Boniface Uji Ago

Malignancies in AIDS patients: the experience of a tertiary hospital in a high prevalence zone

Material and methods A five year retrospective study was carried out to review the frequency of diagnosis of three tumours classified as AIDS defining malignancies (Kaposi sarcoma, non Hodgkin lymphoma, cervical cancer) and one non AIDS defining malignancy (squamous cell carcinoma of the conjunctiva), also commonly diagnosed in these patients. Records of the patients which are histologically confirmed and diagnosed between 1 January 2005 and 31 January 2009 were sorted out and their retroviral status classified.

Sero-prevalence of hepatitis B infection and its risk factors among women admitted for delivery in Ucth, Calabar, Nigeria.

Background: Vertical transmission of hepatitis B virus infection during pregnancy and delivery remains the major route of transmission in low resource areas. The objectives of this study were to determine the sero-prevalence of hepatitis B infection (HBsAg) and the potential risk factors among pregnant women admitted for delivery. Materials and Methods: This cross-sectional study of 300 women admitted for delivery was conducted at University of Calabar Teaching Hospital, Calabar, Nigeria. A pretested questionnaire was used for the collection of socio-demographic data and possible risk factors. Blood sample was collected from each consented woman and the plasma tested for the presence of HBsAg using rapid ELISA test Kits in the laboratory of the hospital. All the data were analyzed using microsoft Original Research Article Iklaki et al.; BJMMR, 8(4): 324-333, 2015; Article no.BJMMR.2015.455 325 SPSS version 17 statistical program. Results: Out of the 300 women studied, positive HBsAg was detected in 14 women, giving a seroprevalence rate of 4.7%. The age of the women studied varied from 16 to 43 years with mean age of 27.9±4.6 years and mean parity of 1.1±1.5. Hepatitis B viral infection was significantly higher among pregnant women who did not attend any antenatal care (unbooked women) than pregnant women who attended antenatal care (booked women). There were statistically significant relationships between HBV infection and 2 or more sexual partners and previous history of induced abortion. Previous histories of blood transfusion, previous surgeries/dental manipulations, tribal marks/tattoos, previous contact with somebody with hepatitis B infection were not statistically significant. The data are related to 14 (4.7%) of HBV infected women in the study. Conclusion: An intermediate prevalence of hepatitis B virus infection was identified which justifies the need for routine screening in pregnancy especially among unbooked women in order to identify and treat the infection.

Obstetric outcomes of booked teenage pregnancies at University of Calabar Teaching Hospital, Nigeria

Background Teenage pregnancy is high-risk and associated with complications due to adverse physiological, anatomical, and socioeconomic factors. The purpose of this study was to determine the patterns and obstetric outcomes of booked teenage pregnancies at the University of Calabar Teaching Hospital (UCTH) in Nigeria. Methods A retrospective comparative analysis of teenage pregnancies and mature mothers at UCTH was carried out from January 2011 to December 2011. A total of 82 teenage pregnancies and 72 mature pregnancies were compared. Results There were 145 teenage deliveries from a total of 2313 deliveries, ie, 6.3% of total deliveries. There was no statistically significant difference in the mode of delivery (cesarean section, spontaneous vaginal delivery, instrumental delivery) between the groups of mothers. There was also no difference in risk of complications, including obstructed labor, retained placenta, uterine atony, pre-eclampsia/eclampsia, and antepartum hemorrhage. However, teenage mothers had more perineal lacerations (P = 0.02) and more preterm labor (P = 0.05), and delivered more low-birth-weight babies (P = 0.02). Conclusion Supervised teenage pregnancy may not be as hazardous as previously thought.

Ebola virus disease: assessment of knowledge, attitude and practice of nursing students of a Nigerian University

Background Ebola virus disease has a high case fatality rate. Health care providers have a key role to play in its management and prevention. Objectives The aim of this study was to determine the knowledge, attitude and practice regarding Ebola virus disease (EVD) among students of Nursing in the University of Calabar, Calabar, Nigeria. Methods This was a descriptive cross-sectional study. A semi-structured,self-administered questionnaire was administered to 178 nursing students. The respondents were selected using systematic random sampling. Results Lecturers were the commonest source of information regarding EVD as reported by 84.5% of the respondents followed by television (76.3%). Nearly 27% of respondents indicated that the fear of EVD had dampened their interest and enthusiasm in the nursing profession. Nearly 12 % indicated that they would not take part as theatre nurses in the surgical operation of a patient who had been certified cured of EVD. A similar proportion indicated their unwillingness to attend to a woman in labour even if she had been certified cured of EVD. Conclusion Majority of the students were knowledgeable about EVD. Although majority of them had favorable attitude towards EVD patients, there was evidence of stigmatizing and discriminatory attitude that needs to be addressed.

Sociodemographic characteristics and handling of life‑threatening obstetric cases by traditional birth attendants in Cross River State, Nigeria

Background: Majority of pregnant women, especially in remote rural areas still desire to be delivered by traditional birth attendants (TBAs) who neither have the skills nor the equipment to treat life-threatening complications. Objective: To determine the sociodemographic characteristics of TBAs and how they manage life-threatening obstetric cases. Methodology: This was a prospective study carried out over a 3-month period during the training of TBAs in the state on the reduction of maternal mortality. A total of 540 TBAs from 18 Local Government Area of the state participated in the study. Data obtained were sex, age, levels of education, number of deliveries conducted per month, difficult cases encountered, and how they managed them. The data were analyzed using Epi Info version-7 and presented in tables. Results: TBAs are mostly females, i.e. 538 (99.6%) and only 2 (0.4%) were males. Majority of the TBAs were above the age of 55 years, i.e. 488 (88.9%); had primary education 416 (77.0%); married 396 (71.6%); and grand multiparous 293 (54.3%). Most TBAs deliver 4 newborn monthly, i.e. 148 (22.6%), and the mean number of newborn delivered monthly was 3.9. Concerning the mode of handling of the difficult cases, majority, i.e. 338 (62.6%) have a nurse/midwife they always call for assistance while only 147 (27.2%) refer their life-threatening cases directly to the nearby hospital. Conclusion: TBAs still plays a role in deliveries in most rural and urban areas. Majority of TBAs do not refer their life-threatening cases directly to the nearby hospital. Therefore, TBAs should be trained on how to identify life-threatening cases and promptly refer to hospitals for better outcome.

The Value of Mobile Ultrasound Services in Rural Communities in South-South Nigeria

AIM This paper examines the activities of mobile services units including ultrasound services in rural and urban communities in the Calabar region of South-South, Nigeria. MATERIALS AND METHODS Consenting individuals were invited and attended five medical outreach activities in rural and urban areas of the Calabar region between January and June 2016. Abdomino-pelvic scans were done. Subsequently the results were analyzed. RESULTS Five hundred and seventy-four (574) individuals had Abdomino-pelvic scans done, using a curvilinear probe to assess the abdomino-pelvic organs. The female to male ratio was 1.46:1. The age ranged from 1-78 years with a mean of 40.63 (standard deviation of 17.5). The commonest sonographic finding was uterine fibroids, 21 (8.1%). Fifty-four percent of the scans were normal. The commonest sonographic finding in men was prostatic enlargement. CONCLUSION Medical outreach activities provided by mobile units provide much needed ultrasound services in poor resource settings in Nigeria. Significant clinical pathologies were identified at fairly high rates.

Non‑pregnancy related gynaecological causes of death in a Nigerian Tertiary Hospital

Background: Most gynaecological causes of death are related to pregnancy such as ectopic pregnancy, unsafe abortion, septic incomplete abortion, and gestational trophoblastic diseases. Hence, it was necessary to review the non-pregnancy related causes of gynaecological deaths in our centre. Aims and Objectives: The aim of this study was to review gynaecological deaths due to non-pregnancy related causes among women in our centre at the University of Calabar Teaching Hospital (UCTH). Materials and Methods: This was a 5-year retrospective review of case notes of women who died in the gynaecological ward of UCTH. The demographic profile of the women, the diagnosis and the cause of death were extracted for analysis. All those whose diagnoses were pregnancy related were excluded. Results: There were 38 gynaecological deaths, which were not pregnancy related. Of these, ovarian cancer (19) and cervical cancer (11) constituted 30 cases or 78.9% of causes of death. Endometrial cancer (3), uterovaginal prolapse (3), uterine leiomyosarcoma (1), and vulvovaginal cancer (1) constituted 8 cases or 21.1% of deaths. No deaths were recorded from uterine fibroids, dysfunctional uterine bleeding, pelvic inflammatory disease, etc., Conclusion: Cancers constitute the majority of causes of gynaecological deaths in women who are not pregnant. This emphasises the need for cancer prevention, early diagnosis and effective treatment.