Episiotomies In The Jos University Teaching Hospital

Background: Episiotomy is the commonest minor obstetric operation. There is however significant risks associated with the routine use of episiotomy. It is associated with the immediate problem of more perineal pain in the puerperium, and the long-term problem of potential sexual dysfunction resulting from superficial dyspareunia or pain at the introitus. Objective: To determine the rate of episiotomy, the indications, and to observe changes in the use of episiotomy since 1998 in the Jos University Teaching hospital. Methodology: This was a retrospective study of all consecutive deliveries in the maternity unit of the Jos University Teaching hospital. The records of all deliveries in the maternity unit of the hospital were retrieved and checked for total deliveries within the study period. Records of patients that had episiotomy were collated and analyzed for age, parity, and the indication for the episiotomy. The records were analyzed using the Epi-Info 2002 software. Results: A total of 15,228 deliveries were conducted and 3,769 episiotomies were performed with an overall rate of 24.8%. There was a general decrease of the rate from 28.4% in 1998 to 20.8% in 2003. Medio-lateral incisions were commonly used and the primipara accounted for 54.9% of the episiotomies. The commonest (52.6%) indication was for imminent perineal tear with the fetal head pressing on the perineum. Conclusion: Episiotomies are commonly performed obstetric minor operations in the Jos University Teaching Hospital. Primiparity appears to be a risk factor for episiotomy. The commonest indication was imminent perineal tear in the second stage of labour. Key words: episiotomy, vacuum, forceps, prematurity, perineum, obstetric, Jos Highland Medical Research Journal Vol. 3 (1) 2005: 31-3

Evaluation of the OptiMAL Test for Rapid Diagnosis of Malaria

This study evaluated the ability of a newly developed rapid test for laboratory diagnosis of malaria. OptiMAL is a rapid test that utilizes a dipstick coated with monoclonal antibodies against the intracellular parasite dehydrogenase (PLDH). The differentiation of Plasmodium species is based on antigenic differences between the PLDH forms. Blood samples from 62 of clinically diagnosed patients were examined using the microscopy of Giemsa-stained blood films and the OptiMAL test. The blood films indicated that 27% of the patients were positive for P.falciparum (including one case of mixed infection with P. malariae), while the OptiMAL test recorded 34% for P. falciparum. The OptiMAL test failed to diagnose malaria at concentrations less than 100 per microliter of blood, while those missed by microscopy may be due to sequestration of the parasite coupled with low parasite density. The OptiMAL test was modified by using fingerprick instead of venepuncture and this simplifies the test both in terms of cost and trained personnel. There was no significant difference between the two methods (x2 = 1.513;P>0.05), but the OptiMAL test has the advantages of being faster, requires almost no specialized laboratory experience and extremely sensitive and specific even in field situations. We conclude that the OptiMAL test is an effective tool for the rapid diagnosis of malaria. (Af. J. of Clinical and Experimental Microbiology: 2003 4(1): 14-17

Reproductive desires and intentions of HIV-positive women of reproductive age attending the adult HIV clinic at the Jos University Teaching Hospital, Jos, Nigeria

Background: The advent of highly active antiretroviral therapy (HAART) in the medical management of human immunodeficiency virus (HIV) infection has modified the natural history of HIV, resulting in improvements in the quality of life and life expectancy of women living with HIV. Consequently, many HIV-positive women of reproductive age are considering the possibility of having their own biological offspring. Materials and Methods: This was a cross-sectional study conducted among HIV-positive women of reproductive age attending the adult HIV clinic at the Jos University Teaching Hospital, Jos, Nigeria. Equal numbers of HIV-positive women of reproductive age in serodiscordant and seroconcordant relationships, who met the selection criteria, were recruited using convenience sampling technique. Data were collected using a pretested questionnaire in a face-to-face interview, and were analyzed using the Statistical Package for the Social Sciences statistical software (version 17) to determine their reproductive intentions using Chi-square and t-test. Multiple logistic regressions were used to determine the relationship between independent variables and the intentions of respondents to have children. Results: A total of 500 women were recruited for the study (250 in serodiscordant relationship and 250 in seroconcordant relationship). The overall reproductive desires and intentions were 60% and 56.4%, respectively. The reproductive intentions among those in serodiscordant and seroconcordant relationships were 63.2% and 49.6%, respectively. The difference was statistically significant. Conclusion: The reproductive intentions among the HIV- positive women in this study were high, the intentions being much higher among those in serodiscordant relationship. With a compelling intention to exercise their parenthood, there is a need for us to provide appropriate reproductive and sexual health services and support for all HIV-positive women of reproductive age