Background: Hypertensive disorders are one of the most common medical complications of pregnancy. It is a major cause of fetomaternal morbidity and mortality. Objectives: This article compares the clinical outcome of anesthetic techniques for parturients with hypertensive disorder undergoing cesarean section. Methods: We conducted a retrospective review of the medical records of patients with hypertensive disorders in pregnancy, who underwent cesarean section from January 2016 to December 2017. Data collected included demographic profiles, specific hypertensive disorders, anesthetic techniques, and maternal and neonatal outcome. Result: Over the reviewed period, 1294 cesarean sections were done, out of which 95 (7.3%) patients had hypertensive disorders in pregnancy. Preeclampsia was the most common hypertensive disorder (45.3%) and it was more common among the multiparus patients. Eight-two patients (86.3%) underwent subarachnoid block with 0.5% heavy bupivacaine, 10 patients (10.5%) had general anesthesia with relaxant technique using isoflurane as the volatile agent, whereas three patients (3.2%) had epidural block with 0.5% plain bupivacaine. Eighty-six patients (90.5%) were done as emergency whereas nine patients (9.5%) were done as elective. A total of 82 (86.3%) neonates had good APGAR score of >7. There was no significant difference between the anesthetic techniques and neonatal outcome, P = 0.642. The proportion of blood loss was more during emergency surgeries. There was no statistical significant difference between the nature of surgery and estimated blood loss, P = 0.691. Out of the 95 parturient, 12 (12.6%) had hypotension that necessitated use of vasopressor (ephedrine), out of which 11 cases were done as emergency whereas one was done as elective. There was no significant difference between the nature of the surgery and the use of vasopressor, P = 0.942. Conclusion: The choice of anesthesia did not have a significant difference on maternal and neonatal outcome following cesarean section in parturient with hypertensive disorders in pregnancy.
Background: Hypertension is the single most important modifiable risk factor for developing stroke and its recurrence. Evidence suggests that antihypertensive treatment rates following stroke remain poor worldwide and non-adherence to secondary preventive medication is a disturbing clinical problem associated with recurrence and poor outcomes. Aim: The aim of this study was to determine the predictors of non-adherence to antihypertensive medications among stroke survivors 3 months after their stroke. Materials and methods: This was a cross-sectional study, involving stroke survivors attending the out-patient neurology clinic at the University of Benin Teaching Hospital, Benin City, 3 months after their stroke. Demographic and clinical characteristic were obtained, with a questionnaire, while medication adherence was measured by pill count method. In the final logistic regression analysis, the independent variables were age, gender, educational status, marital status, modified Rankin scale, polypharmacy, and types of stroke while medication non-adherence was the dependent variable. Results: One hundred and twelve stroke survivors participated. There were 58(51.8%) males and the mean age was 72(12) years. The non-adherence rate in this study was 57.1 %(64/112). The significant predictors of non-adherence to antihypertensive medications were the female gender ( P = 0.009), severe disability ( P = 0.003), the older participants ( P = 0.004), and polypharmacy ( P = 0.002). Conclusion: Non-adherence to antihypertensive drugs following stroke was observed in our study, which would affect blood pressure control leading to stroke recurrence. To prevent recurrent strokes, stroke survivors must adhere to their antihypertensive drugs, while involving patient and family members in decision making with regards to treatment plans.
Introduction: Glaucoma is a blinding eye disease, the hallmark of which is elevation of intraocular pressure (IOP). Glaucoma is nearly impossible to diagnose and treat without expensive equipment and IOP reduction, respectively. Hence, the need for a biomarker is an aid in diagnosis and an alternative treatment option to IOP reduction. Brain-derived neurotrophic factor (BDNF) may serve as both a biomarker and a therapeutic option. However, the exact role of BDNF and its dynamics during glaucoma is not well demonstrated, especially in a Sub-Saharan African population. This study, therefore, examines the serum levels of BDNF and its relationship with IOP. Patients and Methods: Intraocular pressure (IOP) and serum BDNF were measured in 44 glaucoma patients and 41 controls. Results: Glaucoma patients had higher IOP compared to controls. They also had higher BDNF (2.578 ± 0.210) compared to controls (1.745 ± 0.111). Glaucoma patients on medications had higher BDNF (3.086 ± 0.180) compared to those not on medications (0.605 ± 0.116). Serum BDNF significantly correlated with IOP. Conclusion: In conclusion, glaucoma patients have higher IOP and serum BDNF concentrations compared to nonglaucoma controls. IOP negatively correlates with serum BDNF in patients with glaucoma. Untreated glaucoma appears to decrease serum levels of BDNF, whereas treatment of the condition increases it. Serum BDNF may serve as a potential therapeutic target and useful diagnostic and monitoring tool in the management of glaucoma.
Background: Pregnancy-induced hypertension (PIH) is a syndrome of hypertension with or without proteinuria, occurring when systolic blood pressure is greater than or equal to 140 mmHg and diastolic blood pressure is greater than or equal to 90 mmHg at gestational age of 20 weeks and above in a woman who has been previously normotensive. Doppler ultrasound (DUS) is now routinely used for evaluation of accessible vessels, hence its clinical application in patients with PIH. Aims and Objective: To evaluate the usefulness of DUS of the uterine artery (UA) in women with PIH. Materials and Methods: This was a prospective case–control study in which ultrasound examination of the uterus of 400 patients (200 hypertensive and 200 normotensive pregnant women) was performed. The UA Doppler indices, resistivity index, and systolic/diastolic ratio (RI and SD/DV) were recorded. Results: The mean RI in the PIH group (0.64 ± 0.07) was significantly higher than the mean of 0.50 ± 0.06 among the control group (t = 19.922, df = 398; P < 0.0001). In addition, the mean SD/DV ratio was significantly higher in the PIH group (3.04 ± 0.67) than in the control group (2.09 ± 0.29) (t = 18.270, df = 398; P < 0.0001). The Doppler spectral waveform patterns of the UA in both the groups revealed the presence of diastolic notch in 81.5% of the patients with PIH but in none of the control patients (Fisher’s exact P < 0.0001). Conclusion: Doppler parameters of the UA are abnormal in PIH, and its predictive value in PIH would be useful in the management of such patients.
Background High incidence of malnutrition have been reported in patients with a moderate and advanced HIV disease, but data on the nutritional status of patients with early and mild HIV infection are lacking. This study compared the nutritional status of antiretroviral therapy (ART)-naïve HIV-positive patients with high CD4 counts receiving care in Kaduna state to HIV negative controls.Materials and Methods Consecutive 90 consenting HIV-infected adults, who were ineligible for ART in the 2013 treatment guideline, were enrolled alongside 90 age-and-sex-matched HIV seronegative healthy individuals, and compared for body mass index (BMI), hemoglobin, serum albumin, vitamin B12, zinc, and copper.Results Majority (77%) of participants in both groups were females, slightly younger than the males (ages 39.0 ± 4.0 vs 40.0 ± 2.2 years, P > 0.05). HIV-negative persons had significantly higher nutritional indices (BMI, serum albumin, vitamin B12, zinc, and copper levels) than HIV-infected patients, whereas the indices were worse in WHO clinical stage II than WHO clinical stage I patients. HIV and marital status were significantly associated with malnutrition.Conclusion WHO clinical stage I/II HIV-infected persons have significantly lower nutritional indices than HIV-negative controls. Significant malnutrition therefore occurs in early HIV infection before the start of anti-retrovirals (ARVs) and the occurrence of opportunistic infections.
Acute aortic dissection is a medical emergency with high mortality. It presents mostly with typical features of sudden onset chest pain that is tearing in nature and radiates to the back, neck, or the abdomen. However, it may present with atypical features like abdominal pain, nonspecific abdominal or chest discomfort, altered bowel habit, vomiting, and features of acute renal dysfunction leading to diagnostic dilenma. These atypical features are mostly reported in western population. We report a case of 48-year old man with Stanford type B acute aortic dissection that was initially diagnosed as acute abdomen.
Introduction: Biliary ascites is a rare condition in infancy and is commonly caused by the perforation of the extrahepatic bile duct. The cystic duct is the part of extrahepatic biliary tract most rarely affected. This is likely to be the first case of biliary ascites of infancy, secondary to spontaneous cystic duct perforation in our centre. Methods: Consent was obtained from the parents of the child. Ethical approval was also obtained from the research and ethics committee of Ahmadu Bello University Teaching Hospital, Shika, Zaria. The case notes of the child were summarized and the relevant literature was reviewed to give the report a context. Results: A three-month-old boy presented with ten days history of jaundice, a week history of abdominal distention, and a day’s history of fever. There was associated bilateral inguinal hernia, excessive cry, refusal to feed, and weight loss. Pregnancy history was normal. He was acutely ill-looking, irritable, febrile with an axillary temperature of 37.7°C, mildly pale, jaundiced with a greenish tinge, had a weight of 4.7kg. He had gross ascites and bilateral reducible inguinal hernia. Bedside abdominal paracentesis reveals thick yellow and foamy fluid. Abdominal ultrasound scan revealed gross ascites, clotting profile was deranged, there was hyperbilirubinaemia of 228 umol/L, other laboratory results including liver function test were normal. He was commenced on medical management for presumed sepsis with obstructive jaundice. Five days into the admission, there was no significant improvement, and the diagnosis was reviewed to a ruptured choledochal cyst and the child was prepared for an explorative laparotomy. Intra-operatively, the cystic duct was perforated. Cholecystectomy and repair of the common bile duct were performed and the child did well postoperatively. Conclusion: Perforated cystic duct should be suspected in infants presenting with jaundice abdominal distension, acholic stools with or without fever, vomiting, and inguinal hernias. Early diagnosis and prompt surgical intervention greatly reduce morbidity and mortality from the disease.
Introduction: Severe acute malnutrition (SAM) is a disease of the developing world. Poverty and famine have escalated its prevalence. In Nigeria, the Boko Haram menace has resulted in an upsurge of internally displaced persons in need of food and shelter. It is estimated that about 16 million children are affected by malnutrition worldwide and accounts for two million deaths worldwide annually. Evidence suggests incomplete vaccination predisposes to malnutrition and its unwanted sequelae. Anecdotal findings show that most siblings of children with SAM were incompletely vaccinated and hence are at risk of SAM. The study thus aimed at assessing their socio demographic characteristics and immunization to document their vulnerability to development of SAM. Materials and Methods: This was a cross-sectional study of socio-demographic characteristics and immunization status of siblings of children with SAM being rehabilitated in the Paediatric nutrition clinic of Ahmadu Bello University Teaching Hospital Shika Zaria, between March 2009 and September 2014. The information was directly obtained from the mothers of the children as they presented to the clinic and then recorded into a structured questionnaire. Results: The socio-demographic characteristics of 229 parents and immunization status of siblings of children with SAM were reviewed. Most family settings were monogamous (54.2%) and the majority of the fathers were semi-skilled labourers (26.2%). Only 76 (33.2%) of the mothers had some form of formal education while 153 (66.8%) were not formally educated. The majority of the subjects received BCG vaccine but only 56% and 55.5% of the subjects completed their DPT3 and oral polio 3 vaccinations respectively. Conclusion: The study showed that fathers of siblings of children with SAM were semi-skilled labourers while their mothers were predominantly stay at home and not formally educated with limited source of income. Furthermore, BCG vaccination was the most commonly received vaccine and it is recommended that concerted effort should be made towards improving vaccine delivery among siblings of children with SAM. Adult literacy and empowerment of mothers may help achieve improved immunization of siblings of children with SAM.
Background: Routine eye screening of pupils in schools as a matter of health policy is not obligatory in Nigeria. The administrative setting, organization, environment and social background of pupils in public and private schools are often different. Objectives : To determine the ocular health status of pupils in private and public primary schools in Sabon-Gari, Zaria, Kaduna state, Nigeria, and ascertain whether there are differences. Materials and Methods: This was a descriptive cross-sectional study. A multistage sampling technique was used to select the pupils. Visual acuity assessment using Snellen’s chart was done while anterior segment examination was carried out with a pen torch and loupe. Posterior segment was examined using a direct ophthalmoscope (Heine Beta 200). Results: A total of 540 pupils were selected from six primary schools, comprising 270 from three private schools and an equal number from 3 public schools. The ages of the pupils ranged from 3 to 16 years with a mean of 8.42 (SD ± 2.16). Females were 272 (50.4%) and males 268 (49.6%) (F:M = 1.01:1). The prevalence of ocular morbidities from the study was 22.8%. It was 24.4% in public and 21.1% in private schools respectively. Ametropia was the commonest ocular disorder seen in private schools pupils, 17 (6.3%), while vernal conjunctivitis, 23 (8.5%), was the most frequent findings in the public schools. Conclusion: Though ametropia was the commonest ocular morbidity seen among private school pupils and allergic conjunctivitis among those in public schools, these were not statistically significant ( P > 0.05).
Introduction: Neonatal male circumcision is routinely carried out in most places in Nigeria, sub-Saharan Africa. The main reasons why parents bring their sons for circumcision are religious and cultural with a few medical indications like phimosis, paraphimosis and balanitis also being noted. Several techniques of this age long practice have been described and options range from the non-device to device techniques. Circumcision with the Gomco clamp (GC) is not yet as popular in this part of the world even though it has been reported to be safe. Aims and Objectives: To describe our experience and technique using the gomco clamp (GC) for neonatal male circumcision in our environment. Materials and Methods: A retrospective study of 63 newborn boys whose parents gave consent and who were assessed and found fit for circumcision from August 2015 to November 2015 was carried out. They all had circumcision by the same surgeon using gomco clamp at Garki hospital Abuja, Nigeria. Data obtained from patients’ medical records included age, indication, size of gomco clamp and any procedure related complications. They were followed up at 6weeks in the surgical outpatient clinic and then 1year by telephone call to their parents. Results: The average age of the male neonates at circumcision was 10.8 +/- 4.38 days (range from 6 to 26 days) and median age 8days. The indications for circumcision were religion (43, 68%) and cultural (20, 32%). The only early procedure-related complications observed was mild bleeding in two (3.2%) boys and this succumbed to simple pressure. Long term complications included one (1.6%) each penile skin bridge following adhesions between the prepuce and glans and redundant foreskin which were corrected by free hand dorsal and ventral slit circumcision at 8months. Conclusion: Male circumcision can be performed at any age, but there are cost and safety benefits of doing this procedure during the neonatal period. Circumcision using the Gomco clamp (GC) is simple to learn.
Background: The maxillary sinus is characterized by a considerable variation in sizes and shapes and between the right and left sides. Due to easy access to all its walls and surfaces, imaging via computerized tomography (CT) has enhanced the quality and quantity of information obtainable from the assessment of the maxillary sinus. Aim: To determine normal variations in shapes and symmetry of the maxillary sinus using CT. Methods: A total of 130 subjects comprising 79 males and 51 females, between the ages of 20 and 80 years, with normal maxillary sinus CT anatomy, who had head CT scans carried out at the Radiology Department of the Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, over a period of five years, were used for this study. Images were taken with a GE Bright Speed Multidetector Helical CT (GE Healthcare, USA, 2005) Scanner, while films were viewed on the computer monitor. Variations in shapes of the maxillary sinus were identified on axial images and classified based on their resemblance to known shapes of solids. Data were analyzed using Minitab 16.0 statistical package (Minitab inc. USA). Results: Five distinct shapes of the maxillary sinus were identified. These were: irregular in two subjects (0.77%) (right = 1 and left = 1); oval in three subjects (1.15%) (right = 2 and left = 1); quadrangular in three subjects (1.15%) (right = 2 and left = 1); spherical in 61 subjects (23.46%) (right = 30 and left = 31); and triangular 191 (73.46%) (right = 95 and left = 96). Shapes were symmetrical in 85.38% and asymmetrical in 14.62% of subjects. Conclusion: Five normal but distinct shapes of the maxillary sinus were identified, with the predominant shape, being the triangular type, and sinuses of individuals were frequently symmetrical in shape.
Background: Complications can arise during the postpartum period and if unrecognized can lead to physical discomfort, psychological distress, and a poor quality of life for the mothers. The true burden of postpartum maternal morbidity is still not known. It is estimated to be highest in low- and middle-income countries. Objective: This study was aimed at determining the pattern of postpartum morbidities at Aminu Kano Teaching Hospital and their possible determinants. Methodology: It was a cross-sectional study of women admitted into postnatal ward of Aminu Kano Teaching Hospital, Kano, Nigeria, on account of postpartum morbidities from January 1to December 31, 2016. The admission register of antenatal/postnatal ward was retrieved and only women admitted within the postpartum period were included in the study. Result: There were 3933 deliveries over the studied period and 141 women were admitted for postpartum morbidities. The most common morbidities were anaemia (35.5%), hypertensive disorders (19.6%), and puerperal sepsis (19.6%). Nearly 70% of the patients were unbooked and had spontaneous vaginal delivery. There was a significant association between postpartum morbidities and booking status, level of educational, and mode of delivery. Conclusion: Anaemia, hypertension, and sepsis are the common postpartum morbidities in Kano, north-west Nigeria. Health education on the importance of quality antenatal and intrapartum care will go a long way in reducing these morbidities.
Introduction: Motorcycle injuries, particularly from low income countries like Africa and Asia contribute significantly to road traffic injuries globally, according to recent estimates by the World Health Organization. Objective: To determine the prevalence of visual acuity disorders, knowledge of road safety rules and one-year prevalence of road crashes in male commercial motorcyclists. Methodology: Male commercial motorcyclists numbering 191 were selected from the motorcycles’ parks in Ekpoma, using a multi-staged random sampling technique. Structured interviewer administered questionnaires were used for data collection. Data were analysed using SPSS version 20. Results: A vast majority 189 (99.0%) of respondents had good visual acuity (with visual acuity of between 6/5 and 6/18), Just one percent of the respondents had poor visual acuity (between 6/24 to 6/60). Most respondents 122 (63%) had a good knowledge of road safety rules while 42.9% had been involved in at least a road traffic crash within a year prior to the survey. Knowledge of road safety rules showed a statistically significant association with the educational status of the respondents ( P <0.001), but had no association with other socio demographic variables like age ( P =0.184), marital status ( P =0.298) and religion ( P =0.511) in respondents. Conclusion: Majority of the male motorcyclist had visual acuity within the normal range, knowledge of road safety rules was good among respondents with the level of education identified as a significant predictor of knowledge Inclusion of at least primary school educational qualification as criteria for all motorcyclists and a proper medical examination of prospective motorcyclists before issuance of driver licenses.
Background: Foreign body (FB) ingestion is a commonly encountered problem in both children and adults in emergency departments. Aim and Objective: This study reviewed the pattern and outcome of rigid esophagoscopic management of pharyngoesophageal FBs in our center. Materials and Methods: The records of patients managed for impacted pharyngoesophageal FBs at the study center over a period of 10 years were reviewed. Information obtained was collated and analyzed using SPSS version 18. Results: A total of 153 patients were reviewed. Among these, 96 (62.7%) were males with sex ratio (M:F) of 1.6:1. The mean age was 23.5 ± 2.3 years. The main presenting complaint was dysphagia 127 (83%). Coin was the most common FB, 33 (21.6%). The most common site of impaction was at the cricopharyngeal sphincter, 58 (37.9%). Complication was encountered in 43 (28.1%) patients. The most common complication encountered during rigid esophagoscopy was mucosal tear, 35 (22.9%). Most patients [97 (63.4%)] stayed for 1 to 3 days on admission; 151 (98.7%) had successful rigid esophagoscopic removal of their FBs. There is a statistically significant correlation between type of FB and duration of impaction with development of complication following rigid esophagoscopy (P value = 0.006 and 0.014, respectively). Conclusion: Rigid esophagoscopy was highlighted in this study as an effective method of removal of pharyngoesophageal FBs; however, ion disc battery and artificial denture are relatively associated with increased complications.
Aim To determine the turnaround time (TAT) for surgical pathology specimens (SPS) seen in our department and to identify the various determinants (variables) that affect it. Materials and method This is a cross-sectional descriptive study (prospective) of all SPS that were sent to the histopathology laboratory of University of Uyo Teaching Hospital (UUTH). A special proforma/questionnaire was designed for this study taking into account the various stages of converting a histopathological request to a result. Results Following specimen accessioning, the mean number of days before grossing was 1.65 ± 0.97 days. Tissue processing took a mean of 2.30 ± 2.05 days. Many of the processed SPS (histopathological slides) were reviewed and reported by histopathology resident doctors and consultant histopathologists within second and third days after processing in the laboratory (24.1% and 23.2% respectively), with a mean of 5.18 ± 13.07 days. Typing of result and verification of result took a mean of 2.99 ± 13.16 days. The shortest time interval to transform a histological request to a standard result was four days while the mean TAT was 8.47 ± 3.34 days. There was a significant correlation between the histological diagnosis and TAT. Conclusion Overnight fixation should be limited to large operating room specimens and not generalised. Provision of automated tissue processor, multi-headed and projecting microscopes will improve the TAT. All laboratory staff should be made to know that each stained glass slide represents a living patient and that the results are awaited.
Background Foreign body impaction in the airways is usually accidental in adults and deliberate insertion is rare. Magicians and other traditional healers perform various forms of magic, which are dangerous and could sometimes fail. This report conveys our recent experience with the aspiration of needles by magicians following failed magic.Case Summary Two male magicians aged 19 and 24years presented with the aspiration of 2 needles each while performing magic to sell their traditional medicines. Both had similar symptoms of dysphagia, odynophagia and neck pain. Plain radiograph of the soft tissue neck confirmed long sewing needles in the Pharynx and larynx respectively. Both patients had their foreign bodies successfully removed under general anaesthesia.Conclusion Dangerous forms of magic could fail and may lead to life-threatening emergencies. Fatal outcomes are only avoided if facilities and expertise are readily available.
Background: Closure of the cleft palate defect without tension is frequently a challenge. Many surgical techniques exist for cleft palate repair. These techniques mostly inculcate some form of palatal flap mobilization. Adequate mobilization of the palatal flaps can achieve closure without tension, thereby reducing the incidence of palatal fistulae. Aim: This article aims to describe and illustrate a simplified technique of palatal flap mobilization in cleft palate repairs. Materials and method: A descriptive narrative of cleft palatal repair was done with emphasis on a simplified technique for palatal flap mobilization. Variations of this technique for von Langenbeck, Bardach, and isolated soft palatal repairs are also described with illustrations. Conclusion: A simplified technique of palatal mobilization can enhance palatal cleft closure without tension, thereby reducing incidence of palatal fistulas.
Introduction: Intestinal parasitic infection (IPI) is one of the major and serious medical and public health problems in developing countries including Ethiopia. Effective prevention and control of IPIs require the identification of local risk factors, particularly among school children. Objective: This article assesses the prevalence of IPIs and associated risk factors among school children in Bamo no. 2 primary school in Adele town, East Arsi in southeast Ethiopia. Materials and Methods: Study participants were selected by using multistage sampling technique. A total of 417 school children were enroled in Bamo no. 2 primary school in Adele town, East Arsi. Structured questionnaires were used to identify environmental, sociodemographic, and behavioral factors. Stool specimens were collected and examined for parasites using direct smear and formal–ether concentration technique. Data were analyzed using SPSS Version 20. A bivariate and multivariate logistic regression analysis was done. P value less than 0.05 was considered as statistically significant. Results: The overall prevalence of IPIs in the present study was 113/417 (27.1%), for at least one intestinal parasite. A total of six parasites were detected; the most prevalent were Ascaris lumbricoides [50 (12.00%)], Entamoeba histolytica/dispar [43 (10.3)], Trichuris trichiura [35 (8.4%)], Giardia lamblia [31 (7.4%)], Hymenolepsis nana [13 (3.1%)], and Teania saginata [12 (2.9%)]. In addition to these, single [49 (15.45%)] and multiple [64 (20.18%)] infections were identified. In this study, the most significantly associated risk factors for the occurrence of IPIs were grade level, water type used, hand washing habit before meal and after defecation, defecation habit, and eating unwashed/uncooked vegetable (P < 0.05). Conclusion: Intestinal parasites were prevalent in varying magnitude among the school children. Therefore, the Woreda health office, school community, and nongovernmental organizations need to give education on personal hygiene and environmental sanitation, and treatment should be taken into account to reduce the prevalence of IPIs.
Background Male factor infertility in Nigeria accounts for up to 50% of all infertility cases, most of which happen as a result of abnormalities of testicular function and infection. Male factor can be assessed by seminal fluid analysis; however scrotal ultrasound is now increasingly being used to evaluate males with infertility.Objectives The objective of this study is to determine the spectrum of scrotal abnormalities on ultrasound in sub-fertile and fertile men.Patients and method This was a prospective study which spanned for a period of eight months (January–August 2016). A total of 270 patients were included in the study comprising of 180 consecutive males who were being evaluated for sub-fertility and 90 apparently normal fertile adults who underwent a scrotal scan at the radiology department of University of Abuja Teaching Hospital using 7.5 MHz of EMP G70, China scan machine with Doppler facility. All patients were scanned in supine and upright position in both B and Doppler modes and any scrotal abnormalities were recorded.Result The mean age of sub-fertile and fertile subjects studied was 29 ± 11.4 years and 34 ± 16.3 years, respectively. Scrotal abnormalities were commoner in the sub-fertile group compared to the fertile group with a prevalence rate of 45.0% and 32.2%, respectively. Varicocele was the most common finding in both groups with a higher prevalence rate of 50.6% in the sub-fertile group compared to 48.3% in fertile group. This distribution was statistically significant (P = 0.000). Varicocele was observed more on the left. Hydrocele was the second most common finding in both groups.Conclusion The role of scrotal scan in evaluating infertility cannot be overemphasized. In this study, ultrasound scan was used to evaluate 45.0% of sub-fertile subjects with scrotal abnormalities. Ultrasound being non-invasive and readily available should be considered as an important investigation in accessing cases of infertility.
This work tries to look at how the integration of traditional birth attendants (TBAs) into the health sector in Nigeria can be a strategy for reducing maternal deaths. Skilled birth attendance in Nigeria is below 40% and most deliveries are with unskilled personnel like the TBAs. In the light of current evidence that training of TBAs can have some positive effect on neonatal outcome and with inconclusive evidence on their role in maternal health, this “birthing workforce” can be harnessed by the Nigerian government by re-defining their roles as health promoters with the overall aim of improving skilled attendance at deliveries and the reduction of maternal morbidity and mortality.
