International Journal of Medicine and Biomedical Research

Prevalence and risk factors for stillbirths in a tertiary hospital in Niger Delta area of Nigeria: a ten year review

C.O. Njoku, C.I Emechebe, E.M Eyong, J.T Ukaga, K.C. Anachuna

Background: Stillbirth is a silent but major cause of perinatal mortality and source of foetal wastage.

Aim: To determine the prevalence of stillbirth, demographic characteristics and identify the possible risk factors in our Hospital.

Methods: This was a ten year cross-sectional retrospective study of stillbirths between 1st January, 2004 and 31st December, 2013. All cases of stillbirths from 28 weeks of gestation or the foetal weight of at least 1000g were included in the study.

Results: There were a total of 19,347 deliveries with 937 stillbirths, giving a stillbirth rate of 48.4/1,000 total births or 4.8%. Of the 937 stillbirths identified, only 582 (62.1%) case files could be retrieved and was used for analyses. There were 381(65.5%) macerated and 201(34.5%) fresh stillbirths. Stillbirth rate were higher among grand multiparous women, women with primary education and unbooked women. There were 309(53.1%) male stillbirths and 273(46.9%) female stillbirths. Male foetuses were higher among fresh stillbirth (54.9%) while female foetuses had more macerated stillbirths (48.8%) than fresh stillbirths (45.1%). The major causes of stillbirths were hypertensive disorders of pregnancy (18.9%), prolonged/obstructed labour (13.6%), anaemia in pregnancy (12.2%) and abruption placentae (9.3%). A total of 121(20.8%) of the stillbirths were unexplained.

Conclusion: The prevalence of stillbirth in our environment is high. Identified factors such as grandmultiparity, low education, unbooked pregnancy, anaemia in pregnancy, obstructed labour and ruptured uterus are modifiable. Every effort directed at reducing these factors must be made by all healthcare givers including policy makers to reduce stillbirths.

Key words: Stillbirth, miscarriage, perinatal mortality, anaemia in pregnancy, obstructed labour, uterine rupture

Frequency of ABO and Rhesus blood groups among blood donors in Lagos, Nigeria

F.A. Faduyile, A.O. Ojewale, F.I Osuolale

Background: The ABO is a blood group system that is responsible for most blood transfusion reactions, transplant rejections and determining some forensic cases. The ABO and Rhesus blood group systems have been shown to show variations in different part of the world and race.

Aim: The study is to show the frequency of ABO and Rhesus blood groups amongst blood donors in Lagos, Nigeria and confirm Hardy-Weinberg equilibrium.

Methods: This is a two-year retrospective study of all blood donors from the two major tertiary health institutions in Lagos State between July 2004 and June 2006. Data from the blood bank records were extracted and analysed using SPSS version 20. Hardy-Weinberg equation was used to confirm if the population is in equilibrium.

Results: In all, 11,911 donors were analysed and showed A+ 20.4%, A- 0.97%, B+ 16.7%, B- 0.87%, AB+ 2.2%, AB- 0.17%, O+ 55.6%, O- 3.1% and RhD positive frequency is 95.6%. The allelic frequency in this study is O – 0.7631, A - 0.1303, B – 0.1066 and Rh – 0.7786. There is no significant difference between the blood group distributions from the two institutions.

Conclusion: Blood group O was the commonest blood group seen followed by group A. This is at variance with other studies in Nigeria where blood group B was the second commonest. The population was also found to be in Hardy-Weinberg equilibrium. The study provides important and reliable genogeographical information that can advance the fields of blood transfusion, organ transplantation and forensic medicine in Nigeria.

Key words: Blood group, ABO, Rhesus, allelic frequency, Hardy-Weinberg equilibrium, transfusion reactions

Determinants and effect of girl child marriage: a cross sectional study of school girls in Plateau State, Nigeria

EA Envuladu, RJ Umaru, NO Iorapuu, IA Osagie, EO Okoh, AI Zoakah

Background: Child marriage is a major problem contributing to maternal morbidity and mortality in Nigeria. It has effect on both social and health of not only the girl child but the children born to these young mothers.

Aim: This study aimed at assessing the determinants of early marriage among secondary school girls in Plateau State and its effect especially on their health and education.

Methods: The study was a cross sectional study of young girls in 21 secondary schools across the three geopolitical zones in Plateau state, selected through a simple random sampling technique after obtaining consent from the JUTH ethical committee and permission from the State ministry of education and the principals of the various schools.

Results: The study found that while must marriages among girls are forceful marriages, the factors that influenced early marriage was poor educational level of parents, poverty and place of residence. The girls who married among them reported having had some health challenges and educational backwardness as a result of early marriage.

Conclusion: This study found that poverty and poor education are the underlying cause of child marriage and child marriage is usually against the will of the girls who desire to be educated.

Key words: Early marriage, maternal and childhood morbidity and mortality, Child Right Act, girl child education, puberty, teenage pregnancy

Congenital epulis: a report of two cases and review of the literature

O.O. Omisakin, SA Kache, S.O Ajike

Background: Congenital epulis of the newborn is a rare benign soft-tissue tumour of the gingival, which is also called gingival granular cell tumour of the newborn. These slow growing soft tissue tumors affect the gingivae of a new born child. It is essential to document the presentation and the management of this lesion because of its rare nature.

Aim: To highlight the clinical presentation, diagnosis and management of the lesion.

Methods: Two clinical cases of congenital epulis were used to illustrate the presentation and surgical management of the lesion.

Findings: The first clinical case is a one month old female child with a protruding gum tumour on the anterior alveolar process of the mandible. The second case is a one week old male child with a gingival growth on the anterior alveolar process of the mandible. All the tumours were surgically excised under local anaesthesia.

Conclusion: Congenital epulis could interfere with the functions of the oral cavity. Therefore, it is imperative to surgically excise it when diagnosed. Following the management of the two cases presented, it is essential that the mouth of all newborns must be examined to rule out any such lesion.

Key words: Congenital epulis, gingival, tumour, alveolar process, neonate, surgical excision

Parasitic diarrhoea in treatment-naïve HIV-positive patients attending the University of Ilorin Teaching Hospital (UITH) Highly Active Antiretroviral Treatment (HAART) Clinic

A.A Joseph, G.H Ano-Edward

Background: HIV is a public health issue with diarrhoea being the commonest gastrointestinal symptom especially in individuals with lower CD4+ cell counts. Most times, parasitic infections present as diarrhoea. Depending on geographical location, the pathogens responsible for diarrhoea vary.

Aim: To relate the degree of immunodeficiency in HIV-infected patients to diarrhoea as a result of infestation by parasitic agent.

Methods: 250 HIV positive and 250 HIV negative participants were recruited. Stool and blood samples were taken from all participants. Macroscopic and microscopic examinations of the stool were done while CD4+ count was estimated from the blood sample collected. Wet preparation of stool sample was done and concentrated stool was used for modified Ziehl Neelsen staining.

Results: Diarrhoea was present in 200 participants, 118 of which were among the HIV positive group. Parasites were demonstrated in 82.3% of the test participants with diarrhoea and 17.7% of the controls with diarrhoea. Of the HIV positive with diarrhoea, 70.3% had a CD4 <200 cells/μl and 29.7% had a CD4 of 200-500cells/μl. Parasites in both groups were Ascaris lumbricoides, Balantidium coli, Entamoeba histolytica, Schistosoma mansoni, Hookworm, Strongyloides stercoralis and coccidian parasites though at varying frequencies. Of the 79 with parasites, 60 had single parasitosis, while 19 had multiple parasitosis. CD4 count was the only variable that correctly predicts presence of diarrhoea.

Conclusion: Diarrhoea associated with parasitic infection HIV patients is a function of the immune status of the individual.

Key words: People Living with HIV/AIDS (PLWHA), HIV/AIDS, diarrhoea, intestinal parasite, HAART NAÏVE, immunosuppression

Intrapartum symphysio-fundal height measurement as a predictor of low birth weight in a low resource setting

B.O Enaohwo, J.O Alegbeleye, G Bassey

Background: Low birth weight (LBW) increases the risk of perinatal morbidity and mortality and of the long term neurologic and developmental disorders. Early identification of LBW is necessary to decrease complications and enhance the survival of the newborn.

Aim: To determine the usefulness of symphysio-fundal height as a predictor of low birth weight in a low resource setting.

Methods: This was a prospective cross-sectional study of consecutive 214 parturients who presented in early labour to the Central Hospital Warri (CHW) from November 1, 2013 to February 28, 2014. Their demographic characteristics were obtained using a structured proforma. Three measurements of the symphysio-fundal height (SFH) were taken using a non-elastic tape and the mean of the three readings were calculated to the nearest centimeter. The data obtained were analyzed using statistical package SPSS version-21.

Results: Two hundred and fourteen parturients delivered during the period. The mean age and parity were 29.45±4.75years and 1.59±1.56 respectively. Twenty of the parturients (9.3%) delivered before 37weeks, 165 (77.1%) delivered at 37-40weeks while the remaining 29 parturients (13.5%) delivered at 41weeks gestation and beyond. The mean birth weight was 3184+502g. SFH measurement of 29-35 cm had a low sensitivity (3.7-37%) but a high specificity, positive and negative predictive values for low birth weight. There was a high sensitivity, specificity, positive and negative predictive values for both normal and macrosomic babies.

Conclusion: Symphysio-fundal height measurement is a simple, cheap and effective screening test to predict newborn with low birth weight.

Key words: Intrapartum, symphysio-fundal height (SFH), low birth weight, safe delivery, maternal and childhood morbidity and mortality, obstetric care

Treatment with methanolic extract of Ocimum gratissimum (Linn.) leaf reversibly normalizes urine protein-creatinine ratio in Wistar rat model of gentamicin-induced kidney injury

Background: Due to its rapid onset of action, high antibacterial efficacy and low cost, gentamicin (GEN) is still been used (particularly in underdeveloped and developing countries) despite its nephrotoxic antibiotic effects. Experimental ethno-botanical evaluations are imperative in a world with increasing incidence of kidney injury; a condition that is expensive to treat or manage.

Aim: Effects of methanolic extract of Ocimum gratissimum (Linn.) leaf (MOGL) on urine proteincreatinine ratio (UPC) was determined in rats with GEN-induced kidney injury.

Methods: This study involved the use of 50 rats such that graded doses of MOGL (100, 200 and 400 mg/kg p.o.) were administered following 8 days exposure to GEN (100 mg/kg i.p) and comparison were made against the control, toxic, 2 weeks and 4 weeks MOGL treatment groups at p <0.05.

Results: GEN induced nephrotoxicity as depicted by significant perturbations in plasma and urine levels of creatinine and total protein (p <0.05); significantly lowered creatinine clearance and abnormal elevations of UPC as well as deleterious alterations of the kidney antioxidant system (GSH and TBARS) (p <0.05). Histopathological examination showed glomerular atrophy, formation of densely eosinophilic/ colloid cast within the tubules and severe loss of cellular constituents in the medullary interstitium. When compared with the control, these conditions were significantly normalized after 2 week MOGL treatment (p <0.05) with a deleterious reversal from normalcy at 4 week MOGL treatment (p <0.05).

Conclusion: This study substantiated that MOGL has therapeutic potentials that becomes deleterious after sub-chronic administration in rat model of GEN-induced kidney injury.

Key words: Gentamicin, renal function test, Ocimum gratissimum, urine protein-creatinine ratio, creatinine clearance, antioxidant system

Correction

O.A Sofola

International Journal of Medicine and Biomedical Research
Volume 5 Issue 1 January – April 2016

Title: The profile of tuberculosis infection at the Babcock University Teaching Hospital
Pages: 1-8
The title should read:
“The profile of tuberculosis infections at the Babcock University Teaching Hospital”
Authors’ names should also appear as:

“Shobowale E.O1*, Elikwu C.J1,Olusanya A.O2, Abiodun O3”

The affiliations remain the same:

“’1Department of Medical Microbiology and Parasitology, Babcock University, Ogun State. 2Pathcare Laboratories, Lagos. 3Department of Community Health, Babcock University, Ogun State.”

The errors are regretted.

-Editor-in-Chief, IJMBR