The Pattern and Obstetric Outcome of Hypertensive Disorders of Pregnancy in Nnewi, Nigeria

BACKGROUND:Hypertension is a common medical complication of pregnancy. It is one of the leading causes of maternal and fetal mortality and morbidity worldwide. Early detection, close surveillance and timely delivery are necessary to reduce complications associated with the condition.OBJECTIVES: To determine the pattern, risk factors, maternal and fetal outcomes in women with hypertensive disorders of pregnancy.METHODOLOGY:This was a descriptive retrospective study of the pattern and obstetrics outcome of hypertensive disorders in Nnewi.. The Obstetric variables from 148 women with hypertensive disorders of pregnancy at the Nnamdi Azikiwe University Teaching Hospital Nnewi, from the 1st January 2004 to 31st December 2008 were analyzed. Stastical analysis was done using Epi Info version 3.3.2. The level of statistical significance was set at P<0.05.RESULTS: of the 4021 deliveries in the hospital during the period under review, 148(3.7%) were managed for hypertensive disorders of pregnancy. Only 138 folders were used for analysis. The mean age of the women was 31.3±5.7years. Majority of the women were unbooked (57.2%). Pre-eclampsia was the commonest type of hypertensive disorder of pregnancy (46.4%) with the majority presenting with severe disease. The level of proteinuria was significant in 74.6% of cases of preeclampsia. The mean gestational age at delivery was 35.3±1.5weeks. The mean birth weight was 1.6±0.3kg. Twenty-four intra uterine deaths were recorded giving a stillbirth rate of 17.4%. The perinatal mortality rate was 20.9%.  Diagnosis was made in the ante-partum period in 92.0% of the cases while 55.2% of the women delivered through Caesarean section. Eight maternal deaths were recorded, giving a case fatality rate of 5.8%. CONCLUSION: Hypertensive disorders of pregnancy are associated with high maternal and fetal morbidity and mortality in Nnewi, Nigeria. Antenatal care will help in early diagnosis and timely intervention of the cases. There is need for strengthening of communication and referral systems in the healthcare.KEY WORDS: Hypertensive disorders, pattern, obstetrics outcome.Erratum Note: Mbachu 1, Udigwe GO, Okafor CI, Umeonunihu OS, Ezeama C, Eleje GU on the article “The Pattern and Obstetric Outcome of Hypertensive Disorders of Pregnancy in Nnewi, Nigeria” on Page Nig. J. Med 2013. 117-122. Should read: Mbachu II, Udigwe GO, Okafor CI, Umeonunihu OS, Ezeama C, Eleje GU

Comparison of serum levels of calcium and magnesium among preeclamptic and normotensive pregnant women at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

Background:Despite numerous studies, the exact aetiology of pre-eclampsia remains unknown. Some studies have shown that supplementation of calcium and magnesium could ameliorate the effects of pre-eclampsia. The objective of this study was to compare the calcium and magnesium levels in the serum of Nigerian women with or without pre-eclampsia.Methods:In this study, serum calcium and magnesium levels were determined using atomic absorption spectrometry in 54 patients and 48 healthy normotensive pregnant women. The mean, standard deviation, Student’s‘t’ test and Pearson correlation were employed.Results:Serum calcium was significantly lower in patients than controls (9.17 ± 0.6 vs. 7.22 ± 0.5 mg/dl. P <0.001) (t test). Plasma Magnesium was significantly lower in patients than controls 13.19 ± 1.1 vs. 9.81 ± 0.7 mg/dl. P <0.001). The systolic and diastolic blood pressure showed significant inverse correlation with both calcium and magnesium (P<0.01).Conclusion:There was significant reduction in the levels of calcium and magnesium in patients with pre-eclampsia. Dietary supplementation of these trace elements may help to prevent pre-eclampsia

The practice of hepatocellular cancer surveillance in Nigeria

Background: Hepatocellular cancer is a disease of global and public health importance due to the widespread distribution of risk factors and associated high case fatality. Hepatocellular Cancer (HCC) in Sub-Saharan Africa is commonly seen among the younger age groups (&lt;45 years) who present mostly in the terminal stage, when the disease is not amenable to any curative therapy. Hepatocellular Carcinoma surveillance employs the use of simple, cheap and readily available investigations, to detect early curable cancer in individuals with risk factors for HCC.Objectives:The aim of this study is to assess the practice of hepatocellular cancer screening among physicians.Methodolgy:This is a nationwide online survey carried out among physicians who care for patients with HCC. A questionnaire was sent out via a web link to all consenting doctors in Nigeria. The responses were collated in a cloud-based application and data was analysed using Epi-info version 20.Results:Atotal of 218 respondents, 142 were males (65.1 %) with a mean age of 37.6 ± 5.7 years. The modal age group was 31-40 years 153 (69.5%). The main factors considered as a hindrance to surveillance were; the cost of the tests (57.7%), failure of return of patients (50.5%) and not being aware of a surveillance program (45.2 %). The majority of the respondents were Gastroenterologists and Family Physicians. 54% of the gastroenterologists and 64% of the family physicians have never offered HCC surveillance to their patients.Conclusion:This survey highlights a knowledge gap in HCC surveillance among physicians. There is a need to make HCCsurveillance a daily routine among patients at risk by all physicians. Keywords: Surveillance, Hepatocellular Carcinoma, HBV, HCV, Cancer screening

An appraisal of vent house vacuum delivery

A retrospective analysis of Ventouse deliveries over a 10 year period at St. Charles Borromeo Hospital, Onitsha, Nigeria is presented. Between January 1991 and December 2000, 15802 deliveries were conducted, 572 were Ventouse deliveries, giving a Ventouse rate of 3.6%. The age range of the patients was 17-44 years, with a mean age of 28.2+ 5.5 years. The commonest indication for Ventouse delivery was prolonged second stage of labour 34.9% (195), followed by cephalopelvic disproportion in 10.6% (59), while the least indication was brow presentation in second stage of labour 1.3% (7). The maternal morbidity was mainly vaginal tear/laceration that occurred in 2.2% (12) of the patients. The success rate of Ventouse delivery was 91.6% (511). The corrected perinatal death rate was 9/1000 deliveries. Ventouse has a high success rate in prolonged second stage of labour, in first stage of labour and in fetal mal-positions. With the decline in the use of obstetric forceps and its teaching in most health institutions, ventouse becomes the instrument of first choice when assisted vaginal delivery is considered. Nigerian Journal of surgical sciences Vol. 16 (2) 2006: pp. 72-7

Sexual abuse among juvenile female street hawkers in Anambra State, Nigeria

Street hawking exposes young girls to all forms of hazards, including sexual abuse. This descriptive study examines the size of the problem and the consequences of sexual abuse on juvenile female street hawkers randomly recruited from two urban towns in Anambra State of Nigeria. Data was collected with semi structured, interviewer administered questionnaires. The mean age of the female hawkers was 13.0 + 2.2 years. Out of 186 respondents, 130 (69.9%) had been sexually abused with 32 (17.2%) having had penetrative sexual intercourse (28.1% were forced and 56.3% submitted willingly) while hawking. Majority (59.4%) of the sexual partners were adults. Other types of sexual abuse experienced include inappropriate touches (106 cases; 81.5%) and verbal abuses (121 cases; 93.1%).. There was low awareness of the twin risks of pregnancy (43.1%) and sexually transmitted infections (54.3%) following sexual abuse among the respondents. Sexual abuse of young female hawkers is an issue of great public health importance. Poverty alleviation, health education and protective child right policies will decrease its prevalence and the associated risks Keywords: Adolescents, In- School, Sexual activity, Sexual exposure, NigeriaAfrican Journal of Reproductive Helath Vol. 12 (2) 2008: pp. 111-11

Depressive Disorders Among In-School Adolescents: How Prevalent in Anambra State, Nigeria

Background: Depressive disorders are the leading causes of ill-health and disability globally. Depression among adolescents is usually associated with a range of adverse later outcomes which include suicidality, and general poor physical and mental health.Objective: To determine and compare the prevalence of depressive disorders among in-school adolescents in urban and rural areas of Anambra State.Methodology: This was a cross-sectional analytical study of urban and rural in-school adolescents in Anambra State, Nigeria. A total of 1187 secondary school adolescents in government-owned schools in Anambra State was selected using multi-stage sampling technique. Patient Health Questionnaire-9 (PHQ-9) was the study instrument.Results: The mean age of the participants was 15±2 years. The overall prevalence of depression was 12.5%. The proportion of urban participants identified with depression was significantly higher than that of their rural counterparts (14.5% versus 9.6%). Multiple regression showed that increased odds of developing depression are associated with urban setting (p = 0.001), female gender (p=0.018), and late adolescence (p=0.025).Conclusion: This study showed that depressive disorders are prevalent among in-school adolescents in Anambra State, with some of the associated factors being urban setting, female gender and late adolescence. There is need for multi-sectoral intervention programs to address these identified factors. Key Words: In-school adolescents, Depressive disorders, Nigeria, Urban-rural, Patient health questionnaire-9 (PHQ-9

Effects of the coronavirus pandemic among adolescents and young people living in South-East Nigeria

Background: Information on the effects of the coronavirus pandemic on adolescents and young people, who are in a critical phase of transition to adulthood is sparse. We evaluated the effects of coronavirus disease (COVID-19) among adolescents and young people living in Southeast Nigeria.Objective: To evaluate the effects of the coronavirus pandemic on young people in NigeriaMethods: A cross-sectional (online and onsite) study of 328 Nigerian youths was conducted, and data on sociodemographic profile and effects of the pandemic collected through pre-tested self-administered questionnaires, were analysed using STATA 16.0, with the significance level for tests of association set at p&lt;0.05.Results: The mean age of participants was 16.8±3.3 years. Two hundred and eleven participants (64.3%) experienced a fear of death significantly associated with a low monthly income (p&lt;0.001), 62/328(18.9%) respondents had experienced intra-familial sexual abuse, significantly associated with age group (p=0.003). Positive effects reported by 190/328(57.9%) participants included learning new things (88/190 =46.3%), spending time with loved ones (39/190 =20.5%), spending time on studies (29/190 =15.3%, p=0.015), significantly associated with age group; and time for rest and self-discovery (34/190 =17.9%, p=0.038) significantly influenced by age group.Conclusions: A significant number of participants had a fear of death and intra-familial sexual abuse which was strongly associated with monetary poverty, and age; while some participants positively engaged in self-discovery, rest and studies. Thus, the mental health and social welfare of youths should be focused on, and positive skills enhanced during this pandemic and afterward

Efficacy of zinc supplementation for the treatment of dysmenorrhoea: a double-blind randomised controlled trial

Objectives To determine the efficacy of zinc sulfate supplementation in managing dysmenorrhoea. Methods In total, 103 high school students were randomised into an experimental arm (52 students) and a control arm (51 students) and received 40-mg zinc sulfate or placebo, respectively, over three cycles. Primary outcome measures were the mean Visual Analogue Scale score, which measured pain over three cycles, and the frequency of nausea and vomiting. Secondary outcomes were the use of additional analgesics and the frequency of allergic reactions. Results Fifty participants were analysed in each group. Mean pain scores were not significantly different between the groups before administering zinc sulfate therapy. Following the intervention, the mean pain scores for the treatment (2.80 ± 2.28) and placebo (3.48 ± 2.85) groups were not significantly different in the first cycle; however, scores in the treatment group were significantly better in the second (2.56 ± 1.97 vs 3.80 ± 2.77) and third (1.95 ± 1.72 vs 3.95 ± 2.82) cycles. No significant differences were observed between the groups in the nausea and vomiting incidence and the requirement for additional analgesics. Conclusions Zinc sulfate reduces dysmenorrhoea severity with minimal or no adverse effects, especially with more than one cycle of usage. Trial Registration Number: PACTR202105843292338. The trial is publicly available and was registered at www.pactr.org on 25 May 2021