The study investigates the hydrogeochemical characteristics of some towns in the Abakaliki Basin, comprising, Ishiagu, Aka Eze, Amaseri, Afikpo and Okposi communities, with the aim of sourcing for portable water in th...The study investigates the hydrogeochemical characteristics of some towns in the Abakaliki Basin, comprising, Ishiagu, Aka Eze, Amaseri, Afikpo and Okposi communities, with the aim of sourcing for portable water in the area. The basin is underlain by Albian sediments, essentially shales, in the lowlands, which were affected by low-grade metamorphism that had produced slates. The highlands comprise basic intrusives from episodes of magmatism and metallic ore mineralisation. Injection of brines into the aquifer system and low, seasonal aquifer recharge from rainfall results in poor water quality in the area. The study analyzes the geochemical distribution in water sources in the area and identifies sources of pollutants to guide the better choice of portable water. Results of hydrogeochemical analysis of both surface and groundwater from the communities were compared with World Health Organization to identify portable water locations in the area. While the salt lake at Okposi is the main source of brine intrusion in the study area, the Pb/Zn mine at Ishiagu is the main source of mine-water pollution in the study area. Most chemical parameters, (especially Cl<sup>-</sup>, Na<sup>+</sup>, Ca<sup>2+</sup>, Mg<sup>2+</sup>, SO<sub>4</sub><sup>2-</sup>, HCO<sub>3</sub><sup>-</sup>) maintain high concentrations within the salt lake area, with the values declining away from the salt lake. The main anthropogenic source of pollution in the area, especially at Ishiagu, is the indiscriminate surface mining of lead-zinc without proposer waste management practices. Possible sourcing for portable water in the study area includes a deep borehole at Ishiagu, away from lead-zinc intrusives. At the Okposi axis, searching for portable water in boreholes should target shallower aquifers that do not communicate with the deeper-seated brine zones, likewise targeting zones farther away from these brine-invaded areas. A controlled pumping rate could potentially ensure that the cone of depression was not low enough to reach the brine zone at depth. In addition, desalination could also potentially render the salt water drinkable if properly handled to eliminate the high concentration of salts in the water to the level of acceptable limit by the WHO. Based on the study, the best area to target for portable water in the study area is Afikpo, with most geochemical elements naturally occurring within WHO’s standard concentration while portable water could be harnessed in areas further away from mining sites, especially at deep groundwater.展开更多
Background: Ectopic pregnancy is a common cause of maternal morbidity and mortality in the 1st trimester of pregnancy;without timely diagnosis and intervention, ruptured ectopic pregnancy can become a life threatening...Background: Ectopic pregnancy is a common cause of maternal morbidity and mortality in the 1st trimester of pregnancy;without timely diagnosis and intervention, ruptured ectopic pregnancy can become a life threatening condition. Objective: This study aims to give baseline indices on the incidence, clinical presentation, risk factors and the management of cases of ectopic pregnancy that presented in Alex Ekwueme Federal University Teaching Hospital, Abakaliki over a 5-year period. Materials and Method: This is a 5-year retrospective study of patients who were diagnosed with ectopic pregnancy between January 1st 2012 and December 31st 2016. The statistical analysis was done using SPSS version 22. Result: During the study period, there were 11,932 deliveries while 7725 Gynaecology patients were admitted. Over the same period there were 156 patients diagnosed and managed for ectopic pregnancy, accounting for 1.31% of all deliveries and 2.0% of all Gynaecological admissions. The modal age group was 26 - 30 years 68 (43.6%), 122 (78.2%) were married, while 34 (21.7%) were single. Nulliparous were 41 (26.3%) and primiparous were 33 (21.2%). The commonest presenting complaints were lower abdominal pain and amenorrhea, and the commonest identified risk factor was previous pelvic inflammatory disease. Most of the cases were ruptured prior to presentation and partial salpingectomy was the management in all tubal pregnancy while two cases were unruptured and had salpingostomy and another case was abdominal pregnancy and had exploratory laparotomy only. Out of 156 women that presented with ectopic pregnancy, 8 (5.1%) died before surgery could be done due to late presentation. Fifty-seven women presented in a state of shock and 9 (5.8%) of the cases were complicated with acute renal failure. Conclusion: Ruptured ectopic pregnancy is a major cause of maternal morbidity and early pregnancy loss. Late presentation is a common feature in our environment;hence widespread advocacy on case identification and early presentation is urgently needed.展开更多
Introduction: Unhygienic cord-care practices are major public health concern because of the associated gross neonatal and infant morbidity and mortality. Various factors have been linked to these practices. This study...Introduction: Unhygienic cord-care practices are major public health concern because of the associated gross neonatal and infant morbidity and mortality. Various factors have been linked to these practices. This study aims to identify the determinants of cord care practices among mothers in Abakaliki, Ebonyi State, South East, Nigeria. Methods: A cross sectional questionnaire based study involving women attending antenatal clinics and those who brought their babies to the immunization clinics of Federal Teaching Hospital, Mile Four Hospital and Maternal/Child Primary Health Care Center, all in Abakaliki. Results: Two hundred and seventy three mothers participated in the study. The majority of the participants aged 26 to 35 years (60.07%), had tertiary education (49.45%) and were business women (38.46%). Mothers who had secondary and tertiary education basically applied methylated spirit (p-value 0.0014) and chlorhexidine (p-value 0.0289) as a form cord care while those who had primary or no formal education cared for cord using hot water, Vaseline, close up tooth paste and local herbs. The mothers educational status, occupation and parity also determined the care given the umbilical cord after birth. Conclusion: Cord care practices are determined and influenced by several factors in Ebonyi State. Health education and awareness campaigns should be upheld and targeted among women of child bearing age found in women meetings, local markets and primary health care delivery centers especially in the rural setting.展开更多
Background: Comprehensive estimates of the incidence of gynaecological malignancies reported from Nigeria are very limited due to limitation in record maintenance. Female cancer is a public health problem the world ov...Background: Comprehensive estimates of the incidence of gynaecological malignancies reported from Nigeria are very limited due to limitation in record maintenance. Female cancer is a public health problem the world over. The malignancies of the female genital organs are major causes of morbidity and mortality which necessitates data for policy formulation and health planning. Aim: To establish the profile of gynaecologic malignancies reported in our centre, with reference to incidence, histological subtypes and frequency of involvement at various sites and to compare the procured data with those from other national and international centers. Materials and Method: In this descriptive retrospective study, the records pertaining to all the pathological specimens categorized as gynaecological malignancies from January 1st, 2013 to December 31st, 2015 at our facility were studied and compared with the available international data. Data analysis was done using Epi Info software version 7.2.1 (CDC Atlanta Georgia). Result: Two hundred and eleven (211) cases of gynaecological malignancies were seen during the study period and this constituted 13.4% of gynaecological admissions. Cervical malignancies were the commonest constituting 49.2% of all gynaecological malignancies followed by ovarian malignancies (27.8%), endometrial cancers (11.9%), vulva (5.6%), choriocarcina (3.9%) and vagina (1.6%). The data obtained was compared with data from Surveillance, Epidemiology and End Result (SEER) programme in the United States and European Union. All malignancies except cervical cancers affected a younger age group at our centre. Cervical cancers presented at a relatively more advanced stage, Ovarian cancers were more localized, whereas uterine, vulva and vaginal cancers presented at a similar stages as compared to Western data. Conclusion: This study presents a composite data of Gynaecological malignancies from Southeast Nigeria. Advanced stage of presentation of cervical cancers suggests lacunae in screening programmes available. Compared with Western data, ovarian malignancies were more localized at presentation for which environmental or genetic factors may be responsible.展开更多
Introduction: Dyspareunia is one of the most common complaints in gynae-cologic practice with tremendous effect on both quality of life and sexual rela-tionship of women. Objectives: To determine the prevalence of dys...Introduction: Dyspareunia is one of the most common complaints in gynae-cologic practice with tremendous effect on both quality of life and sexual rela-tionship of women. Objectives: To determine the prevalence of dyspareunia and its effect on sexual life among gynaecology clinic attendees in Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and Methods: A cross-sectional study was conducted on consenting participants between 12th May 2016 and 25th July 2016. Anonymous self-administered questionnaires were used collection information on dyspareunia and its effect on sexual life at the Gynaecology clinic. The data was analyzed using Epiinfo version 7.1.5. Results: One hundred and four (104) women participated in this study. Most of the women studied were Igbos (95.19%), and were mainly between the age ranges of 21 - 30 years (66.35%). Most of them were married (89.42%), and were also mainly of the Pentecostal denomination (40.78%). The mean age at coitarche was 20.6 ± 3.95 years. Prevalence of dyspareunia was 36% and only 16% sought medical help. The various responses to dyspareunia were avoidance of sex 11%, reduced frequency of intercourse 8%, less desire for sex 19%, while majority of women with dyspareunia tolerated it (62%). Conclusion: The prevalence of dyspareunia is high in our society afflicting young women in their reproductive years with associated enormous stress on their sexual life.展开更多
Background: Pregnancies complicated by diabetes are associated with significant increase in maternal and perinatal morbidity and mortality. The management of diabetes in pregnancy is a great challenge in a low resourc...Background: Pregnancies complicated by diabetes are associated with significant increase in maternal and perinatal morbidity and mortality. The management of diabetes in pregnancy is a great challenge in a low resource setting because of limited resources and facilities to care for these women. Aim: To determine the maternal and perinatal outcomes of diabetic pregnant women managed at Alex Ekwueme Federal University Teaching Hospital Abakaliki, Southeast, Nigeria. Materials and methods: This was a 7-year retrospective case-control study that compared pregnancy outcomes among women with pregnancies complicated by diabetes and those without diabetes managed at Alex Ekwueme Federal University Teaching Hospital, Abakalikibetween January 1st, 2012 and December 31st, 2018. The statistical analysis was done using SPSS version 22. Results: The incidence of diabetes in pregnancy in this study was 6.6 per 1000 deliveries. Of 126 women in diabetic arm of the study, 81 were diagnosed during pregnancy and 45 were known diabetic prior to conception. Over two-thirds of 126 women with pregnancy complicated by diabetes achieved good blood glucose control during pregnancy. Both groups differ in their mean BMI and women with diabetes in pregnancy were more likely to be obese compared with control (diabetic;30.1 ± 2.5 versus control;23.4 ± 2.1, P < 0.0001). Pregnant women with diabetes were more likely to be delivered by cesarean section when compared with non-diabetic women (86 versus 23, OR = 9.6, 95% CI: 5.35 - 17.32, P < 0.0001). Similarly, the incidence of polyhydramnious was higher in paturients with diabetes when compared with the control groups (26 versus 13, OR = 2.2, 95%CI: 1.10 - 4.63, P = 0.02). There were no differences between both study groups with regards to other maternal outcomes. The incidence of fetal macrosomia, neonatal hypoglycemia and neonatal respiratory distress syndrome were significantly higher among women whose pregnancies were complicated by diabetes when compared with the control [Diabetics;fetal macrosomia (62.7%), neonatal hypoglycemia (44.4%) and neonatal respiratory distress syndrome (22.2%) versus Control;fetal macrosomia (34.1%), neonatal hypoglycemia (7.9%) and neonatal respiratory distress syndrome (5.6%) respectively]. Conclusion: Women with pregnancies complicated by diabetes had a higher incidence of adverse maternal and perinatal outcomes. Clinical recognition of diabetes in pregnancy is important because institution of therapy, and antepartum fetal surveillance can reduce the maternal and perinatal morbidity and mortality associated with the condition.展开更多
Background: Labour is a stressful physical and psychological experience in a woman’s life, requiring optimal coping mechanism. Companionship provides such needed support in this vulnerable moment of women. The presen...Background: Labour is a stressful physical and psychological experience in a woman’s life, requiring optimal coping mechanism. Companionship provides such needed support in this vulnerable moment of women. The presence of a companion of the woman’s choice had been noted to have a positive influence on her satisfaction with the birth process. Objectives: To ascertain the attitude of antenatal clinic attendees to companionship in labour and delivery and their preferred companions. Methods: A descriptive cross sectional study was conducted between 10th June 2016 and 28th July 2016 on 297 antenatal clinic attendees at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The respondents completed an anonymous, self-administered questionnaire assessing the attitude of antenatal clinic attendees to companionship in labour and delivery and their preferred companions. The data was analyzed using EpiinfoTM version 7.1.5. Results: A total of 297 pregnant women participated in the study. They were mainly Igbos (93.27%), and Christians (96.97%). Their ages ranged from 18 - 50 years with most of them between 21 - 30 years (68.35%). Most of the women had tertiary education (48%), and were unemployed (36.36%). Ninety two percent of the respondents wished for companionship in labour, while 32.66% has had companion in previous delivery(ies). All of the women that had experienced companionship expressed satisfaction with it. Majority of them preferred their Partners/Husbands as companions (47%). Conclusion: Majority of our women were desirous of companionship and preferred their partners/husbands.展开更多
Background: Microbial keratitis often results in poor visual outcome despite treatment. A revision of treatment protocol based on local evidence may be required in order to obtain better treatment outcome. Objectives:...Background: Microbial keratitis often results in poor visual outcome despite treatment. A revision of treatment protocol based on local evidence may be required in order to obtain better treatment outcome. Objectives: To determine the predisposing factors and predominant microbiological diagnosis of corneal ulcers seen at the Federal Teaching Hospital Abakaliki (FETHA), Ebonyi State, Nigeria. Materials and Methods: This is a preliminary report of an on-going longitudinal descriptive study of all consenting corneal ulcer patients managed at the FETHA eye clinic over a 4-month period. Information obtained were socio-demographic data, presenting complaints, duration of symptoms prior to presentation, history of preceding trauma, medications used before presentation, presenting and final visual acuity and microbiological diagnosis. Results: A diagnosis of corneal ulcer was made in 8 out of the 852 outpatients seen over the study period giving a hospital prevalence rate of 0.59%. Five patients (62.50%) were males, five (62.50%) were farmers and 4 patients (50%) were above 60 years of age. The microbial diagnoses were bacterial keratitis 37.5% (Staphylococcus aureus), fungal keratitis 25% (Fusarium spp. and aspergillus) and acanthamoeba (25%). None of the patients ever used contact lenses. There was a history of eye trauma in 50% of the patients. All the eyes presented blind after a period of failed attempts to treat by self or quacks. Mean duration before presentation was two weeks. Treatment improved the visual acuity in 37.5% of patients. Conclusion: Bacteria, fungi and acanthamoeba organisms were the microbiological isolates from the scrapings of corneal ulcer patients seen in the eye clinic of FETHA;with bacterial organisms being the most common. Farming activities, preceding eye trauma, delayed presentation, self-medication and use of traditional eye medications (TEM) were common findings among the patients. A future larger study is recommended to confirm the findings of this study. Eye health education campaigns should be directed at farmers to encourage early presentation to hospitals.展开更多
Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of child bearing age. About half of these women are asymptomatic. Adverse outcomes are consistently associated with bacterial vaginosis i...Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of child bearing age. About half of these women are asymptomatic. Adverse outcomes are consistently associated with bacterial vaginosis in pregnancy and in the puerperium. This study, which was done to look at the prevalence, involved recruiting 230 participants, and screening them for BV using the Amsel’s criteria. It is hoped that identification and treatment of these women will help prevent some of the sequela associated with BV. Restoration of the vaginal microflora by treating identified cases of BV will also help reduce the transmission of HIV and herpes simplex virus (HSV) as BV propagates their replication and vaginal shedding. Two hundred and thirty women in the age range 16 - 40 years were screened for BV. All the participants douched, soap and water being predominantly used. 55 women (23.9%) had BV based on Amsel’s criteria. Women with only one sexual consort had the highest incidence of BV (51.9%).展开更多
Background: Sickle cell disease (SCD) is associated with an increased risk of medical complications during pregnancy and they constitute a very high-risk group with associated increased maternal and perinatal morbidit...Background: Sickle cell disease (SCD) is associated with an increased risk of medical complications during pregnancy and they constitute a very high-risk group with associated increased maternal and perinatal morbidity and mortality especially in a low resource setting. Objective: To determine the pregnancy outcomes among women with sickle cell disease delivered at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and methods: This was a 7-year retrospective case-control study undertaken from January 2012 to December 2018 that compared pregnancy outcomes among women with and without haemoglobinopathy in pregnancy managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA). The statistical analysis was done using SPSS version 22. Results: The incidence of SCD in pregnancy was 6.9 per 1000 deliveries. The age distribution of the women ranged from 18 to 45 years of age with a mean of 26.4 ± 2.4 years. The incidence of stillbirth was higher in women with HbSS when compared with HbSC but this difference did not reach statistical significance (P = 0.05). Live birth rate was higher in women with HbAA genotype when compared with those with SCD. Caesarean section rate was higher among women with SCD when compared with control (SS versus AA, P = 0.004;SC versus AA, P Conclusion: This study showed that the maternal mortality in SS and SC patients in pregnancy was not different from those of HbAA women in our hospital, although other maternal and fetal outcomes were still poor among women with SCD when compared with women without SCD.展开更多
Background: World over, there has being an improvement in birth spacing resulting in a reduction in the perinatal and maternal morbidity and mortality rates. Objective: To appraise the factors influencing inter-pregna...Background: World over, there has being an improvement in birth spacing resulting in a reduction in the perinatal and maternal morbidity and mortality rates. Objective: To appraise the factors influencing inter-pregnancy interval (IPI) among pregnant women receiving antenatal care at Federal Teaching Hospital Abakaliki. Methods: A descriptive cross-sectional study was done among antenatal attendee, with at least one previous delivery, in Federal Teaching Hospital, Abakaliki over a six month period using a structured questionnaire. Data obtained was analysed using IBM SPSS Statistics version 20. Results: The mean age of the respondents was 28.6 (95% CI 28.1 - 29.1) years. The majority (231, 70%) were multiparous. Most respondent (162, 49.1%) had their last delivery 6 - 12 months prior to conception. The significant determinants of IPI include: maternal age, marital status, place of residence, social class, baby’s sex, family income, use of contraceptive, parity and outcome of her last confinement. Contraceptive knowledge is high (300, 90.9%);more than 50% had the desire to use some form of contraceptive but majority (132, 40%) said they will never use contraceptive after delivery. Conclusions: Majority of the women had an IPI of 6 - 12 months. The major determinant of this includes having a live birth in last delivery, parity, marital status, and place of residence. The attitude to contraception is poor;effort needs to be directed into identifying the immediate and remote causes of this as this will help in proper education and counselling needed to increase contraceptive uptake.展开更多
Background: The placenta is in a key position to determine the final birth weight of foetuses because adequate placental function is necessary for delivery of nutrients, oxygen, and hormones to the foetus. The relatio...Background: The placenta is in a key position to determine the final birth weight of foetuses because adequate placental function is necessary for delivery of nutrients, oxygen, and hormones to the foetus. The relationship between the placental weight and birth weight of the neonates has been reported from several publications but such reports from Abakaliki are lacking in literature. Aim: To determine the relationship between the placental weight and birth weight of the neonates delivered at term at the Alex Ekwueme Federal University Teaching Hospital Abakaliki. Materials and Method: It was a retrospective study conducted between 1st January 2015 and 31st December 2015. The statistical analysis was done using Epi Info software version 7.2.1 (CDC Atlanta Georgia). Result: The mean birth weight was 3344 ± 488 g while the mean placental weight was 617 ± 78 g. The mean placental weight to birth weight ratio (PBWR X 100) was 19.94% ± 4.2%. Increase in birth weight of the neonate was associated with a corresponding increase in placental weight with a strong statistical significance level (P = 0.968). One thousand nine hundred and five (90.5%) patients had PBWR that ranged between 15% and 24%, which was associated with good immediate neonatal outcome. The placental weight to birth weight ratio outside this range was associated with increased admission into NICU and perinatal mortality at an odd ratio of 0.5844 and a statistical significance level (P) of 0.0036. Conclusion: There is a positive correlation between placental weight and birth weight of the neonate. Knowing the PBWR at birth may help to know the foetus at risk of immediate poor neonatal outcome in order to expedite actions to prevent possible poor perinatal outcome.展开更多
<strong>Background: </strong><span style="font-family:;" "=""><span style="font-family:Verdana;">An intensive care unit (ICU) is a special unit of a hospital ...<strong>Background: </strong><span style="font-family:;" "=""><span style="font-family:Verdana;">An intensive care unit (ICU) is a special unit of a hospital that provides intensive treatment for patients with severe or life-threatening illnesses and injuries, which require constant care and close monitoring with life support equipment. The mortality rate is still very high in most ICUs especially in the developing countries due to late presentation of patients, unavailability of well trained staff and lack of life support equipment. There has not been any previous study on the mortality pattern in ICU of Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA). It is against this background that we embarked on this retrospective descriptive hospital based study of the mortality pattern in ICU of a Tertiary Hospital in Abakaliki, South-eastern Nigeria. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">This is a retrospective descriptive hospital based study. The admission and discharge registers of the ICU ward were used to extract information on biodata, diagnosis, duration and outcome of all admissions from January to December 2019 (12</span></span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">months). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 174 (male 113, female 71) patients were admitted over the 12</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">months period with mean age of 46.31</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">12.28</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">years. Seventy</span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">one (40.8%) of the patients died from predominantly stroke, acute abdomen, trauma, sepsis, renal failure, acute diabetic complications and cancer in descending order. Acute diabetic complications had 100% case fatality rate, followed by stroke (71%), renal failure (62.5%), cancer (60%), sepsis (55.5%), acute abdomen (34%) and trauma (23%). The mean duration of ICU admission was 4.2 days for the non-survivors and 6.3 days for survivors. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The ICU mortality rate was high and constituted of mainly stroke, acute abdomen and trauma which are essentially preventable. Female sex, medical diagnosis and ICU admission duration of less than 6 days were associated with higher ICU mortality.</span></span>展开更多
<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Globally, the rise in the rate of caesarean section is becomi...<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Globally, the rise in the rate of caesarean section is becoming a public health problem. This study examined the rate, indications and complications of caesarean section at the Federal Teaching Hospital Abakaliki (FETHA). </span><b><span style="font-family:Verdana;">Subjects and Methods:</span></b><span style="font-family:Verdana;"> This was a </span><span style="font-family:Verdana;">six-year</span><span style="font-family:Verdana;"> retrospective study covering January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2012 to December 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2017. Patients who met the inclusion criteria were identified from the theatre records and their case notes retrieved from the health information unit of the hospital. Information extracted includes sociodemographic data, indications and types of caesarean section performed and the complications. Data was collected using a structured proforma and entered into a secured personal computer. Data analysis was performed </span><span style="font-family:Verdana;">by means of</span><span style="font-family:Verdana;"> Epi Info version 7. Results are presented in tables, means and simple percentages. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">During this period, a total of 11,215 deliveries were recorded at FETHA, of these, 3908 were delivered by CS giving a caesarean section rate of 34.8%. The mean age of the study subjects was 29.3 ± 5.03 years. Almost half (49.7%) of the patients were in the 20 - 29 age group. Multiparous women made up 36.0% while nulliparous women were 12.6%. T</span><span><span style="font-family:Verdana;">he most common indication for an emergency caesarean section was </span><span style="font-family:Verdana;">failure</span><span style="font-family:Verdana;"> to progress in labour with 20.0% contribution and the most common indication for elective caesarean section was </span><span style="font-family:Verdana;">previous</span><span style="font-family:Verdana;"> caesarean section with 13.5%. Majority of the babies were delivered at term (77.0%) with an average gestational age of 38 ± 2.6 weeks. Almost </span><span style="font-family:Verdana;">two-thirds</span><span style="font-family:Verdana;"> of the subjects (62.5%) had </span><span style="font-family:Verdana;">emergency</span><span style="font-family:Verdana;"> caesarean section. The average </span><span style="font-family:Verdana;">birthweight</span><span style="font-family:Verdana;"> was 3.03 ± 0.71 kg. Maternal anaemia was the most common complication </span><span style="font-family:Verdana;">recorded</span><span style="font-family:Verdana;"> 38.0%. There was direct maternal death in 2.0%</span></span><span style="font-family:Verdana;"> of the study population. Severe birth asphyxia was recorded in 12.3% of the babies while there was 3.2% perinatal death. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">There is a high rate of </span><span style="font-family:Verdana;">caesarean</span><span style="font-family:Verdana;"> section from this study. The World Health Organization has stated that there is no additional maternal or fetal benefit with </span><span style="font-family:Verdana;">caesarean</span><span style="font-family:Verdana;"> section rate of greater than 10% - 15%. Stakeholders and </span><span style="font-family:Verdana;">policy makers</span><span style="font-family:Verdana;"> need to do more to mitigate this rising trend.</span></span>展开更多
Background: Post stroke depression (PSD) is the most common psychiatric complication following stroke. There has not been any study to demonstrate its burden in Abakaliki, Nigeria. It is against this backdrop that we ...Background: Post stroke depression (PSD) is the most common psychiatric complication following stroke. There has not been any study to demonstrate its burden in Abakaliki, Nigeria. It is against this backdrop that we embarked on this study of the frequency and pattern of PSD in Abakaliki Nigeria. Method: This is a cross-sectional observational hospital based study undertaken at the Adult Neurology Outpatient Clinics of Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria from February 2021 to July 2021 (6 months period). Results: Amongst the 110 stroke survivors enrolled in the study, 36 (32.7%) had Post Stroke Depression (PSD) with preponderance of mild type. Female gender and young age were associated with the presence of PSD. Conclusion: Post stroke depression is prevalent amongst stroke survivors in Abakaliki, Nigeria and more preponderant in women and young individuals.展开更多
Background: The Bartholin’s gland cysts and abscesses are one of the most common vulva cyst or abscesses in gynaecological practice. Symptomatic cases give significant discomfort to sufferers and have a negative impa...Background: The Bartholin’s gland cysts and abscesses are one of the most common vulva cyst or abscesses in gynaecological practice. Symptomatic cases give significant discomfort to sufferers and have a negative impact on their quality of life. Objective: To investigate the incidence, pattern of presentation and management of Barthholin’s gland cysts and abscesses in the Federal Teaching Hospital Abakaliki (FETHA) Ebonyi State, Nigeria. Methodology: This was a four-year retrospective study of cases of Bartholin’s gland cysts and abscesses in FETHA. We studied all cases of Bartholin’s gland cysts and abscesses that were managed at the Federal Teaching Hospital Abakaliki from 1<sup>st</sup> January 2012 to 31<sup>st</sup> December 2015. Results: During the study period, there were 1015 gynaecological surgical cases of which 18 were for Bartholin’s gland cysts or abscess giving an incidence of 1.78%. The mean age of the patients was 28.8 ± 5.6 years with 61% of the patients within the age range of 21 to 30 years. The commonest risk factor that was found for the occurrence of Bartholin’s gland cyst or abscess was previous history of the disease in 14 (77.8%) followed by previous history of sexually transmitted diseases 8 (44.4%). Pain was the commonest presenting symptom in 14 (77.8%) of cases. The left vulva was the commonest site of disease as noted in 15 (83.3%) of patients. Escherichia coli and Staphylococcus aureus were the commonest isolates on swabs with 16 (88.9%) and 14 (77.8%) prevalence respectively. The disease presented commonly in form of abscess as observed in 10 (55.6%) of patients. All the patients had Marsupialization as the modality of treatment. Conclusion: Symptomatic Bartholin’s gland cyst and abscess cause significant morbidity for the sufferers and decreased quality of life. Accurate diagnosis and treatment is advocated to prevent chronicity and complications. Although options of treatment abound, Marsupialization remains the mainstay of treatment in low resource setting like ours.展开更多
Background: The Federal Teaching Hospital is the only tertiary hospital in Ebonyi State Nigeria. It receives referrals from the general and private hospitals, primary health centers in the state as well as the surroun...Background: The Federal Teaching Hospital is the only tertiary hospital in Ebonyi State Nigeria. It receives referrals from the general and private hospitals, primary health centers in the state as well as the surrounding state. Breast feeding is a social norm among the indigenes of the state hence practiced commonly. Aim: The study was aimed at determining the knowledge and practice of exclusive breast feeding among the women presenting in the hospital. Methods: This was a cross-sectional study in the maternity unit of the hospital over three months’ period from March to May 2015. A structured data sheet was administered to each mother presenting in the maternity unit of the hospital and willing to participate which were consecutively recruited into the study. Results: A total of 500 mothers participated in the study. About 98.4% were aware of exclusive breast feeding while 90.2% practiced it for different reasons and duration. Only 76.4% practiced it for a period of 4 - 6 months. Majority of the mothers (90.0%) got the information about exclusive breast feeding from the hospital. Times of initiation of breast feeding after delivery were 38.2% within 30 minutes and 33.2% an hour respectively. Seventy six percent of the mothers’ breastfed on demand. About 91.6% were willing to practice exclusive breast feeding for subsequent babies. Surprisingly 10.2% of the mothers discarded their colostrums. Practice of exclusive breast feeding was significantly related to educational status and occupation. Conclusion: Greater awareness and practice of exclusive breastfeeding has been achieved but more still needed to be done especially about the time of initiation, giving of colostrums and the duration of exclusive breast feeding since up to 10.4% of the participants still discarded their colostrums particularly those that delivered outside the hospital.展开更多
Hiccups are common, usually mild with no obvious cause and often resolve spontaneously. They are classified as transient, persistent and intractable depending on the duration. Drug induced hiccups have been reported i...Hiccups are common, usually mild with no obvious cause and often resolve spontaneously. They are classified as transient, persistent and intractable depending on the duration. Drug induced hiccups have been reported in medical literature but not common and corticosteroids are often cited. This report involved 2 male patients who developed persistent hiccups following use of oral dexamethasone for inflammatory conditions. The hiccups were severe and intolerable and could not stop despite use of metoclopramide and chlorpromazine. The hiccups only stopped following discontinuation of the dexamethasone. It should be noted that low dose of dexamethasone was used. Management of dexamethasone induced hiccups involves discontinuation of the drug, steroid rotation if the patient is steroid dependent and use of metoclopramide and chlorpromazine. Clinicians should be aware of this known but rare adverse effect of dexamethasone as it could be severe, distressful and negatively impart patients care. There is a need for a high index of suspicion whenever a patient develops hiccups while taking dexamethasone.展开更多
文摘The study investigates the hydrogeochemical characteristics of some towns in the Abakaliki Basin, comprising, Ishiagu, Aka Eze, Amaseri, Afikpo and Okposi communities, with the aim of sourcing for portable water in the area. The basin is underlain by Albian sediments, essentially shales, in the lowlands, which were affected by low-grade metamorphism that had produced slates. The highlands comprise basic intrusives from episodes of magmatism and metallic ore mineralisation. Injection of brines into the aquifer system and low, seasonal aquifer recharge from rainfall results in poor water quality in the area. The study analyzes the geochemical distribution in water sources in the area and identifies sources of pollutants to guide the better choice of portable water. Results of hydrogeochemical analysis of both surface and groundwater from the communities were compared with World Health Organization to identify portable water locations in the area. While the salt lake at Okposi is the main source of brine intrusion in the study area, the Pb/Zn mine at Ishiagu is the main source of mine-water pollution in the study area. Most chemical parameters, (especially Cl<sup>-</sup>, Na<sup>+</sup>, Ca<sup>2+</sup>, Mg<sup>2+</sup>, SO<sub>4</sub><sup>2-</sup>, HCO<sub>3</sub><sup>-</sup>) maintain high concentrations within the salt lake area, with the values declining away from the salt lake. The main anthropogenic source of pollution in the area, especially at Ishiagu, is the indiscriminate surface mining of lead-zinc without proposer waste management practices. Possible sourcing for portable water in the study area includes a deep borehole at Ishiagu, away from lead-zinc intrusives. At the Okposi axis, searching for portable water in boreholes should target shallower aquifers that do not communicate with the deeper-seated brine zones, likewise targeting zones farther away from these brine-invaded areas. A controlled pumping rate could potentially ensure that the cone of depression was not low enough to reach the brine zone at depth. In addition, desalination could also potentially render the salt water drinkable if properly handled to eliminate the high concentration of salts in the water to the level of acceptable limit by the WHO. Based on the study, the best area to target for portable water in the study area is Afikpo, with most geochemical elements naturally occurring within WHO’s standard concentration while portable water could be harnessed in areas further away from mining sites, especially at deep groundwater.
文摘Background: Ectopic pregnancy is a common cause of maternal morbidity and mortality in the 1st trimester of pregnancy;without timely diagnosis and intervention, ruptured ectopic pregnancy can become a life threatening condition. Objective: This study aims to give baseline indices on the incidence, clinical presentation, risk factors and the management of cases of ectopic pregnancy that presented in Alex Ekwueme Federal University Teaching Hospital, Abakaliki over a 5-year period. Materials and Method: This is a 5-year retrospective study of patients who were diagnosed with ectopic pregnancy between January 1st 2012 and December 31st 2016. The statistical analysis was done using SPSS version 22. Result: During the study period, there were 11,932 deliveries while 7725 Gynaecology patients were admitted. Over the same period there were 156 patients diagnosed and managed for ectopic pregnancy, accounting for 1.31% of all deliveries and 2.0% of all Gynaecological admissions. The modal age group was 26 - 30 years 68 (43.6%), 122 (78.2%) were married, while 34 (21.7%) were single. Nulliparous were 41 (26.3%) and primiparous were 33 (21.2%). The commonest presenting complaints were lower abdominal pain and amenorrhea, and the commonest identified risk factor was previous pelvic inflammatory disease. Most of the cases were ruptured prior to presentation and partial salpingectomy was the management in all tubal pregnancy while two cases were unruptured and had salpingostomy and another case was abdominal pregnancy and had exploratory laparotomy only. Out of 156 women that presented with ectopic pregnancy, 8 (5.1%) died before surgery could be done due to late presentation. Fifty-seven women presented in a state of shock and 9 (5.8%) of the cases were complicated with acute renal failure. Conclusion: Ruptured ectopic pregnancy is a major cause of maternal morbidity and early pregnancy loss. Late presentation is a common feature in our environment;hence widespread advocacy on case identification and early presentation is urgently needed.
文摘Introduction: Unhygienic cord-care practices are major public health concern because of the associated gross neonatal and infant morbidity and mortality. Various factors have been linked to these practices. This study aims to identify the determinants of cord care practices among mothers in Abakaliki, Ebonyi State, South East, Nigeria. Methods: A cross sectional questionnaire based study involving women attending antenatal clinics and those who brought their babies to the immunization clinics of Federal Teaching Hospital, Mile Four Hospital and Maternal/Child Primary Health Care Center, all in Abakaliki. Results: Two hundred and seventy three mothers participated in the study. The majority of the participants aged 26 to 35 years (60.07%), had tertiary education (49.45%) and were business women (38.46%). Mothers who had secondary and tertiary education basically applied methylated spirit (p-value 0.0014) and chlorhexidine (p-value 0.0289) as a form cord care while those who had primary or no formal education cared for cord using hot water, Vaseline, close up tooth paste and local herbs. The mothers educational status, occupation and parity also determined the care given the umbilical cord after birth. Conclusion: Cord care practices are determined and influenced by several factors in Ebonyi State. Health education and awareness campaigns should be upheld and targeted among women of child bearing age found in women meetings, local markets and primary health care delivery centers especially in the rural setting.
文摘Background: Comprehensive estimates of the incidence of gynaecological malignancies reported from Nigeria are very limited due to limitation in record maintenance. Female cancer is a public health problem the world over. The malignancies of the female genital organs are major causes of morbidity and mortality which necessitates data for policy formulation and health planning. Aim: To establish the profile of gynaecologic malignancies reported in our centre, with reference to incidence, histological subtypes and frequency of involvement at various sites and to compare the procured data with those from other national and international centers. Materials and Method: In this descriptive retrospective study, the records pertaining to all the pathological specimens categorized as gynaecological malignancies from January 1st, 2013 to December 31st, 2015 at our facility were studied and compared with the available international data. Data analysis was done using Epi Info software version 7.2.1 (CDC Atlanta Georgia). Result: Two hundred and eleven (211) cases of gynaecological malignancies were seen during the study period and this constituted 13.4% of gynaecological admissions. Cervical malignancies were the commonest constituting 49.2% of all gynaecological malignancies followed by ovarian malignancies (27.8%), endometrial cancers (11.9%), vulva (5.6%), choriocarcina (3.9%) and vagina (1.6%). The data obtained was compared with data from Surveillance, Epidemiology and End Result (SEER) programme in the United States and European Union. All malignancies except cervical cancers affected a younger age group at our centre. Cervical cancers presented at a relatively more advanced stage, Ovarian cancers were more localized, whereas uterine, vulva and vaginal cancers presented at a similar stages as compared to Western data. Conclusion: This study presents a composite data of Gynaecological malignancies from Southeast Nigeria. Advanced stage of presentation of cervical cancers suggests lacunae in screening programmes available. Compared with Western data, ovarian malignancies were more localized at presentation for which environmental or genetic factors may be responsible.
文摘Introduction: Dyspareunia is one of the most common complaints in gynae-cologic practice with tremendous effect on both quality of life and sexual rela-tionship of women. Objectives: To determine the prevalence of dyspareunia and its effect on sexual life among gynaecology clinic attendees in Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and Methods: A cross-sectional study was conducted on consenting participants between 12th May 2016 and 25th July 2016. Anonymous self-administered questionnaires were used collection information on dyspareunia and its effect on sexual life at the Gynaecology clinic. The data was analyzed using Epiinfo version 7.1.5. Results: One hundred and four (104) women participated in this study. Most of the women studied were Igbos (95.19%), and were mainly between the age ranges of 21 - 30 years (66.35%). Most of them were married (89.42%), and were also mainly of the Pentecostal denomination (40.78%). The mean age at coitarche was 20.6 ± 3.95 years. Prevalence of dyspareunia was 36% and only 16% sought medical help. The various responses to dyspareunia were avoidance of sex 11%, reduced frequency of intercourse 8%, less desire for sex 19%, while majority of women with dyspareunia tolerated it (62%). Conclusion: The prevalence of dyspareunia is high in our society afflicting young women in their reproductive years with associated enormous stress on their sexual life.
文摘Background: Pregnancies complicated by diabetes are associated with significant increase in maternal and perinatal morbidity and mortality. The management of diabetes in pregnancy is a great challenge in a low resource setting because of limited resources and facilities to care for these women. Aim: To determine the maternal and perinatal outcomes of diabetic pregnant women managed at Alex Ekwueme Federal University Teaching Hospital Abakaliki, Southeast, Nigeria. Materials and methods: This was a 7-year retrospective case-control study that compared pregnancy outcomes among women with pregnancies complicated by diabetes and those without diabetes managed at Alex Ekwueme Federal University Teaching Hospital, Abakalikibetween January 1st, 2012 and December 31st, 2018. The statistical analysis was done using SPSS version 22. Results: The incidence of diabetes in pregnancy in this study was 6.6 per 1000 deliveries. Of 126 women in diabetic arm of the study, 81 were diagnosed during pregnancy and 45 were known diabetic prior to conception. Over two-thirds of 126 women with pregnancy complicated by diabetes achieved good blood glucose control during pregnancy. Both groups differ in their mean BMI and women with diabetes in pregnancy were more likely to be obese compared with control (diabetic;30.1 ± 2.5 versus control;23.4 ± 2.1, P < 0.0001). Pregnant women with diabetes were more likely to be delivered by cesarean section when compared with non-diabetic women (86 versus 23, OR = 9.6, 95% CI: 5.35 - 17.32, P < 0.0001). Similarly, the incidence of polyhydramnious was higher in paturients with diabetes when compared with the control groups (26 versus 13, OR = 2.2, 95%CI: 1.10 - 4.63, P = 0.02). There were no differences between both study groups with regards to other maternal outcomes. The incidence of fetal macrosomia, neonatal hypoglycemia and neonatal respiratory distress syndrome were significantly higher among women whose pregnancies were complicated by diabetes when compared with the control [Diabetics;fetal macrosomia (62.7%), neonatal hypoglycemia (44.4%) and neonatal respiratory distress syndrome (22.2%) versus Control;fetal macrosomia (34.1%), neonatal hypoglycemia (7.9%) and neonatal respiratory distress syndrome (5.6%) respectively]. Conclusion: Women with pregnancies complicated by diabetes had a higher incidence of adverse maternal and perinatal outcomes. Clinical recognition of diabetes in pregnancy is important because institution of therapy, and antepartum fetal surveillance can reduce the maternal and perinatal morbidity and mortality associated with the condition.
文摘Background: Labour is a stressful physical and psychological experience in a woman’s life, requiring optimal coping mechanism. Companionship provides such needed support in this vulnerable moment of women. The presence of a companion of the woman’s choice had been noted to have a positive influence on her satisfaction with the birth process. Objectives: To ascertain the attitude of antenatal clinic attendees to companionship in labour and delivery and their preferred companions. Methods: A descriptive cross sectional study was conducted between 10th June 2016 and 28th July 2016 on 297 antenatal clinic attendees at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The respondents completed an anonymous, self-administered questionnaire assessing the attitude of antenatal clinic attendees to companionship in labour and delivery and their preferred companions. The data was analyzed using EpiinfoTM version 7.1.5. Results: A total of 297 pregnant women participated in the study. They were mainly Igbos (93.27%), and Christians (96.97%). Their ages ranged from 18 - 50 years with most of them between 21 - 30 years (68.35%). Most of the women had tertiary education (48%), and were unemployed (36.36%). Ninety two percent of the respondents wished for companionship in labour, while 32.66% has had companion in previous delivery(ies). All of the women that had experienced companionship expressed satisfaction with it. Majority of them preferred their Partners/Husbands as companions (47%). Conclusion: Majority of our women were desirous of companionship and preferred their partners/husbands.
文摘Background: Microbial keratitis often results in poor visual outcome despite treatment. A revision of treatment protocol based on local evidence may be required in order to obtain better treatment outcome. Objectives: To determine the predisposing factors and predominant microbiological diagnosis of corneal ulcers seen at the Federal Teaching Hospital Abakaliki (FETHA), Ebonyi State, Nigeria. Materials and Methods: This is a preliminary report of an on-going longitudinal descriptive study of all consenting corneal ulcer patients managed at the FETHA eye clinic over a 4-month period. Information obtained were socio-demographic data, presenting complaints, duration of symptoms prior to presentation, history of preceding trauma, medications used before presentation, presenting and final visual acuity and microbiological diagnosis. Results: A diagnosis of corneal ulcer was made in 8 out of the 852 outpatients seen over the study period giving a hospital prevalence rate of 0.59%. Five patients (62.50%) were males, five (62.50%) were farmers and 4 patients (50%) were above 60 years of age. The microbial diagnoses were bacterial keratitis 37.5% (Staphylococcus aureus), fungal keratitis 25% (Fusarium spp. and aspergillus) and acanthamoeba (25%). None of the patients ever used contact lenses. There was a history of eye trauma in 50% of the patients. All the eyes presented blind after a period of failed attempts to treat by self or quacks. Mean duration before presentation was two weeks. Treatment improved the visual acuity in 37.5% of patients. Conclusion: Bacteria, fungi and acanthamoeba organisms were the microbiological isolates from the scrapings of corneal ulcer patients seen in the eye clinic of FETHA;with bacterial organisms being the most common. Farming activities, preceding eye trauma, delayed presentation, self-medication and use of traditional eye medications (TEM) were common findings among the patients. A future larger study is recommended to confirm the findings of this study. Eye health education campaigns should be directed at farmers to encourage early presentation to hospitals.
文摘Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of child bearing age. About half of these women are asymptomatic. Adverse outcomes are consistently associated with bacterial vaginosis in pregnancy and in the puerperium. This study, which was done to look at the prevalence, involved recruiting 230 participants, and screening them for BV using the Amsel’s criteria. It is hoped that identification and treatment of these women will help prevent some of the sequela associated with BV. Restoration of the vaginal microflora by treating identified cases of BV will also help reduce the transmission of HIV and herpes simplex virus (HSV) as BV propagates their replication and vaginal shedding. Two hundred and thirty women in the age range 16 - 40 years were screened for BV. All the participants douched, soap and water being predominantly used. 55 women (23.9%) had BV based on Amsel’s criteria. Women with only one sexual consort had the highest incidence of BV (51.9%).
文摘Background: Sickle cell disease (SCD) is associated with an increased risk of medical complications during pregnancy and they constitute a very high-risk group with associated increased maternal and perinatal morbidity and mortality especially in a low resource setting. Objective: To determine the pregnancy outcomes among women with sickle cell disease delivered at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and methods: This was a 7-year retrospective case-control study undertaken from January 2012 to December 2018 that compared pregnancy outcomes among women with and without haemoglobinopathy in pregnancy managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA). The statistical analysis was done using SPSS version 22. Results: The incidence of SCD in pregnancy was 6.9 per 1000 deliveries. The age distribution of the women ranged from 18 to 45 years of age with a mean of 26.4 ± 2.4 years. The incidence of stillbirth was higher in women with HbSS when compared with HbSC but this difference did not reach statistical significance (P = 0.05). Live birth rate was higher in women with HbAA genotype when compared with those with SCD. Caesarean section rate was higher among women with SCD when compared with control (SS versus AA, P = 0.004;SC versus AA, P Conclusion: This study showed that the maternal mortality in SS and SC patients in pregnancy was not different from those of HbAA women in our hospital, although other maternal and fetal outcomes were still poor among women with SCD when compared with women without SCD.
文摘Background: World over, there has being an improvement in birth spacing resulting in a reduction in the perinatal and maternal morbidity and mortality rates. Objective: To appraise the factors influencing inter-pregnancy interval (IPI) among pregnant women receiving antenatal care at Federal Teaching Hospital Abakaliki. Methods: A descriptive cross-sectional study was done among antenatal attendee, with at least one previous delivery, in Federal Teaching Hospital, Abakaliki over a six month period using a structured questionnaire. Data obtained was analysed using IBM SPSS Statistics version 20. Results: The mean age of the respondents was 28.6 (95% CI 28.1 - 29.1) years. The majority (231, 70%) were multiparous. Most respondent (162, 49.1%) had their last delivery 6 - 12 months prior to conception. The significant determinants of IPI include: maternal age, marital status, place of residence, social class, baby’s sex, family income, use of contraceptive, parity and outcome of her last confinement. Contraceptive knowledge is high (300, 90.9%);more than 50% had the desire to use some form of contraceptive but majority (132, 40%) said they will never use contraceptive after delivery. Conclusions: Majority of the women had an IPI of 6 - 12 months. The major determinant of this includes having a live birth in last delivery, parity, marital status, and place of residence. The attitude to contraception is poor;effort needs to be directed into identifying the immediate and remote causes of this as this will help in proper education and counselling needed to increase contraceptive uptake.
文摘Background: The placenta is in a key position to determine the final birth weight of foetuses because adequate placental function is necessary for delivery of nutrients, oxygen, and hormones to the foetus. The relationship between the placental weight and birth weight of the neonates has been reported from several publications but such reports from Abakaliki are lacking in literature. Aim: To determine the relationship between the placental weight and birth weight of the neonates delivered at term at the Alex Ekwueme Federal University Teaching Hospital Abakaliki. Materials and Method: It was a retrospective study conducted between 1st January 2015 and 31st December 2015. The statistical analysis was done using Epi Info software version 7.2.1 (CDC Atlanta Georgia). Result: The mean birth weight was 3344 ± 488 g while the mean placental weight was 617 ± 78 g. The mean placental weight to birth weight ratio (PBWR X 100) was 19.94% ± 4.2%. Increase in birth weight of the neonate was associated with a corresponding increase in placental weight with a strong statistical significance level (P = 0.968). One thousand nine hundred and five (90.5%) patients had PBWR that ranged between 15% and 24%, which was associated with good immediate neonatal outcome. The placental weight to birth weight ratio outside this range was associated with increased admission into NICU and perinatal mortality at an odd ratio of 0.5844 and a statistical significance level (P) of 0.0036. Conclusion: There is a positive correlation between placental weight and birth weight of the neonate. Knowing the PBWR at birth may help to know the foetus at risk of immediate poor neonatal outcome in order to expedite actions to prevent possible poor perinatal outcome.
文摘<strong>Background: </strong><span style="font-family:;" "=""><span style="font-family:Verdana;">An intensive care unit (ICU) is a special unit of a hospital that provides intensive treatment for patients with severe or life-threatening illnesses and injuries, which require constant care and close monitoring with life support equipment. The mortality rate is still very high in most ICUs especially in the developing countries due to late presentation of patients, unavailability of well trained staff and lack of life support equipment. There has not been any previous study on the mortality pattern in ICU of Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA). It is against this background that we embarked on this retrospective descriptive hospital based study of the mortality pattern in ICU of a Tertiary Hospital in Abakaliki, South-eastern Nigeria. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">This is a retrospective descriptive hospital based study. The admission and discharge registers of the ICU ward were used to extract information on biodata, diagnosis, duration and outcome of all admissions from January to December 2019 (12</span></span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">months). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 174 (male 113, female 71) patients were admitted over the 12</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">months period with mean age of 46.31</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">12.28</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">years. Seventy</span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">one (40.8%) of the patients died from predominantly stroke, acute abdomen, trauma, sepsis, renal failure, acute diabetic complications and cancer in descending order. Acute diabetic complications had 100% case fatality rate, followed by stroke (71%), renal failure (62.5%), cancer (60%), sepsis (55.5%), acute abdomen (34%) and trauma (23%). The mean duration of ICU admission was 4.2 days for the non-survivors and 6.3 days for survivors. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The ICU mortality rate was high and constituted of mainly stroke, acute abdomen and trauma which are essentially preventable. Female sex, medical diagnosis and ICU admission duration of less than 6 days were associated with higher ICU mortality.</span></span>
文摘<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Globally, the rise in the rate of caesarean section is becoming a public health problem. This study examined the rate, indications and complications of caesarean section at the Federal Teaching Hospital Abakaliki (FETHA). </span><b><span style="font-family:Verdana;">Subjects and Methods:</span></b><span style="font-family:Verdana;"> This was a </span><span style="font-family:Verdana;">six-year</span><span style="font-family:Verdana;"> retrospective study covering January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2012 to December 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2017. Patients who met the inclusion criteria were identified from the theatre records and their case notes retrieved from the health information unit of the hospital. Information extracted includes sociodemographic data, indications and types of caesarean section performed and the complications. Data was collected using a structured proforma and entered into a secured personal computer. Data analysis was performed </span><span style="font-family:Verdana;">by means of</span><span style="font-family:Verdana;"> Epi Info version 7. Results are presented in tables, means and simple percentages. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">During this period, a total of 11,215 deliveries were recorded at FETHA, of these, 3908 were delivered by CS giving a caesarean section rate of 34.8%. The mean age of the study subjects was 29.3 ± 5.03 years. Almost half (49.7%) of the patients were in the 20 - 29 age group. Multiparous women made up 36.0% while nulliparous women were 12.6%. T</span><span><span style="font-family:Verdana;">he most common indication for an emergency caesarean section was </span><span style="font-family:Verdana;">failure</span><span style="font-family:Verdana;"> to progress in labour with 20.0% contribution and the most common indication for elective caesarean section was </span><span style="font-family:Verdana;">previous</span><span style="font-family:Verdana;"> caesarean section with 13.5%. Majority of the babies were delivered at term (77.0%) with an average gestational age of 38 ± 2.6 weeks. Almost </span><span style="font-family:Verdana;">two-thirds</span><span style="font-family:Verdana;"> of the subjects (62.5%) had </span><span style="font-family:Verdana;">emergency</span><span style="font-family:Verdana;"> caesarean section. The average </span><span style="font-family:Verdana;">birthweight</span><span style="font-family:Verdana;"> was 3.03 ± 0.71 kg. Maternal anaemia was the most common complication </span><span style="font-family:Verdana;">recorded</span><span style="font-family:Verdana;"> 38.0%. There was direct maternal death in 2.0%</span></span><span style="font-family:Verdana;"> of the study population. Severe birth asphyxia was recorded in 12.3% of the babies while there was 3.2% perinatal death. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">There is a high rate of </span><span style="font-family:Verdana;">caesarean</span><span style="font-family:Verdana;"> section from this study. The World Health Organization has stated that there is no additional maternal or fetal benefit with </span><span style="font-family:Verdana;">caesarean</span><span style="font-family:Verdana;"> section rate of greater than 10% - 15%. Stakeholders and </span><span style="font-family:Verdana;">policy makers</span><span style="font-family:Verdana;"> need to do more to mitigate this rising trend.</span></span>
文摘Background: Post stroke depression (PSD) is the most common psychiatric complication following stroke. There has not been any study to demonstrate its burden in Abakaliki, Nigeria. It is against this backdrop that we embarked on this study of the frequency and pattern of PSD in Abakaliki Nigeria. Method: This is a cross-sectional observational hospital based study undertaken at the Adult Neurology Outpatient Clinics of Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria from February 2021 to July 2021 (6 months period). Results: Amongst the 110 stroke survivors enrolled in the study, 36 (32.7%) had Post Stroke Depression (PSD) with preponderance of mild type. Female gender and young age were associated with the presence of PSD. Conclusion: Post stroke depression is prevalent amongst stroke survivors in Abakaliki, Nigeria and more preponderant in women and young individuals.
文摘Background: The Bartholin’s gland cysts and abscesses are one of the most common vulva cyst or abscesses in gynaecological practice. Symptomatic cases give significant discomfort to sufferers and have a negative impact on their quality of life. Objective: To investigate the incidence, pattern of presentation and management of Barthholin’s gland cysts and abscesses in the Federal Teaching Hospital Abakaliki (FETHA) Ebonyi State, Nigeria. Methodology: This was a four-year retrospective study of cases of Bartholin’s gland cysts and abscesses in FETHA. We studied all cases of Bartholin’s gland cysts and abscesses that were managed at the Federal Teaching Hospital Abakaliki from 1<sup>st</sup> January 2012 to 31<sup>st</sup> December 2015. Results: During the study period, there were 1015 gynaecological surgical cases of which 18 were for Bartholin’s gland cysts or abscess giving an incidence of 1.78%. The mean age of the patients was 28.8 ± 5.6 years with 61% of the patients within the age range of 21 to 30 years. The commonest risk factor that was found for the occurrence of Bartholin’s gland cyst or abscess was previous history of the disease in 14 (77.8%) followed by previous history of sexually transmitted diseases 8 (44.4%). Pain was the commonest presenting symptom in 14 (77.8%) of cases. The left vulva was the commonest site of disease as noted in 15 (83.3%) of patients. Escherichia coli and Staphylococcus aureus were the commonest isolates on swabs with 16 (88.9%) and 14 (77.8%) prevalence respectively. The disease presented commonly in form of abscess as observed in 10 (55.6%) of patients. All the patients had Marsupialization as the modality of treatment. Conclusion: Symptomatic Bartholin’s gland cyst and abscess cause significant morbidity for the sufferers and decreased quality of life. Accurate diagnosis and treatment is advocated to prevent chronicity and complications. Although options of treatment abound, Marsupialization remains the mainstay of treatment in low resource setting like ours.
文摘Background: The Federal Teaching Hospital is the only tertiary hospital in Ebonyi State Nigeria. It receives referrals from the general and private hospitals, primary health centers in the state as well as the surrounding state. Breast feeding is a social norm among the indigenes of the state hence practiced commonly. Aim: The study was aimed at determining the knowledge and practice of exclusive breast feeding among the women presenting in the hospital. Methods: This was a cross-sectional study in the maternity unit of the hospital over three months’ period from March to May 2015. A structured data sheet was administered to each mother presenting in the maternity unit of the hospital and willing to participate which were consecutively recruited into the study. Results: A total of 500 mothers participated in the study. About 98.4% were aware of exclusive breast feeding while 90.2% practiced it for different reasons and duration. Only 76.4% practiced it for a period of 4 - 6 months. Majority of the mothers (90.0%) got the information about exclusive breast feeding from the hospital. Times of initiation of breast feeding after delivery were 38.2% within 30 minutes and 33.2% an hour respectively. Seventy six percent of the mothers’ breastfed on demand. About 91.6% were willing to practice exclusive breast feeding for subsequent babies. Surprisingly 10.2% of the mothers discarded their colostrums. Practice of exclusive breast feeding was significantly related to educational status and occupation. Conclusion: Greater awareness and practice of exclusive breastfeeding has been achieved but more still needed to be done especially about the time of initiation, giving of colostrums and the duration of exclusive breast feeding since up to 10.4% of the participants still discarded their colostrums particularly those that delivered outside the hospital.
文摘Hiccups are common, usually mild with no obvious cause and often resolve spontaneously. They are classified as transient, persistent and intractable depending on the duration. Drug induced hiccups have been reported in medical literature but not common and corticosteroids are often cited. This report involved 2 male patients who developed persistent hiccups following use of oral dexamethasone for inflammatory conditions. The hiccups were severe and intolerable and could not stop despite use of metoclopramide and chlorpromazine. The hiccups only stopped following discontinuation of the dexamethasone. It should be noted that low dose of dexamethasone was used. Management of dexamethasone induced hiccups involves discontinuation of the drug, steroid rotation if the patient is steroid dependent and use of metoclopramide and chlorpromazine. Clinicians should be aware of this known but rare adverse effect of dexamethasone as it could be severe, distressful and negatively impart patients care. There is a need for a high index of suspicion whenever a patient develops hiccups while taking dexamethasone.
