Gynaecological emergencies seen in a referral hospital in Northwest Nigeria: A 3‑year retrospective study

Background: Gynaecological emergencies are common causes of morbidity and mortality worldwide and patients’ characteristics are important determinants of gynaecological emergencies.Objectives: This study was conducted to determine the pattern and management outcome of gynaecological emergencies in Aminu Kano Teaching Hospital (AKTH), Kano.Materials and Methods: A 3‑year retrospective review of all gynaecological  emergencies seen in AKTH between January 2012 and December 2014 was done.Results: A total of 3050 gynaecological consultations were done within the period under review, 1337 of which were  gynaecological emergencies giving an institutional prevalence of 43.8%. The highest (44.5%) frequency was seen in the 21–30‑year age group. Ten different types of gynaecological emergencies were seen with  abortion being the leading (59.3%) gynaecological emergency. Incomplete abortion is the most common form of miscarriage in age’s ≥ 20 years; in the Parous; and amongst married women. Sexual assault occurred in 5% of the patients, with 47.8% occurring in individuals aged below 10 years. The least common gynaecological emergency was coital laceration which accounted for 0.5%. The prevalence of  mortality from gynaecological emergencies was 3.7%. The most common cause of mortality from a gynaecological emergency was bleeding gynaecological  malignancy and carcinoma of the cervix accounting for 41.2%.Conclusion: Gynaecological emergencies are common and abortions are the most common emergency at AKTH. Patient   characteristics play a significant role in their pattern of presentation, while outcomes of these emergencies are related to their cause and manner of presentation. Increased surveillance and advocacy of policies that strongly punish individuals convicted of sexual assault should be encouraged, and increased awareness and utilization of Pap smear should be encouraged for early detection of premalignant and early stage carcinoma of the cervix. Further research is required to identify the possible risk factors/causes of abortion in this environment.Key words: Aminu Kano Teaching Hospital; gynaecological emergency; pattern; review

Effect of Light Quality and Quantity on the Accumulation of Flavonoid in Plant Species

Light effects including its intensity, wavelength, and duration are important environmental factors that affects flavonoid accumulation. Ultraviolet (UV) light can induce flavonoid biosynthesis. Under normal condition, flavonoids are produced in response to stress, and they function as UV filters. In this paper, we review how light quality and quantity affect the accumulation of flavonoid in plant species. High light intensity can influence flavonoid accumulation, but in heliophytes, the opposite is true. Some medicinal plants require shady environment for flavonoid accumulation. In monocots, the flavonoid is situated in both epidermis and mesophyll while in dicot, it is found only in the epidermis. This review leads to a conclusion that high variation in flavonoids accumulation in response to light can occur within and between plant species

Perceived Indications, Safety and Efficacy of Perinatal Use of Traditional and Spiritual Remedies among Mothers of Under-Five Children in Kano, North- Western Nigeria

Background: Herbal and spiritual remedies are increasingly being used in the management of perinatal conditions. Objectives: To determine the pattern of use of herbal and spiritual remedies during perinatal period, and the perceived indications, efficacy and safety of these remedies among mothers of under-five children in Kano. Subjects and Methods: A descriptive crosssectional design was used to study a random sample of 189 mothers. Data were analyzed using IBM SPSS statistics 22. The chi-square test and Fisher’s exact test were used for univariate analysis.Result: The means of respondents’ age and their number of children were 33.3 ± 9.2 years and 4.7 ± 2.6 respectively. Three-quarters of the mothers (76.2%) used herbal and/or spiritual remedies within the perinatal period, mostly orally (97.9%); 63.2% used them in combination with orthodox medicines. The main indications were maintaining good health during pregnancy (39.6%); easy labour and safe delivery (39.6%); and treatment of common ailments (28.5%). Majority believed that herbal (66.1%) and spiritual (70.9%) remedies are very effective on pregnancy related problems; 57.1% and 78.8% believed that herbal and spiritual remedies are very effective on problems of labour and pueperium respectively. Most believed that spiritual remedies are safe during pregnancy (94.2%) and in labour and pueperium (97.9%); and herbs are safe during labour and pueperium (91.0%). Conclusion: Health authorities in Nigeria should institutionalize structures for censoring, training, regulation of TM practice and safety of remedies used.Keywords: Indications, Safety, Perinatal use, Traditional remedies, Northwestern Nigeri

Characteristics of COVID-19 cases and factors associated with their mortality in Katsina State, Nigeria, April-July 2020

Introduction: COVID-19 was first detected in Daura, Katsina State, Nigeria on 4 April 2020. We characterized the cases and outlined factors associated with mortality. Methods: We analysed the COVID-19 data downloaded from Surveillance Outbreak Response, Management and Analysis System between 4 April and 31 July 2020. We defined a case as any person with a positive SARS-CoV-2 test within that period. We described the cases in time, person, and place; calculated the crude and adjusted odds ratios and 95% confidence intervals for factors associated with mortality. Results: We analysed 744 confirmed cases (median age 35, range 1-90), 73% males and 24 deaths (Case fatality rate 3.2%, Attack rate 8.5/100,000). The outbreak affected 31 districts, started in week 14, peaked in week 26, and is ongoing. Highest proportion of cases in the age groups were 26.7% (184) in 30-39, 21.7% (153) in 20-29 years, and 18.3% (129) in 40-49 years. While the highest case fatality rates in the age groups were 35.7% in 70-79, 33.3% in 80-89 years, and 19.4% in 60-69 years. Factors associated with death were cough (AOR: 9.88, 95% CI: 1.29-75.79), age ≥60 years (AOR: 18.42, 95% CI: 7.48-45.38), and male sex (AOR: 4.4, 95% CI: 0.98-20.12). Conclusion: Male contacts below 40 years carried the burden of COVID-19. Also, persons 60 years and above, with cough have an increased risk of dying from COVID-19. Risk communication should advocate for use of preventive measures, protection of persons 60 years and above, and consideration of cough as a red-flag sign

Bone regeneration and stem cells.

?  Introduction ?  Bone fracture healing and healing problems ?  Biomaterial scaffolds and tissue engineering in bone formation -  Bone tissue engineering -  Biomaterial scaffolds -  Synthetic scaffolds -  Micro- and nanostructural properties of scaffolds -  Conclusion ?  Mesenchymal stem cells and osteogenesis -  Bone tissue -  Origin of osteoblasts -  Isolation and characterization of bone marrow derived MSC -  In vitro differentiation of MSC into osteoblast lineage cells -  In vivo differentiation of MSC into bone -  Factors and pathways controlling osteoblast differentiation of hMSC -  Defining the relationship between osteoblast and adipocyte differentiation from MSC -  MSC and sex hormones -  Effect of aging on osteoblastogenesis -  Conclusion ?  Embryonic, foetal and adult stem cells in osteogenesis -  Cell-based therapies for bone -  Specific features of bone cells needed to be advantageous for clinical use -  Development of therapeutic biological agents -  Clinical application concerns -  Conclusion ?  Platelet-rich plasma (PRP), growth factors and osteogenesis -  PRP effects in vitro on the cells involved in bone repair -  PRP effects on osteoblasts -  PRP effects on osteoclasts -  PRP effects on endothelial cells -  PRP effects in vivo on experimental animals -  The clinical use of PRP for bone repair -  Non-union -  Distraction osteogenesis -  Spinal fusion -  Foot and ankle surgery -  Total knee arthroplasty -  Odontostomatology and maxillofacial surgery -  Conclusion ?  Molecular control of osteogenesis -  TGF-β signalling -  FGF signalling -  IGF signalling -  PDGF signalling -  MAPK signalling pathway -  Wnt signalling pathway -  Hedgehog signalling -  Notch signalling -  Ephrin signalling -  Transcription factors regulating osteoblast differentiation -  Conclusion ?  Summary This invited review covers research areas of central importance for orthopaedic and maxillofacial bone tissue repair, including normal fracture healing and healing problems, biomaterial scaffolds for tissue engineering, mesenchymal and foetal stem cells, effects of sex steroids on mesenchymal stem cells, use of platelet-rich plasma for tissue repair, osteogenesis and its molecular markers. A variety of cells in addition to stem cells, as well as advances in materials science to meet specific requirements for bone and soft tissue regeneration by addition of bioactive molecules, are discussed

Gynaecological emergencies seen in a referral hospital in Northwest Nigeria: A 3-year retrospective study

Background: Gynaecological emergencies are common causes of morbidity and mortality worldwide and patients' characteristics are important determinants of gynaecological emergencies. Objectives: This study was conducted to determine the pattern and management outcome of gynaecological emergencies in Aminu Kano Teaching Hospital (AKTH), Kano. Materials and Methods: A 3-year retrospective review of all gynaecological emergencies seen in AKTH between January 2012 and December 2014 was done. Results: A total of 3050 gynaecological consultations were done within the period under review, 1337 of which were gynaecological emergencies giving an institutional prevalence of 43.8%. The highest (44.5%) frequency was seen in the 21–30-year age group. Ten different types of gynaecological emergencies were seen with abortion being the leading (59.3%) gynaecological emergency. Incomplete abortion is the most common form of miscarriage in age's ≥ 20 years; in the Parous; and amongst married women. Sexual assault occurred in 5% of the patients, with 47.8% occurring in individuals aged below 10 years. The least common gynaecological emergency was coital laceration which accounted for 0.5%. The prevalence of mortality from gynaecological emergencies was 3.7%. The most common cause of mortality from a gynaecological emergency was bleeding gynaecological malignancy and carcinoma of the cervix accounting for 41.2%. Conclusion: Gynaecological emergencies are common and abortions are the most common emergency at AKTH. Patient characteristics play a significant role in their pattern of presentation, while outcomes of these emergencies are related to their cause and manner of presentation. Increased surveillance and advocacy of policies that strongly punish individuals convicted of sexual assault should be encouraged, and increased awareness and utilization of Pap smear should be encouraged for early detection of premalignant and early stage carcinoma of the cervix. Further research is required to identify the possible risk factors/causes of abortion in this environment

Perceptions about Eclampsia, Birth Preparedness, and Complications Readiness among Antenatal Clients Attending a Specialist Hospital in Kano, Nigeria

Background. Eclampsia is a reliable indicator of poor birth preparedness and complications readiness. We determined perceptions about eclampsia, birth preparedness, and complications readiness among antenatal clients in Kano, Nigeria. Materials and Method. A cross-sectional design was used to study 250 randomly selected antenatal clients. Data was analyzed using SPSS 16.0. Result. The mean age of the respondents was 26.1 ± 6.4 years. The majority perceived that eclampsia is preventable through good ANC (76.4%) and hospital delivery (70.8%). Overall, 66.8% had good perception about eclampsia. Having at least secondary school education and multigravidity were associated with good perception about eclampsia on multivariate analysis. About a third (39.6%) of the mothers was less prepared. On binary logistic regression, good perception about eclampsia and multigravidity were associated with being very prepared for birth. Up to 37.6% were not ready for complications. Half (50.4%) knew at least three danger signs of pregnancy, and 30.0% donated blood or identified suitable blood donor. On multivariate analysis, having at least secondary school education, being very prepared for birth, and multigravidity emerged as the only predictors of the respondents' readiness for complications. Conclusion and Recommendations. Health workers should emphasize the practicability of birth preparedness and complications readiness during ANC and in the communities, routinely review plans, and support clients meet-up challenging areas. The importance of girl-child education to at least secondary school should be buttressed

Perceptions about Eclampsia, Birth Preparedness, and Complications Readiness among Antenatal Clients Attending a Specialist Hospital in Kano, Nigeria

Background. Eclampsia is a reliable indicator of poor birth preparedness and complications readiness. We determined perceptions about eclampsia, birth preparedness, and complications readiness among antenatal clients in Kano, Nigeria. Materials and Method. A cross-sectional design was used to study 250 randomly selected antenatal clients. Data was analyzed using SPSS 16.0. Result. The mean age of the respondents was 26.1 ± 6.4 years. The majority perceived that eclampsia is preventable through good ANC (76.4%) and hospital delivery (70.8%). Overall, 66.8% had good perception about eclampsia. Having at least secondary school education and multigravidity were associated with good perception about eclampsia on multivariate analysis. About a third (39.6%) of the mothers was less prepared. On binary logistic regression, good perception about eclampsia and multigravidity were associated with being very prepared for birth. Up to 37.6% were not ready for complications. Half (50.4%) knew at least three danger signs of pregnancy, and 30.0% donated blood or identified suitable blood donor. On multivariate analysis, having at least secondary school education, being very prepared for birth, and multigravidity emerged as the only predictors of the respondents’ readiness for complications. Conclusion and Recommendations. Health workers should emphasize the practicability of birth preparedness and complications readiness during ANC and in the communities, routinely review plans, and support clients meet-up challenging areas. The importance of girl-child education to at least secondary school should be buttressed

Factors responsible for under-utilization of postnatal care services in Maiduguri, north-eastern Nigeria

Background: In Maiduguri, the utilization of available postnatal care services is still very low. This may be influenced by demographic, socioeconomic, cultural, and obstetric factors among others. Objective: The aim of this study is to understand the current status of utilization of maternal postnatal health care services and identify factors responsible for under.utilization of available postnatal care services in Maiduguri. Materials and Methods: A. cross.sectional, questionnaire.based study was conducted involving 350 women in their reproductive age group. (15.49. years), who had delivered previously, residing in Maiduguri and who came to access any of the available maternal health care services at the State Specialist Hospital, Maiduguri over a 3.month period. The Chi.squared statistics and multivariate logistic regression analysis were used. Results: Out of the grand total of 350 questionnaires that were distributed during the study period, 18 questionnaires were excluded from analysis due to incomplete responses, 332 with complete responses were therefore analyzed, giving a response rate of 94.9%. The results showed that only 16.9% of the respondents attended postnatal care services within 42. days after delivery. Most of the mothers. (60.9%) were not knowledgeable about postnatal care services. A. very high proportion of participants. (69.4%) did not attend antenatal clinics, and over. 70% of the study population had delivered at home. The study has identified some factors that have an important influence on utilization of postnatal care services in Maiduguri. These included awareness of postnatal care services. (odds ratio. [OR] 12.04, 95% confidence interval. [CI]: 10.26, P =. 0.000), higher educational status of the woman. (OR 7.15, 95% CI: 5.19, P =0.000), lower parity. (OR 5.22, 95% CI: 3.21, P = 0.001) and marital status. (married woman.OR 3.44, 95% CI: 2.17, P =0.002). Educational attainment of the husband also significantly affected the respondents' seeking behavior of postnatal care. (OR 2.01, 95% CI: 1.13, P =0.042). Conclusion: Utilization of postnatal care services is quite low in Maiduguri. Socioeconomic and sociodemographic factors influenced the use of postnatal care services. Government should provide culturally acceptable health educational programs and expands maternal health care services into the communities for the better, effective and efficient health care delivery