Perinatal Presentation and Outcome of High Birthweight Infants in Zaria, Nigeria.

Background: Infants with high birth weight are candidates for birth trauma, birth asphyxia and sometimes, death. Perinatologists are therefore gradually beaming the search lights on the contribution of high birthweight delivery to perinatal morbidity and mortality. Objectives: To determine the prevalence presentation and outcome of high birthweight deliveries in Zaria. Methods: A retrospective review of records of babies delivered at Ahmadu Be l lo University Teaching Hospital , Zaria , weighing 4000 grams and above at birth, over a 4-year period was undertaken. Maternal and neonatal records were obtained from the delivery suite and neonatal unit respectively, between January, 2005 and December, 2008. Data were analyzed with EPI INFO version 3.5.1 and statistical significance was set at p<0.05. Results: Of the 3065 deliveries in the study period, 167 (5.5%) weighed 4000 grams and above, giving a prevalence of 54.5 per 1000 births. The male: female ratio was 1.2:1, mean birthweight was 4340±290 grams and 65.9% of them were delivered during the rainy season. High birthweight delivery was associated with high maternal age, high birth order and assisted delivery. Per inatal asphyxia , hypoglycaemia , hyperbilirubinaemia, sepsis and trauma were the common perinatal conditions in high birthweight babies. Perinatal mortality rate for high birthweight babies was 3.9 per 1000 total births and 71.9 per 1000 high birthweight deliveries. Conclusion: High birthweight deliveries in the present study had high perinatal morbidity and mortality. Antenatal prediction and generous use of Caesarian section could reduce the prevalent morbidity and mortality rates.Key Words: High birthweight, Presentation, Outcome

Sheehan's Syndrome; A Rare Complication of Postpartum Hemorrhage - Case Report and Review of the Literature

Sheehan Syndrome is a Condition that may occur in a woman who bleeds severely during child birth. Severe bleeding during child birth can cause tissue death in the pituitary gland, which may cause the +0 gland to lose its ability to function properly. We reported a case of a 21 year old lady gravida 1 para 1 (alive) who developed Sheehan's syndrome six months after extreme post partum hemorrhage. High level of suspicious was employed based on clinical history and couple with the laboratory blood tests and magnetic resonance Imaging (MRI) findings in arriving at diagnosis of this rare complication of lifethreatening blood loss during or after child birth. We also highlighted the importance of proper medical care in preventing extreme bleeding during child birth, otherwise, Sheehan's syndrome is not preventable.Keywords: Sheehan's Syndrome, Post Partum Hemorrhag

Hysterectomies pattern at a tertiary healthcare center, northern Nigeria

Background: The uterus is an important female genital organ for menstrual and reproductive functions. However, there are various gynecologic and obstetric indications for carrying out hysterectomy.Objectives: To determine the indications and the patterns of hysterectomies done at Ahmadu Bello University Teaching Hospital, Zaria Nigeria.Materials and Methods: 5‑year retrospective descriptive study on patients who had hysterectomy done from 2011 to 2015.Results: The age range of the patients was 2–70 years with a mean of 48.6 ± 8.8 years. Hysterectomies constituted 19.3% of total gynecology surgeries done during the same period. Of these total abdominal hysterectomy 144 (87.8%) was the most common, next was vaginal hysterectomy with pelvic floor repair 13 (7.9%), and then subtotal hysterectomy was 7 (4.3%). The most common indication for total abdominal hysterectomy was multiple uterine fibroids, a benign uterine tumor.Conclusion: Hysterectomy is a common gynecological surgery which may be used to treat benign uterine pathologies, especially when there is no more desire for conception. It could also be lifesaving in uncontrollable postpartum hemorrhage as well as malignant pelvic organ pathologies, especially in early stages.Keywords: Gynecological surgery; hysterectomy, pattern; uterine fibroid

Malignant Tumours of the Female Genital Tract in Zaria, Nigeria: Analysis of 513 Cases

Background: Female genital tract malignant tumours are common tumours that affect mainly the young female population. Unfortunately, the preventable carcinoma of the cervix is still the leading cause of cancer morbidity and mortality. Methods: This is a retrospective histopathological analysis of female genital tract malignant tumours diagnosed over an eleven-year period (1993 - 2003). The information required was retrieved from histology bench books and request cards. Results: In an analysis of 513 cases in Zaria, 77% were carcinoma of the cervix and this was the commonest. This was followed by the corpus uteri (10.1%), and ovarian tumours (8.4%). Tumours of the vagina and vulva were uncommon. One case of adenocarcinoma of the fallopian tube which accounted for 0.2% was noted. The commonest type of cervical cancer was squamous cell carcinoma (89.5%). Choriocarcinoma (57.7%) was the most common tumour of the corpus uteri and among ovarian tumours; serous papillary cystadenocarcinoma was the commonest (25.6%), followed by malignant granulosa cell tumour (20.9%). One case of ovarian Burkitt's lymphoma which accounted for 2.3% was noted. Malignant tumours of the corpus uteri and the cervix are more common in the fifth decade, while ovarian tumours are commoner in the fourth decade of life. Conclusion: Carcinoma of the cervix was the commonest malignancy encountered in this study. Fortunately it is preventable by the routine Pap smear. Therefore governments of African countries should establish and sustain such screening centres.Arri\ue8re-plan : Les tumeurs malignes du syst\ue8me g\ue9nital f\ue9minin sont commune et affectent g\ue9n\ue9ralement la jeune femme. Malheureusement le cancer du col de l'ut\ue9rus pourtant \ue9vitable, reste la cause majeur de mortalit\ue9 et morbidit\ue9 lie au cancer. M\ue9thode : Ceci est une analyse r\ue9trospective, de 1993 - 2003, des tumeurs malignes du syst\ue8me g\ue9nital f\ue9minin vues au D\ue9partement d'Anatomie Pathologie du centre Hospitalier Universitaire Ahmadu Bello Teaching Hospital, Zaria. Les donn\ue9es utilis\ue9es ont \ue9taient r\ue9cup\ue9r\ue9es de la banque des donn\ue9es du D\ue9partement d'Anatomie Pathologie. R\ue9sultats : Sur 513 cas r\ue9cup\ue8res, 77% \ue9taient des cancers du col de l'ut\ue9rus et \ue9taient les plus commun. Ceci \ue9taient suivi par les cancer de l'ut\ue9rus (10.1%), et des tumeurs des ovaires (8.4%). Les cancers du vagin et de la vulve \ue9taient rares. Un cas d'ad\ue9nocarcinome de la trompe de Fallope qui repr\ue9sente 0.2% a \ue9t\ue9 observ\ue9. Les types les plus commun des cancer du cal de l'ut\ue9rus \ue9taient les carcinome squameux (89.5%). Le cancer de l'ut\ue9rus le plus fr\ue9quent \ue9tait le choriocarcinome (57.7%), alors que l'ad\ue9nocarcinome papillaire cystique \ue9tait le plus commun des cancers des ovaires, suivi par cancer granuleux (20.9%). Un cas de lymphome de Burkitt ,2.3%, a \ue9t\ue9 observ\ue9. Le cancer de l'ut\ue9rus et du col de l'ut\ue9rus sont fr\ue9quent durant la cinqui\ue8me d\ue9cade, alors que ceux des ovaires apparaissent \ue0 la quatri\ue8me d\ue9cade de vie. Conclusion : le cancer de col de l'ut\ue9rus \ue9tait la tumeur maligne la plus fr\ue9quente de cette \ue9tude. Heureusement il est \ue9vitable si un frottis cervical est fait avec suivi. Les gouvernements africains devraient \ue9tablir des campagnes et des centres de d\ue9tection du cancer du col de l'ut\ue9rus

Anogenital distance and umbilical cord testosterone level in newborns in Zaria, Northern Nigeria

The anogenital distance (AGD) is the distance between the anus and the base of the penis in males and anus to fourchette (AF) distance in females and is a sexually dimorphic index that, on average, is twice as great in males as in females, so it is used as an indicator of appropiate masculine development. In this study, the anogenital distance (AGD) and anthropometric measurements such as birth weight, birth length, head circumference and placenta weight of 200 newborns (100 male, 100 female) were taken and umbilical cord serum was assayed for testosterone concentration using Radioimmunoassay (Microwell). Data obtained were analysed using Student t-test and Pearson’s Correlation Analysis as applicable. Results revealed that mean total anogenital distance was 22.53±0.70mm, and it was significantly higher in males: 31.11±0.64mm than in females: 13.89±0.26mm and we observed that there was positive correlation between birth weight and AGD in females. In males head circumference correlated positively with AGD. The mean cord testosterone concentration was 2.78±0.30ng/ml in males and 2.09±0.22ng/ml in females and did not have any significant correlation with anogenital distance. It was concluded that AGD of the population studied, though high was not significantly higher than AGD in other parts of the world and umbilical cord testosterone level did not have any significant effect on AGD. Keywords: Anogenital distance, Ethnicity, Umbilical cord testosterone, Anthropometry Nig. J. Physiol. Sci 26(June 2011) 023 – 02

Assessing Democratic Governance in the Nigerian Fourth Republic, 1999 -2014

The paper assesses democratic governance in the Nigerian fourth republic. Most Nigerians expected the return to democratic governance on May, 29 1999 to set the stage for the socio-economic and political transformation of the country. The paper contends that the democratic experience has been problematic for Nigerians. The paper, underpinned by the elite theory, is descriptive, historical and analytical in nature and employs the secondary source in the gathering of data. The paper argues that the uninterrupted character of the democratic transition, improvement in civil and political rights and some economic development dividends are positive outcome of the democratic experience. Yet, the successes associated with the democratic experience seem to have been overshadowed by poor governance, the problems of poverty, de-industrialization, widespread unemployment, large scale collapse of infrastructure, illiteracy, insecurity of lives and property, political corruption, and weak governance institutions. Consequently, public trust in the democratic process, institutions and actors is in decline. The paper suggests amongst others, responsible and effective political leadership and civil society as critical to a productive democratic performance in Nigeria

Uterine inversion complicating traditional termination of pregnancy: case report

Abortion services remain cladenstine and unsafe in most parts of Africa. This is a case of a mid-trimester abortion induced by traditional methods which resulted in uterine inversion, a previously unreported complication of induced abortion. Until abortion services are accessible and safe on the continent, morbidity and mortality from it could be beyond imagination. Keywords: Uterine Inversion; Abortion by traditional methods Obstetrics and Gynaecology Forum Vol. 15(4) 2005: 25-2

Malignant tumours of the female gential tract in Zaria, Nigeria: Analysis of 513 cases

Background/Objective

The awareness and use of modern contraceptive methods among female undergraduate students in a tertiary institution in Northwestern Nigeria

Background: Young Nigerian women receive poor or no sex and contraceptive education and are increasingly being exposed to unplanned pregnancies with the attendant consequences of unsafe abortions. Few studies have been conducted among young women probably due to the low contraceptive use in the country and the belief that contraception is for married women. The study aimed to examine the awareness and use of modern contraceptives among undergraduate females in a tertiary institution in northwestern Nigeria.Methods: It was a prospective, descriptive, cross-sectional study carried out among 329 female students of Ahmadu Bello University, Zaria from November, 2011 to January, 2012. Semi-structured pre-tested questionnaires were administered using the convenience sampling technique. Data was analysed using the SPSS version 16.0.Results: The age range was 16-49 years, mean of 22.7 ± 4.8years. Most were Hausa (31.3%) and majority were Christians (56.6%). Seventy nine per cent were single and 77.5% lived on campus. Ninety-two percent were aware of contraception with the internet (62.3%) being their main source of information.  The contraceptive prevalence was 33.4%. The most known and used method was the male condom,  81.5% and 30.7% respectively. The main reason for the choice of contraceptive methods was non-contradiction to cultural beliefs (93.9%).Conclusion: Contraceptive awareness is high; however rate of use is low. There is a need to further enlighten female students on the availability and use of contraceptive methods.Keywords: Modern, Contraceptive, Undergraduate, Females, Northwestern Nigeri

Fertility Intentions, Contraceptive Awareness and Contraceptive Use among Women in Three Communities in Northern Nigeria

This study measured contraceptive knowledge, contraceptive use and fertility intentions among 1408 women of reproductive age in three communities in Kaduna state, Nigeria. Contraceptive knowledge was relatively high, with 64.6% of women having heard of at least one method. Radio and health facilities were the primary sources of information. The pill was most widely known (54.1%), followed by female sterilization (47.5%) and injectables (47.4%). Knowledge did not reflect use, however, as only 3.1% were current users of any method, among which injectables, pills and traditional waist bands were the most popular. Nearly 10% of non-users intended to begin using a method in the coming year, of whom 37.3% wished to use injectables. When asked about their last birth, 87% of women had desired to become pregnant and only 15% felt that their last pregnancy was mistimed. A sensitive and community-friendly approach is needed to reduce risks associated with high fertility while being respectful of community preferences (Afr. J. Reprod. Health 2010; 14[3]: 65-70).Key words: Rural women, contraception, fertility, northern Nigeria