Utilization of insecticide treated nets among pregnant women in Enugu, South Eastern Nigeria

Background: The goal of roll back malaria partnership is to achieve universal coverage for all populations at risk using appropriate interventions for prevention and case management.Objective: The objective of this study is to determine the use of insecticide treated nets (ITNs) and other anti-vector measures among pregnant women in an area hyper-endemic for malaria.Materials and Methods: Questionnaires were administered to a cross-section of 832 consecutive pregnant women attending antenatal care in three hospitals in Enugu, Nigeria that have high client flow for maternity services. Data collected were analyzed using descriptive and inferential statistics by means of the Statistical Package for Social Sciences (SPSS) version 16. P-value of less than 0.05 was considered statistically significant.Results: The mean age of the women was 33.2 ± 2.9 (range: 15-45) years. Three hundred and fifty nine (43.1%) women owned insecticide treated nets (ITNs), however 325(90.5%) slept under the nets during the index pregnancies; equivalent to 39.1% utilization rate among the 832 women studied. Out of the 325 (39.1%) women that used ITNs; 236 (28.4%) used it singly, while 89 (10.7%) used it in combination with other anti-vector measures. Educational status and social class of the women had strong association with the use of ITNs (P < 0.0001). Women who used ITNs were significantly less likely to have acute malaria, anaemia and babies with low birth weight than women who did not use ITNs (P < 0.05).Conclusion: The use of ITNs is poor among pregnant women in Enugu, but associated with favorable maternal and feto-neonatal outcome. Future measures to increase its use should consider improvement in educational level and social class of our women.Key words: Insecticide treated nets, Malaria, Nigeria, pregnanc

Falls among pregnant women in Enugu, Southeast Nigeria

Background: Falls during pregnancy are major public health issues and a common cause of maternal injury during pregnancy. There is paucity of data on prevalence and risk factors of falls during pregnancy in African population including Nigeria.Objective: To determine the prevalence and risk factors associated with falls during pregnancy in Enugu, Nigeria.Materials and Methods: This was a cross.sectional study of 332 consecutive pregnant women presenting in labor for delivery at the University of Nigeria Teaching Hospital Enugu, Nigeria between 1st May and 31st December, 2012.Results: The mean age of the women was 32.2 } 2.7 (range: 20.42) years. One hundred and eight women (32.5%) reported falling at least once during the index pregnancy. Women aged . 30 years had twofold risk of falling during pregnancy than women aged > 30 years [41.1% (69/168) vs. 23.8% (39/164); odds ratio (OR): 2.23; 95% confidence interval (CI): 1.39.3.58; P < 0.001)]. Similarly, women . 160 cm in height had significantly higher risk of falling during pregnancy than women < 160 cm in height [43.5% (70/161) vs. 22.2% (38/171); OR: 0.37; 95% CI: 0.23.0.60; P < 0.0001)]. Furthermore, primigravidae had almost threefold risk of falling during pregnancy than multigravidae [45.3% (63/139) vs. 23.3% (45/193); OR: 2.73; 95% CI: 1.70.4.37; P < 0.0001)].Conclusion: Falls during pregnancy is common in Enugu, Nigeria. It is, therefore, recommended that women should be counseled during pregnancy on this public health problem and the above.identified risk factors emphasized in order to reduce the prevalence and morbidity.Key words: Enugu, falls, Nigeria, pregnant women, prevalence, risk factor

Studies on anti-ulcer, analgesic and antipyretic properties of the ethanolic leaf extract of Gongronema latifolium in rodents

The ethanol extract of Gongronema latifolium leaves were evaluated for anti-ulcer, analgesic and anti pyretic activities in rats and mice. Ethanol-induced gastric ulceration, acetic acid-induced writhing and formalin-induced nociception were used. Yeast-induced hyperpyrexia was used to investigate the antipyretic activity. The extract produced a significant ulcer protective activity in rats. The extract also decreased pain induced both by acetic acid in mice and early phase of formalin test in rats. A significant reduction in hyperpyrexia was also produced by the extract in rats. This present studyprovides a strong evidence of anti-ulcer, analgesic and antipyretic activities of G. latifolium

Natural coagulates for wastewater treatment; a review for application and mechanism

The increase of water demand and wastewater generation is among the global concerns in the world. The less effective management of water sources leads to serious consequences, the direct disposal of untreated wastewater is associated with the environmental pollution, elimination of aquatic life and the spread of deadly epidemics. The flocculation process is one of the most important stages in water and wastewater treatment plants, wherein this phase the plankton, colloidal particles, and pollutants are precipitated and removed. Two major types of coagulants are used in the flocculation process included the chemical and natural coagulants. Many studies have been performed to optimize the flocculation process while most of these studies have confirmed the hazardous effects of chemical coagulants utilization on the ecosystem. This chapter reviews a summary of the coagulation/flocculation processes using natural coagulants as well as reviews one of the most effective natural methods of water and wastewater treatment

Project OPUS: Development and evaluation of an electronic platform for pain management education of medical undergraduates in resource-limited settings

Introduction Pain is a very frequent symptom that is reported by patients when they present to health professionals but remains undertreated or untreated, particularly in low-resource settings including Nigeria. Lack of training in pain management remains the most significant obstacle to pain treatment alongside an inadequate emphasis on pain education in undergraduate medical curricula, negatively impacting on subsequent care of patients. This study aimed to determine the effect of a 12-week structured e-Learning course on the knowledge of pain management among Nigerian undergraduate medical students. Methods Prospective, multisite, pre-post study conducted across five medical colleges in Nigeria. Structured modules covering aspects of pain management were delivered on an e-Learning platform. Pre- and post-test self-assessments were carried out in the 12-week duration of the study. User experience questionnaires and qualitative interviews were conducted via instant messaging to evaluate user experiences of the platform. User experience data was analysed using the UEQ Data Analysis Tool and Framework Analysis. Results A total of 216 of 659 eligible students completed all sections of the e-Learning course. Participant mean age was 23.52 years, with a slight female predominance (55.3%). Across all participants, an increase in median pre- and post-test scores occurred, from 40 to 60 (Z = 11.3, p<0.001, effect size = 1.3), suggestive of increased knowledge acquisition relating to pain management. Participants suggested e-Learning is a valuable approach to delivering pain education alongside identifying factors to address in future iterations. Conclusion e-Learning approaches to pain management education can enhance traditional learning methods and may increase students’ knowledge. Future iterations of e-Learning approaches will need to consider facilitating the download of data and content for the platform to increase user uptake and engagement. The platform was piloted as an optional adjunct to existing curricula. Future efforts to advocate and support integration of e-Learning for pain education should be two-fold; both to include pain education in the curricula of medical colleges across Nigeria and the use of e-Learning approaches to enhance teaching where feasible. Methods: Prospective, multisite, pre-post study conducted across five medical colleges in Nigeria. Structured modules covering aspects of pain management were delivered on an e-Learning platform. Pre- and post-test self-assessments were carried out in the 12-week duration of the study. User experience questionnaires and qualitative interviews were conducted via instant messaging to evaluate user experiences of the platform. User experience data was analysed using the UEQ Data Analysis Tool and Framework Analysis. Results: A total of 216 of 659 eligible students completed all sections of the e-Learning course. Participant mean age was 23.52 years, with a slight female predominance (55.3%). Across all participants, an increase in median pre- and post-test scores occurred, from 40 to 60 (Z=11.3, p<0.001, effect size=1.3), suggestive of increased knowledge acquisition relating to pain management. Participants suggested e-Learning is a valuable approach to delivering pain education alongside identifying factors to address in future iterations. Conclusion: e-Learning approaches to pain management education can enhance traditional learning methods and may increase students’ knowledge. Future iterations of e-Learning approaches will need to consider facilitating the download of data and content for the platform to increase user uptake and engagement. The platform was piloted as an optional adjunct to existing curricula. Future efforts to advocate and support integration of e-Learning for pain education should be two-fold; both to include pain education in the curricula of medical colleges across Nigeria and the use of e-Learning approaches to enhance teaching where feasible

Patter of Gynaecological Cancers in University of Nigeria Teaching Hospital, Enugu, South Eastern Nigeria

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Trends and Determinants of Episiotomy at The University of Nigeria Teaching Hospital (Unth), Enugu, Nigeria

BACKGROUND: Episiotomy is the most commonly performed obstetric procedure. The indications and efficacy are poorly established and its practice has remained controversial. OBJECTIVE: To determine the rate and the determinants of episiotomy in the parturients at the UNTH, Enugu.METHODS: A five year retrospective review of stepisiotomy at UNTH Enugu between 1 January ,2000 stand 31 December,2004 .RESULTS: Out of 3032 vaginal deliveries, 1201 women had episiotomy during vaginal delivery, giving a rate of 39.6%. The rate fluctuated between 38.7% in 2000 to 32.7% in 2004.The risk of receiving episiotomy is significantly higher among primigravidae than multigravidae [OR=10.92,(95%CI=8.98,13.28]. Similarly, macrosomia(birth weight&gt;4kg) significantly increases the risk of episiotomy[OR=0.096, (95%CI=0.06,0.15]. Women who had instrumental or destructive vaginal delivery are significantly more likely to receive episiotomy than those who had spontaneous vaginal delivery[OR=0.13 (95%CI=0.07,0.26]. The postpartum blood loss is significantly higher among women that received episiotomy than those who did not[t=42.161, P&gt;0.0001]. CONCLUSIONS: The rate of episiotomy in UNTH, Enugu is high. Primigravidity, macrosomia and instrumental deliveries are factors associated with increased risk of episiotomy. Knowledge of these risk factors will guide in predicting episiotomy among paturients in labour ward.KEYWORDS: Episiotomy, Trends, determinants, Enugu-Nigeria

Coinfection with Hepatitis B and C Viruses among HIV Positive Pregnant Women in Enugu South East, Nigeria

Background: Hepatitis B and C viruses coinfection in HIV positive pregnant women is a common public health problem and recognized worldwide. The consequences of this problem in our poor resource setting with the risk of mother to child transmission is obvious with increased morbidity and mortality in our environment. Objective: To determine the prevalence of coinfection patterns of HBV and HCV among HIV positive pregnant women in Enugu Nigeria.Methods: A retrospective survey conducted on 401 Nigeria HIV positive pregnant women seen at Prevention of Mother To Child Transmission (PMTCT) clinic at the UNTH Enugu Nigeria over a 3 year period between 1st January 2007 and 31st December 2009. Results: The prevalence of hepatitis B and C viruses coinfection among HIV positive pregnant women in Enugu is 6.5%. HIV/HBV coinfection was commoner than HIV/HCV coinfection. There was no significant association between hepatitis B and C viruses coinfection and the age, ethnic group, marital or educational status of the women (P&gt;0.05).Conclusion: There is high prevalence of hepatitis B and C coinfection among HIV positive pregnant women in Enugu. This high burden of these hepatotropic virus coinfection calls for continued need to screen for these infections and vaccinate the affected babies for hepatitis B and/or C where appropriate.Keywords: HIV, Hepatitis B, Hepatitis C, PMTCT, pregnant women, Enugu Nigeri

Entrance surface dose of the common radiological investigations in Abuth, Zaria

The entrance surface Dose (ESD) was determined among patients who presented for routine radiological examinations using thermoluminescent dosimeter (TLD) chips placed on averagely built adult [ (30cm) chest width, 60 - 90kg weight and 20-40years)] by multiplying the incident dose/entrances dose by the back scattered factor [BSF] gotten from an experiment. The values obtained from ESD measurements are as follows 8.03 mGy for Abdomen, 0.13mGy for chest AP, 0.69 mGy for chest lateral, 0.5mGy for cervical spine; AP: 0.38mGy for cervical spine lateral; 4.75mGy for hip AP: 12.83 mGy for hip lateral:5.74mGy for lumbar spine, AP lumbar spine lateral is 15.15mGy. 1.38mGy is for pelvis AP. 2.93mGy for skull AP/PA 1.2mGy for skull lateral, 5.46mGy for thorax AP, while the lateral is 14.90mGy. The average dose value is 9.28mGy Range 0.13-14.90mGy (Percentage standard error; ± 1.45). From this studies radiation doses delivered for routine investigations are generally lower than IAEA reference doses. Using these values for optimization of radiation protection practices for patient should be ensured since it does not rule out options for stochastic radiation.Keywords: Entrance Surface Dose, (ESD) Routine Radiological Examinations, Reference value, Measured value, Calculated value, Thermolumnient Dosimeter (TLD