Rakiya Saidu

Intrauterine exposure to tobacco and risk of medically indicated and spontaneous preterm birth.

We investigated the association between prenatal smoking and the occurrence of medically indicated and spontaneous preterm delivery (<37 weeks). We performed a retrospective cohort study of singleton live births in the state of Missouri (n = 1,219,159) using maternally linked cohort data files covering the period 1989 to 2005. The main outcomes of interest were spontaneous and medically indicated preterm and very preterm birth. Logistic regression models were used to generate adjusted odds ratios and their 95% confidence intervals. There were 132,246 (10.8%) infants born preterm in the study population, of which 106,410 (80.5%) were classifiable as spontaneous preterm births and 25,836 (19.5%) were medically indicated preterm deliveries. We found elevated risks for both medically indicated and spontaneous preterm birth associated with maternal cigarette smoking during pregnancy. This heightened risk was particularly evident for medically indicated preterm birth (adjusted odds ratio [95% confidence interval] = 1.48 [1.41 to 1.55]). Women who smoke during pregnancy are at increased risk for preterm birth, and especially for medically indicated preterm delivery.

Obesity in older mothers, gestational weight gain, and risk estimates for preterm phenotypes

OBJECTIVE To assess whether advanced maternal age modifies the relationship between maternal pregravid weight status, gestational weight gain patterns, and the occurrence of spontaneous preterm birth (SPB) and medically indicated preterm birth (MIPB). METHODS Retrospective cohort analysis of vital statistics data from the state of Florida for the period 2004 through 2007 comprising 311,422 singleton pregnancies (two age groups: 20-24 years old or younger women and >or=35 years or older women). Mothers were classified into five clusters based on their pre-pregnancy body mass index (BMI) values: non-obese (less than 30), class I obese (30.0<or=BMI<or=34.9), class II obese (35.0<or=BMI<or=39.9), class III obese (40<or=BMI<or=49.9), and super-obese (BMI>or=50.0). RESULTS MIPB occurred more frequently among older than younger women [11.8% vs. 6.4%, respectively (p<0.0001)) whereas SPB occurred more frequently among younger women [11.3% vs. 10.5%, respectively (p<0.0001)). Maternal obesity increased the risk for MIPB but not for SPB. Regardless of BMI status, the risk of MIPB was elevated among older mothers, particularly among those with suboptimal (<0.23 kg/week) and supraoptimal (>0.68 kg/week) gestational weight gain. A dose-response relationship with increasing gestational weight gain was evident (p<0.01); the greatest risk for MIPB occurred among older mothers with weekly gestational weight gain in excess of 0.79 kg (OR=7.76, 95% CI=5.73-10.5). CONCLUSION The occurrence of medically indicated preterm birth is positively associated with increased maternal pregravid body weight, older maternal age and extremes of gestational weight gain. Targeted pre- and inter-conception weight management efforts should be particularly encouraged in older mothers.

Repeat caesarean delivery as a risk factor for abnormal blood loss, blood transfusion and perinatal mortality

We reviewed 450 cases of caesarean delivery (January–December 2009) at the University of Ilorin Teaching Hospital in Nigeria. We analysed the association between caesarean delivery status (primary or previous) and the following outcomes: abnormal blood-loss, blood transfusion and perinatal mortality. Although significant differences were observed between primary and previous caesarean delivery groups in regards to maternal age, urgency of the caesarean delivery, booking status, and cadre of birth attendant staff, no association was noted between caesarean delivery status and any of the three outcomes. Further analyses identified parity as an important predictor for blood transfusion and abnormal blood loss. In addition, we found a dose–response relationship between parity and abnormal blood loss (< 0.05). Also, mothers with an emergency caesarean delivery of the index pregnancy were more than twice as likely to have a blood transfusion as compared with those with an elective caesarean delivery.

Double-blind randomized controlled trial comparing misoprostol and oxytocin for management of the third stage of labor in a Nigerian hospital

To compare the efficacy of oral misoprostol with that of oxytocin for active management of the third stage of labor (AMTSL).

Behavioral pattern of menopausal Nigeria women

Context : Menopause is one area that has been shrouded in myths and taboos and the way women perceive menopause depends largely on the social belief about menopause in their society. Objective : The aims of this study are to assess how women perceived the physical changes during menopause, what the social as well as the individual adjustment practice to menopausal changes might be. Materials and Methods : Qualitative focal group study among women aged 40 years and above where eight to ten volunteers formed a group. Six sessions were held for different focal group, each lasting 1-2 h. A tape recorder and a notepad were used to record the discussions. Opinions of the women were sought on socio-cultural differences in the perception of aging, perception of menstruation, perceived causes and consequences of menopause, sexual intercourse after menopause, social support networks for menopausal women, and types of care and treatment for women in menopause. Results: The participants in the FGDs used various phrases to describe menopause in local term; while some of the participants attributed disease to be a cause of menopause, others believed that it be could be caused by witchcraft or sorcery. However, younger and old women whose menstrual flow stops prematurely seek assistance, often from traditional or spiritual healers. Conclusion: This study reveals the poor menopausal knowledge among the study group with more than half of the respondents having negative attitude towards menopause in addition to mixed feelings about religious obligation and cohabitation.

Pattern of sexually transmitted infections in human immunodeficiency virus positive women attending antenatal clinics in north-central Nigeria

Background: Sexually transmitted infections (STIs) are prevalent during pregnancy and may have adverse sequalae in both mother and fetus. Interactions between these infections and human immunodeficiency virus (HIV) synergize and may cause adverse pregnancy outcomes and reverse the gains of prevention of mother to child transmission of HIV. Objectives: The objective of this study is to determine the prevalence of candidiasis, trichomoniasis, gonococcal infection, syphilis, and bacterial vaginosis in HIV pregnant women and compare with HIV negative controls. Materials and Methods: A case-control study was conducted during the period from April to December 2010 at the Department of Obstetrics/Gynecology of University of Ilorin Teaching Hospital and three Primary Health Centers in Ilorin. A total of 160 HIV positive pregnant women attending antenatal clinics were recruited, along with the same number of HIV negative matched controls. A structured proforma was used to collect information from patients, vaginal examination was performed and samples were taken from the endocervix and the posterior vaginal fornix with swab sticks. Results: STIs were recovered from 142 women, giving overall prevalence of 44.4%. HIV infected women had a higher prevalence (60%) compared to uninfected (28.8%). The most prevalent STI was vaginal candidiasis (29.1%), followed by bacterial vaginosis (9.7%), and trichomoniasis (5.6%). The prevalence of candidiasis, bacterial vaginosis, and trichomoniasis was higher among HIV positive pregnant women compared to HIV negative controls ( P Conclusion: The prevalence of candidiasis, bacterial vaginosis and trichomoniasis was higher in HIV infected pregnant women compared to uninfected. Routine screening of HIV infected pregnant women for these organisms is advocated.

A retrospective study of stage IB node-negative cervical cancer treated with adjuvant radiation with standard pelvic versus central small pelvic fields

Objective: To compare two types of postoperative radiation therapy (PORT) in early-stage, node-negative cervical cancer treated at Groote Schuur Hospital, Cape Town, South Africa. Materials and methods: A retrospective observational study of patients with stage IB cervical cancer treated with radical surgery between 1984 and 2010. Node-negative patients regarded as at risk of pelvic recurrence received PORT, with or without concurrent cisplatin or additional vaginal brachytherapy. The PORT was given with either whole pelvis fields (WPF), or with central small pelvic fields (SPF). Data concerning indications for adjuvant therapy, treatment outcomes and grade 3–4 treatment-related toxicities, including leg lymphoedema, were extracted from clinical records. Results: Thirty-one patients received WPF, and 56 SPF. The overall 5-year survival rate was 85%. No significant differences in survival rates were found between the WPF and SPF groups (log rank p = 0.67). Relapse patterns and the crude grade 3–4 treatment morbidity rates did not differ, although two patients in the WPF group (6%) died of treatment-related complications. Conclusions: The expected benefit of PORT with SPF, which targets the cervical tumour bed and para-cervical tissues only, is a reduction in small bowel morbidity and lymphoedema. It is not possible to ascertain from this audit whether the SPF technique reduces complications, or that it increases out-of-field pelvic relapses. It seems unlikely that a randomised controlled trial will ever be performed, as a large sample size would be required. Comparisons of pooled SPF data with historical WPF controls seem the best option to establish the safety of this approach.

Menopause perception and care of menopausal women in Nigeria

This article reviews the response of the Arterial Blood Pressure to resistance exercise. Several researchers have adopted several procedures to establish the effects of exercise on reduction of the arterial blood pressure. It is well documented that resistance exercises have attenuating effects on high blood pressure and improve cardiovascular health. However, the exercise protocol, age, fitness level and intensity and consistency determine the effect on blood pressure. Variant in exercise protocols by different authors have made recommendation of a particular dose for a particular result impossible. However, all the studies reviewed proved that resistance exercise have positive effect on the Blood Pressure and also promote cardiovascular health of all categories of people by reducing the risk of heart diseases.Assessment is a vital component of schooling. There is always the need to examine the extent to which stated objectives are achieved. The popular tools for assessment in the school system are tests and examinations. It is therefore pertinent that they are valid for use. Valid tests/examinations yield dependable information and hence rational and appropriate decision making. To enhance the validity of tests/examinations, regular and appropriate validation procedures are necessary. This paper has therefore provided a simplified framework for the validation of tests/examinations; which should be useful to young researchers, examination bodies and test constructors/users. An in-depth review of related literature on the concepts of validity and validation procedures was done. The implications of the expressed views in the literature were presented. The conceptual framework for the validation of examinations was represented using a diagram.This expository paper examines the role of educational media in promoting Information Communication Technology in Nigerian Universities. It takes a critical look at some empirical studies on students’ academic performance after utilizing educational media. The paper also discusses trends in educational media and factors to be considered in promoting effective utilization of educational media in Universities. It recommends that in order to achieve effective educational media utilization, planning, designing and creation of media equipment should be given adequate consideration for quality assurance in media production and utilization.