Sonographic assessment of pregnancy co-existing with uterine leiomyoma in Owerri, Nigeria

Background: Uterine myomas co-existing with pregnancy could cause obstetric complications.Objectives: To assess sonographically the frequency of occurrence and effect of uterine myomas co-existing with pregnancy.Methods: A longitudinal study was conducted during a period of 23 months. A convenience sample of 816 consecutive consenting pregnant women who met the inclusion criteria was evaluated during routine prenatal ultrasound scan. The women were referred for prenatal sonography. One hundred of the subjects who had myoma co-existing with pregnancy and another 100 subjects without myoma were selected for follow-up. These groups were followed up till delivery and obstetric complications and outcomes were documented. Any changes in size and growth rate of myoma were documented.Results: Subjects with myoma co-existing with pregnancy were 12.3%. This was commoner with increasing maternal age. An increase was observed in myoma mean size from 60mm to 63mm from the 1st scan sequence to the 2nd scan sequence and a reduction from 63mm to 59mm in the 3rd scan sequence. Myoma growth rate was 0.667mm per week. Myomas inpregnancy especially large ones caused more complications during delivery when compared to pregnancies without myomas.Conclusion: Routine sonography is important in pregnancy management of uterine myomas co-existing with pregnancy.Keywords: Routine sonography; uterine myoma, pregnancy, obstetric complications

Relationship between Corneal Biomechanical Properties among Pregnant Women in a Tertiary Hospital in Nigeria

Objective: In Nigeria, many pregnant women as well as health‑care providers are unaware of the effect of pregnancy on the eye. The present study investigated the changes in central corneal thickness (CCT), corneal sensitivity (CS), and intraocular pressure (IOP) among pregnant women in a tertiary hospital in Nigeria and the relationship between them. Materials and Methods: A prospective longitudinal study was used. One hundred and thirty‑four pregnant women attending the Obstetric Clinic of the University of Nigeria Teaching Hospital, Enugu, were consecutively recruited in their second trimester for the study. Changes in CCT, CS, and IOP were monitored at the second and third trimesters and 6‑week postpartum. Data obtained were analyzed using Statistical Package for the Social Sciences version 20. The effect of duration of pregnancy on these variables was determined using simple linear regression and further analysis was done using Bonferroni’s post hoc test. Results: The women were aged 18–48 years, with a mean age of 30.81(±5.49) years and majority of them (61.2%) were multigravida. The duration of pregnancy varied inversely and significantly with CS (P < 0.05) and IOP (P < 0.000) with the least values recorded in the third trimester, while it varied directly and also significantly with CCT (P < 0.000) with the highest value obtained in the third trimester. A negative correlation that was significant only in third trimester was found between CCT and IOP (P < 0.02) and CS (P < 0.03). Conclusion: There was a progressive increase in CCT with a corresponding decrease in CS and IOP across the trimesters of pregnancy, but these changes reversed 6‑week postpartum.Keywords: Central corneal thickness, cornea sensitivity, intraocular pressure, pregnanc

Effect of Hibiscus sabdariffa on Blood Pressure and Electrolyte Profile of Mild to Moderate Hypertensive Nigerians: A Comparative Study with Hydrochlorothiazide

Background: Hibiscus sabdariffa (HS) is widely consumed in Nigeria as a refreshing beverage and also as an antihypertensive agent. Since three decades ago when its antihypertensive activities were reported in several animal experiments, its consumption has greatly increased.Aim: The aim of this study is to investigate the effect of HS consumption on blood pressure (BP) and electrolytes of mild to moderate hypertensive Nigerians and compare it with that of hydrochlorothiazide (HCTZ), a diuretic widely used as first‑line antihypertensive drug.Subjects and Methods: Eighty newly diagnosed, but untreated mild to moderate hypertensive subjects attending Medical Out‑Patients clinic of Enugu State University Teaching Hospital, Enugu, were recruited for the study. They were randomly divided into three groups: A, B and C. Those in Groups A were given placebo; those in Group B took HCTZ while those in Group C were given HS. Treatment lasted for 4 weeks. BP, serum, and urine electrolytes were measured at baseline, weekly during treatment and 1 week after withdrawal of treatment.Results: At the end of treatment, both HCTZ and HS significantly (P < 0.001) reduced systolic BP, diastolic BP, mean arterial pressure and serum Na+ compared to placebo. When compared to each other, HCTZ significantly (P < 0.001) reduced serum Na+ and Cl− compared to HS and significantly (P < 0.001) increased K+ and Cl− output in urine. After withdrawal of treatment, the fall in BP and serum Na+ in HS group were significant compared to HCTZ where they returned to baseline values. No side effect was reported during the study.Conclusion: HS was a more effective antihypertensive agent than HCTZ in mild to moderate hypertensive Nigerians and did not cause electrolyte imbalance. HS showed longer duration of action compared to HCTZ and reduction in serum Na+ may be another antihypertensive mechanism of action of HS.Keywords: Clinical Trial, Essential Hypertension and Electrolytes, Hibiscus sabdariffa, Hydrochlorothiazid

Acetylation Pharmacogenetics and Renal Function in Diabetes Mellitus Patients

Activities of human hepatic drug metabolizing enzymes N-acetyl transferase (NATS) had earlier been recognized as a cause of inter-individual variation in the metabolism of drugs. Therefore acetylation of many drugs in human exhibit genetic polymorphism. The aim of the study was to investigate if acetylator status predispose diabetic mellitus patients more to the complications of renal disease, One hundred and twenty (120) diabetics consisting of (50) Type 1 (T1) and 70 Type 2 (T2) diabetes mellitus patients and 100 healthy individuals as controls were classified as slow or rapid acetylator using sulphamethazine (SMZ) as an in vivo probe. The percentage acetylation, recovery of SMZ, creatinine clearance and presence of urinary albumin were determined. A significant difference (P < 0.05) was observed in the percentage of SMZ acetylated between slow and rapid acetylators in control, T1 and T2 subjects. The ratios of slow to rapid acetylators for T1, T2 and control subjects were 1:4, 3:2 and 2:3 respectively. No significant differences were observed in the percentage of SMZ recovered in the urine of slow and rapid acetylators that are diabetics. The difference in creatinine clearance of slow and rapid acetylators in T1 and T2 were significant (P < 0.05). 29% out of 120 (24.2%) diabetics (T1 and T2) exhibited albuminuria out of which 25 (86.2%) had slow acetylator status. These findings suggest that slow acetylator status in diabetes mellitus could be a predisposing factor in the development of renal complications. This underscores the need for a rapid pharmacogenetic testing and therapeutic drug monitoring in such patients. However this inference could be further validated with a larger sample size

First trimester medication use in pregnancy in Cameroon: a multi-hospital survey

Interview-based Questionnaire. This is the questionnaire developed during and study and used to obtain data from the pregnant women. (DOCX 46 kb