Knowledge and utilization of malaria preventive measures among pregnant women at a tertiary hospital in Nigeria’s federal capital territory

Objective: To determine the knowledge and utilization of malaria preventive measures as well as barriers to the utilization of these measures by pregnant women.Materials and Methods: The study was a prospective cross-sectional survey involving pregnant women at the booking clinic of the University of Abuja Teaching Hospital between May and August 2010. Close-ended pre-tested structured questionnaires were administered by interviewer method to 403 consecutive consenting women.Results: The knowledge of malaria and its preventive measures in pregnancy was 71.5%. There was a statistically significant association between knowledge of malaria and educational status (X2 = 16.053, P = 0.035). Intermittent preventive treatment was used by 15.9% of the respondents. Insecticide-treated net ownership was 42.6%; however,its use declined from 28.5% before pregnancy to 24.6% during pregnancy.Conclusion: There is adequate knowledge about malaria and its preventive measures in pregnancy, but the utilization of these measures is poor. There is need for concerted efforts at addressing the barriers to utilization of these effective interventions.Key words: Knowledge, malaria in pregnancy, Nigeria, preventio

Ectopic Pregnancy in Nigeria's Federal Capital Territory: A Six Year Review

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The management challenges of the complications of illegally induced abortions in Benin - City, Nigeria.

Unsafe, induced abortion is one of the three major causes of maternal mortality in Nigeria. Important surgical complications of unsafe induced abortions include post-surgical sepsis and haemorrhage due to trauma to the uterus, cervix and intestines. This study examined the case records of patients with induced abortion requiring major surgical intervention to manage the complications during a five-year period at the University of Benin Teaching Hospital, Benin City, Nigeria. The results show that the most frequent surgical intervention was drainage of pelvic abscess in 38% of the patients. About 30% of` the patients ended up with severe structural damage to the pelvic organs, especially the uterus, with severe implication for the future fertility of these patients. This high risk of infection and significant structural damage is ascribed to the illegal status of abortion in Nigeria. The challenges that these surgical complications pose to the gynaecologist are discussed. The need to adequately equip and train clinicians to recognise and aggressively manage these complications is also discussed. Sahel Medical Journal Vol.7(3) 2004: 95-9

Fetal outcome of twin gestations in a Nigerian Teaching Hospital

BACKGROUND: Although twin gestation is associated with increased perinatal morbidity and mortality, optimal management of this high risk pregnancy is associated with improved outcome for the mother and her baby. Globally, Nigeria has the highest incidence of twinning. This makes studies on twin gestation important, especially on the outcome of the babies which is reflection of the type of care received during the antenatal and intrapartum period.STUDY OBJECTIVE: This study was designed to determine the fetal outcomes of twin deliveries in a tertiary hospital in Nigeria's Federal Capital Territory.METHOD: This was a retrospective study of babies following twin pregnancies delivered in the hospital from 1st January 1998 to 31st December 2007.RESULTS: Out of the 600 babies reviewed, 10.2% were still births giving a still birth rate of 102 per 1000 births. . Majority of the stillbirths (73.8%) occurred amongst the unbooked mothers and was higher amongst the second twins. More of the booked mothers had their babies delivered at term compared to the unbooked ones, 115(38.3%) Vs 66(22.0%).There was a statistically significant association between gestational age at delivery and booking status of the paturients. (X2=16.257, P=0.001).The mean fetal weight was 2.395 kg±0.63. There was no statistically significant difference when the weights of the first and second twin were compared. (t=0.343, P=0.732). Out of the 539 babies born alive, 85.0% had good Apgar score of = 7 in 5 minutes, 13.0% of the first twins had moderate birth asphyxia compared to 16.0% of the second twins. The female to male ratio was 1:1.1.CONCLUSION: Twin gestation is associated with low birth weights and high still birth rate in this centre. Fetal outcome is better in the first twin compared to the second twin. Outcome for babies whose mothers were booked were better compared to the unbooked. Quality antenatal care and intrapartum management will help improve fetal outcome.KEY WORDS: Twin pregnancy, fetal outcome, Abuja, Nigeri

Appendiceal Diverticulitis in a Young Female Diagnosed on Pathology after Laparoscopic Appendectomy for Acute Appendicitis

Background. Appendiceal diverticulitis is a rare cause of inflammation of the appendix, which may mimic acute appendicitis. Its diagnosis is often delayed, and its occurrence carries an increased risk of significant complications, such as perforation. Case Presentation. A 23-year-old woman presented with sudden onset, severe, right lower quadrant abdominal pain and nausea. Her WBC was elevated, and abdominal CT showed findings indicative of acute appendicitis with a 13 mm fluid-filled appendix and local stranding. During laparoscopic appendectomy, significant inflammation was found around the appendix with some mucous material around the tip. The appendix base was not involved, and an endoloop was used to secure the stump. No other intra-abdominal abnormalities were observed. The patient recovered uneventfully. Pathology showed no classic appendicitis but appendiceal diverticulitis with signs of perforation. Discussion. Appendiceal diverticulitis is a rare condition which cannot be distinguished from acute appendicits clinically and on imaging. Diagnosis may be established based on pathology such as in our case. Appendectomy is indicated in appendiceal diverticulitis, and an appendix diverticulum is incidentally found during surgery or other investigations. This is due to the increased risk of perforation and the reported development of malignant tumors, including the appendix carcinoid

Longitudinal Gastrectomy for Nonbariatric Indications

Background. Sleeve gastrectomy is the most commonly performed bariatric procedure. Laparoscopic longitudinal gastrectomy (LLG) may be indicated for other indications. Patients and Methods. Two men and two women aged 67, 72, 77, and 80 years underwent LLG for nonbariatric indications with two having normal weight, one being cachectic, and one severely obese. Results. LLG was discussed with patients prior to surgery, but decision for LLG was made during surgery after contemplating other surgical options. A wide sleeve over a 42 French bougie was created with the staple line being oversewn with running 3–0 silk. Indications included a bleeding Dieulafoy lesion that failed endoscopic clipping, fundus gland polyposis found during paraesophageal hernia repair, fundus nodules suspected to be leiomyosarcoma metastases revealing splenosis on final pathology, and significant gastric dilatation associated with organoaxial gastric volvulus. Three patients had an uneventful recovery; the severely obese patient temporarily lost weight but died after two years from a stroke. The last patient developed dysphagia due to an alpha-loop in the sleeve, which was managed by endoscopic stenting. The device subsequently migrated and was laparoscopically removed, with a side-side gastrogastrostomy performed to straighten the alpha-loop. The patient tolerated food better and with overnight PEG tube feeds gained weight but continued heavy smoking. He died after one year from COPD exacerbation. Conclusion. LLG seems to be an appropriate intervention for various gastric pathologies. Training of residents and fellows in the minimally invasive surgical steps of LLG is encouraged