Abstract Intra-operative consultation between the surgeon and the pathologist is very important. Frozen section technique performed by an experienced pathologist requested for by a surgeon well known to him or her is most valuable in this regard. The aim of frozen section is to establish the presence and nature ofa lesion, adequacy of resection margins, positivity of lymph nodes, and the presence of malignant implants or metastasis in other organs. It however may not be possible to determine theaccurate mitotic count and the degree of dysplasia by frozen sections.Although there were various descriptions of frozen sectiontechnique before and after the turn of the 20th century, LB Wilsonof the Mayo Clinic heralded the beginning of a new era in intraoperativediagnosis.The purpose of this review is therefore to activate intra-operativeconsultation between the surgeon and the pathologist usingfrozen sections, as this will improve clinical services, give bettertraining to resident doctors and improve hospital income.
Objective: To determine the usefulness of shock index in themanagement of ruptured ectopic pregnancy.Method: A retrospective review of cases of ruptured ectopicpregnancy at the University of Maiduguri Teaching Hospital overa 10-year period (January, 1995 to December, 2004) was carriedout.Result: During the study period there were 15, 120 deliveries and136 cases of ruptured ectopic pregnancies, a prevalence of 0.9%.The mean age of the study population was 27.7±4.8 and the meanparity was 2.2±2.3.Majority of the patients (77.8%) had systolicblood pressure above 90mmhg but the diastolic blood pressurewas =60mmhg in 50.4% of the patients. The shock index was>0.70 in 92.3% of the cases and the packed cell volume <30% in60.7%. In 60.7% of the cases the amount of haemoperitoneumfound at laparatomy was >1000mls. Majority of the patients(64.1%) had blood transfusion. The preoperative packed cellvolume (PCV) had the strongest correlation with the amount ofhaemoperitoneum found at laparatomy (r= -0.648, p=0.000),followed by the shock index (r= 0.391, p=0.000). Only PCV<30% (P=0.000) and Shock index >0.70 (P=0.026) weresignificant predictors of haemoperitoneum above 1000ml.Conclusion: The shock index proved to be useful in the Author Affiliations:Corresponding Author:Keyword:Department of Obstetrics andGynaecology, University of MaiduguriTeaching Hospital, PMB 1414Maiduguri, NigeriaDr Ado D GeidamDepartment of Obstetrics andGynaecology, University of MaiduguriTeaching Hospital, PMB 1414Maiduguri, NigeriaEmail: adogeidam@yahoo.com5HOW USEFUL IS SHOCK INDEX IN THE MANAGEMENTOF RUPTURED ECTOPIC PREGNANCYGeidam ADAudu BMMairiga AGOriginal ArticleRuptured Ectopic pregnancy;haemoperitoneum; blood transfusion;vital signs; shock index.
Abstract Background: There is paucity of data in respect of full bloodcount, which include the PCV, Hb, RBC in pregnant women inMaiduguri North- Eastern region of Nigeria.Methodology: A cross-sectional study was carried out at theAnte-natal Clinic of the University of Maiduguri TeachingHospital. The control group was constituted by women from thefamily planning clinic who had weaned their babies. Bloodsamples were taken from 200 pregnant women and 150 nonpregnantcontrols.Results: Eight of the pregnant women were in 1st trimester, 119 in2nd trimester and 73 in 3rd trimester. The mean ± SD of Hb, PCV,and RBC, were: Hb 8.5±2.2 g\dl, 7.9 ±1.7g\dl 8.2 ± 1.7 g\dl, PCV:31.8 ± 5.8%, 28.6 ± 3.6%, 28.7 ± 4.9%, RBC: 4.1±1.1 x 1012\L,4.0 ±0.9 x 1012\L, 3.9±1.9 x 1012\L for 1st, 2nd, and 3rd trimesters,respectively. The non-pregnant women had Hb, PCV, and RBC,of: 11.0 ± 1.34 g\dl, 34.0 ± 3.63%, 4.2 ± 0.58 x1012 \L. There was asignificant fall in Hb PCV and RBC count in pregnancy (P<0.05).The MCV in the 1st, 2nd and 3rd trimesters were 82.3 ± 18.8 fl, 75.6±18.2 fl, and 79.2 ±17.4 fl, respectively. The MCHC in the 1st, 2ndand 3rd trimesters were 26.2 ± 5.1 g\dl, 27.9 ± 5.5 g\dl and 28.2±5.6 g\dl, respectively. The MCH in the 1st, 2nd and 3rd trimesterswere 22.0 ±7.4, 21.0 ±5.3 pg, and 22.0 ±6.2 pg, respectively. Thecorresponding values for the non-pregnant women were: MCV81.4 ± 10.52 fl, MCHC 32.5 ± 2.4 g\dl and MCH 26.3 ± 2.87pg.The MCV, MCHC and MCH were found to be significantly lowerin pregnant than in the non-pregnant women (p<0.05).Conclusion: Our finding showed that there is a significant fall inHb, PCV, and RBC in pregnancy. Further studies are needed todetermine the normal pregnancy values for our population. Author Affiliations:Corresponding Author:Keyword:Department of Physiology*University of Maiduguri, PMB 1069,Maiduguri, And Department of Obs &Gynae** University Teaching HospitalPMB 1414 Maiduguri Borno StateDr (Mrs) M. A. TukurDepartment of Human PhysiologyUniversity of MaiduguriPMB 1069 MaiduguriBorno State.BOMJ, Vol. 4, No. 1, Jan-June 2007. 19ERYTHROCYTE CHANGES IN NORMAL PREGNANCY IN MAIDUGURI,NORTH EASTERN NIGERIATukur MA*Chama C**Enyikwola O*Original ArticleErythrocyte changes, pregnancy,Nigeria