's Multiple Range Test (DMRT) at 1 or 5% probability. The results of the investigation showed that jute plant ( Corchorus olitorius L.) performed best in cocoa plantation soil, with application of 50 kg/ha N. Among the interaction effects, combined application of 50kg/ha of N- fertilizer on cocoa plantation soil gave the best vegetative growth and dry matter yield. Agro-Science Vol. 7 (1) 2008: pp. 78-8

Analysis of cost efficiency in small scale irrigated tomato production: empirical evidence from Niger state, Nigeria.

This study investigated analysis of cost efficiency in small scale irrigated tomato production: empirical evidence from Niger State, Nigeria. Data used for the study were obtained using structured questionnaires administered to 100 randomly selected irrigated tomato farmers from Kontagora and Wushishi Local Government Areas of the state. Stochastic frontier cost function was used to represent the cost frontier of the small scale irrigated tomato farms. The result showed that there was relative presence of economies of scale among the farmers meaning that average farm in the study area produced at a minimum cost considering the size of the farm indicating that they operated in stage II of production surface. The mean cost efficiency of 1.09 obtained from the analysis showed that an average farm in the study area was 9% above the cost frontier, indicating that they were relatively efficient in allocating their scarce resource

Prevalence of cryptosporidium oocyst in calves grazing along river Rima bank in Sokoto, Nigeria

The present study was conducted to investigate the point prevalence of Cryptosporidium oocysts infection in calves grazing along the bank of Rima River Sokoto in October 2011. The river bank is a converging zone for domestic animals reared in different quarters of the town and the  surrounding settlements. A total number of 2,959 cattle were enumerated out of which 147 (4.97%) were calves. Faecal samples were collected from 100 (68.02%) calves by convenient sampling technique. Formol-Ether sedimentation and modified Ziehl-Neelsen staining techniques were used to identify the cryptosporidium oocysts in the faecal samples. Faecal consistency was also used to identify diarrhoeic and non-diarrhoeic calves. Cryptosporidium oocysts were identified in 33 (33.0%) of the calves examined. The detection rate was higher among the male calves (38.46%) than females while the Rahaji breed had the highest prevalence of 62.5%. A total of 6 (18.18%) among the positive cases were diarrhoeic. The differences in prevalence based on sex, breeds and presence of diarrhoea were not statistically significant. Calves may become sources of Cryptosporidia infection to man and other animals in the study area through unrestricted movements and interactions with the environment.Keywords: Calves, Cryptosporidium, Diarrhoea, Rahaji, Rima River, Sokoto

The use of magnesium sulphate (MgSO4) for seizure prophylaxis: clinical correlates in a Nigerian tertiary hospital

Background: Magnesium sulphate use in the prevention of seizures resulting from preeclampsia and eclampsia is widely accepted. However, several protocols exist worldwide. Aim: To determine serum magnesium levels and associated clinical outcomes in severe pre-eclamptic and eclamptic women treated with magnesium sulphate. Methods: Women, 28-41 weeks pregnant or in the puerperium with severe pre-eclampsia or eclampsia, participated in this cross sectional study and their serum magnesium levels were measured using the Atomic Absorption Spectrophotometer (AAS) machine. All participants received the standard Pritchard regimen, including monitoring. Results: Seventy five patients participated in the study. They were mostly overweight (mean BMI 26.38 ± 3.40kg/m2). Mean pre-treatment serum magnesium level was 1.96 ± 0.29 mg/dL; eclamptics had significantly lower levels (p&lt;0.001). Mean treatment serum magnesium level attained was 5.41 ± 0.58 mg/dL. No evidence of magnesium toxicity was observed. Therapeutic range of serum magnesium was required to prevent seizures, and was attained ≥4-hours after loading dose in most of the eclamptics (74%). All convulsions occurred in the interval between the loading dose and the first maintenance dose; eclamptics had greater risk of convulsing while on treatment (RR=11.56, 95%CI= 0.62-216.36, P=0.049). Conclusion: Low serum magnesium level before or during treatment with magnesium sulphate is a risk factor for convulsion in OAUTHC. The Pritchard regimen has a low risk for toxicity thus administration of magnesium sulphate at peripheral centres before referral may be beneficial in preventing repeat convulsions. Modifications involving additions to the loading dose in eclamptics and fewer number of maintenance doses may be beneficial.Key words: Pre-eclampsia, eclampsia, magnesium, convulsion, puerperium, Nigeri