*A LAWAN, O EME

Correspondence to: DR A LAWAN Department of Ophthalmology Aminu Kano Teaching Hospital Kano Nigeria Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Background: The study is a retrospective review of the pattern of refractive errors in children 15 years of age and below in Aminu Kano Teaching Hospital from January to December, 2007. Patients and methods: The clinic refraction register was used to retrieve the case folders of all patients refracted during the review period. Information extracted includes patient's age, sex, and types of refractive error. All patients had basic eye examination (to rule out other causes of subnormal vision) and streak retinoscopy at two third meter working distance. Aphakic patients had EUA and refraction four weeks after surgery. The final refraction given to the patients was used to categorize the type of refractive error. Results: Childhood refractive errors accounted for 5.3% of clinic attendance and were the cause of presenting to hospital in 29% of children in that age group. The common types of refractive errors are astigmatism 53%, hypermetropia 19%, myopia 19%, and aphakia 5%. Conclusion: Refractive errors are common cause of presenting in the eye clinic. Identification and correction of refractive errors in children is an integral part of child eye health.

*UMAR A.S *OCHE M *ARKILLA M.B **ZAILANI SB
Correspondence to: Dr. A S.Umar P.o.box.3886, Sokoto 840001, Nigeria.

Background: Water development projects and irrigation schemes are without doubt very important and sometimes necessary. However, they create distortions in flora and fauna resulting in an increase incidence and prevalence of Schistosomiasis. Objective: This study was conducted to assess the prevalence and intensity of urinary schistosomiasis among school children around the Goronyo dam commissioned in November 2005. Methodology:The study was basically a cross sectional assessment using a pre-tested interviewer administered standardized structured questionnaire to gather baseline information on the bio-data of the pupils. Urine samples were also collected from the pupils and examined for the presence of ova of schistosoma haematobium. A total of 400 pupils were proportionately recruited from schools through a multistage sampling technique and using the list of pupils as the sampling frame. Results: Majority (55.3%) of respondents were 11-12 years old (modal class) with a mean (x) age of 11.5 + 2 years and males (89.8%). The prevalence of infection among schools near or around the dam/canals compared to those far away from the dam/canals was found to be between 45% - 52.5% and 7.7% - 17.7% respectively. This was found to be statistically significant (P<0.001, RR = 4.963 at 95% CI). The overall prevalence of urinary schistosomiasis among school children in the study area was found to be 32.3% (129/400). The age group 13-14 has the highest age specific prevalence of 39.4% (39/99) and all were males. Out of the 129 infected school children, 94 (72.9%) and 34 (27.1%) have light and heavy infection respectively. The later were all males. This might not be unrelated to differences in exposure due to cultural factors among males and females. Conclusion: Based on these findings, the prevalence and intensity of urinary schistosomiasis is high largely as a result of weaknesses in planning (including pre-construction phase), lack of social amenities and no control measure currently in place. There is therefore the need for instituting control measures with involvement and proactive participation of the community.

B. Bako B. M. Audu C. M. Chama O. Kyari A. Idrissa

Correspondence to: Dr.Babagana Bako Department of Obstetrics and Gynaecology University of Maiduguri Teaching Hospital P.M.B 1414, Maiduguri, Borno State. Nigeria E mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Background: Antepartum haemorrhage is one of the obstetric emergencies associated with increased maternal and perinatal morbidity and mortality. Objective: To determine the incidence, types, predisposing factors, complications and outcome of antepartum haemorrhage. Methodology: A retrospective study of cases of antepartum haemorrhage over an 8 year period from January 1999 to December 2006 at the University of Maiduguri Teaching Hospital was carried out. Results: The incidence of antepartum haemorrhage was 1.6% (248/15512), while that of placenta praevia and placental abruption were 0.8% and 0.7% respectively. Typically, placenta praevia was detected early in the pregnancy as low lying placenta in 42(36.8%) of cases, while lower abdominal pain, uterine tenderness and woody hard uterus was found in 88(89.8%), 88(85.4%) and 68(69.4%) of cases of placental abruption respectively. The predisposing factors for antepartum haemorrhage were; increasing maternal age, multiparity, previous abortion, previous uterine instrumentation and uterine scar. Threatened abortion in the index pregnancy was associated with placenta praevia while maternal hypertension was associated with placental abruption. The first bleeding episode occurred intrapartum in 74(34.9%) of patients with APH and the majority of them (57 out of 74) had placental abruption. The commonest mode of delivery was caesarean section, which accounted for 135(63.7%) deliveries and 73.3% of these were patients with placenta praevia. Seventy seven women delivered vaginally and 80.5% of them were patients with placental abruption. Preterm labour and post partum haemorrhage were the most common maternal complications while prematurity and increased perinatal mortality were the most common fetal complications. The perinatal mortality was 85(40.1%). There was no maternal mortality from this series. Conclusion: Antepartum haemorrhage is an obstetric emergency associated with increased maternal and perinatal morbidity and mortality unless prompt resuscitative measures and appropriate treatment are offered. Early booking, appropriate referral of high risk patients and routine ultrasound scanning for placental localization are advocated for early diagnosis and optimum maternal and fetal outcomes.

*AA KULLIMA **BM AUDU **M BUKAR *MB KAWUWA **AG MAIRIGA
Correspondence to: DR AA KULLIMA Department of Obstetrics and Gynaecology, Federal Medical Centre Nguru Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Background: Vesico vaginal fistula commonly affects the poor, less educated, teenage group and those experiencing their first deliveries. Objective: To determine the epidemiological variables are associated with vesico vaginal fistula. Methodology: A total of 80 case records of VVF patients managed over a 10 year period were retrospectively studied. Relevant information pertaining to age, parity, and cause of VVF and outcome of management were retrieved from the case notes. The data was analyzed using SPSS package. Results: VVF Constituted 1.4%, of the total Gynecological admissions and 8.0% of the major Gynecological surgeries performed during the period. The prevalence was highest among the Hausa/Fulani and the Kanuris. Majority (76.2%) were over 20years, with a peak-age specific prevalence rate of 33.8% at the 20- 24 years age group. Teenagers only accounted for 23.8%. Most patients sustained the VVF during their first childbirth (51.3%), by the second delivery 78.8% were involved. All the teenagers had only one delivery, while all the grandmultipara were 40 years and above. Ninety percent of them had no supervised antenatal care and had their deliveries at home under traditional birth attendant (TBAs). In about 90% prolong obstructed labour was the leading cause and most patients belong to the social class IV and V. Seventy five percent had successful repair, while about 50% were either divorced or neglected by their husbands. Conclusion: Vesico-vaginal fistula remains one preventable medical/social calamity, now afflicting not just teenagers and primipara, but predominantly older and parous women. Public health education with the provision of accessible efficient intrapartum care is the cornerstone to eradicating this problem.

Geidam AD, Audu BM, Mairiga AG

Correspondence to: Dr Ado D Geidam Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, PMB 1414 Maiduguri, Nigeria Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Objective: To determine the usefulness of shock index in the management of ruptured ectopic pregnancy. Method: A retrospective review of cases of ruptured ectopic pregnancy at the University of Maiduguri Teaching Hospital over a 10-year period (January, 1995 to December, 2004) was carried out. Result: During the study period there were 15, 120 deliveries and 136 cases of ruptured ectopic pregnancies, a prevalence of 0.9%. The mean age of the study population was 27.7±4.8 and the mean parity was 2.2±2.3.Majority of the patients (77.8%) had systolic blood pressure above 90mmhg but the diastolic blood pressure was =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% in 60.7%. In 60.7% of the cases the amount of haemoperitoneum found at laparatomy was >1000mls. Majority of the patients (64.1%) had blood transfusion. The preoperative packed cell volume (PCV) had the strongest correlation with the amount of haemoperitoneum 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) were significant predictors of haemoperitoneum above 1000ml. Conclusion: The shock index proved to be useful in the.

ABDU L.
Correspondence to: Dr Lawan Abdu MBBS, MSc CEH, FWACS, FMCOphth Department of Ophthalmology Aminu Kano Teaching Hospital Kano, Nigeria. Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Background: Manual (non phaco) extra capsular cataract extraction with posterior chamber intra ocular lens (ECCE + PCIOL) was commenced in Aminu Kano Teaching Hospital Kano in the year 2001. Objectives: Firstly to evaluate the pseudo phakic visual acuity and determine the proportion of patients who attained normal vision (6/6 to 6/18) after surgery. Secondly, to determine if there is a statistically significant difference in normal visual outcome between +19 and +21 diopter sphere (the two available powers of) PCIOL. Patients and methods: The theater register was used to extract names and hospital numbers with type of cataract surgery done on patients from 2001 to 2004. The following categories of patients were excluded; those with associated glaucoma, presence of corneal opacity, traumatic cataracts, secondary cataracts, and patients younger than 40 years. One hundred eyes of 100 patients with age related cataracts, with normal intra ocular pressure, briskly reacting pupils, and accurate four quadrant light projection were selected using simple random number sampling. All patients had manual (non phaco) ECCE. Information extracted from the patients records included age, sex, and visual acuity at presentation and after surgery at 3 months follow up. Visual acuity was measured with either Snellen's or, Illiterate “E” charts at 6 meters. All surgeries were done by the same surgeon. Results: There were 295 patients who had ECCE+PCIOL. Fifty three patients were excluded due to co existing glaucoma, corneal opacity, anterior chamber IOL and evidence of previous eye trauma. One hundred eyes of 100 patients were selected by simple random sampling from the remaining 242 patients. There were 68 males and 32 females (M: F= 2:1). The patients age ranged between 40 and 80 years, 55% were between the ages of 50 to 60 years. Fifty three eyes had PCIOL +19 diopter sphere (DS) power and 47 had PCIOL +21 DS. Before surgery 15% of the eyes were severely visually impaired (SVI) and 85% were blind. Forty eight percent had normal vision after surgery and this improved to 69% with refraction. Twenty seven percent had post operative vision of less than 6/18 to 6/60. Two eyes remained blind after surgery due to chorioretinal scar involving the macular of the operated eye. The second patient had hypertensive retinal exudates (bilateral, with macular involvement in the operated eye). Two eyes were SVI from persistent pseudo phakic macular edema with vitreous degeneration in both eyes of one of the patient. Normal corrected visual outcome was observed in 37% and 32% of patients with +19DS and +21DS PCIOL, respectively. There was no statistically significant difference in normal visual outcome between PCIOL of +19 and +21 DS using X-squared test. (X2=2.6, p<0.05).

*Bukar M **Mayun AA **Musa AB

Correspondence to: Dr Mohammed Bukar Department of obstetrics and gynaecology University of Maiduguri Teaching Hospital P.M.B 1414 Maiduguri Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Mortality from cervical cancer is the leading cause of cancer related deaths in developing countries. Organized cytological screening in developed countries has reduced significantly deaths related to cervical cancer. Opportunistic screenings offered in most parts of the developing world hardly cater for those at high risk. Objective: To review Pap smears in Maiduguri and compare our findings with other studies Methodology: A 15 year cytological review of 2082 Papanicolau smear for cervical cytology was carried out from January 1993 to December 2007 Results: Of the 2082 cervical cytology smears reviewed, 755(36.3%) were normal, 840(40.3%) showed inflammatory changes, while 132(6.3%) revealed infective agents. Cervical intraepithelial neoplasia (CIN) was seen in 162 (7.8%) of cases while invasive cancer was suspected in 13(0.6%). All were subsequently confirmed by histology. One hundred and sixty six (7.9%) of the smears were unsatisfactory. Conclusion: cytological screening for cervical cancer is low in Maiduguri and efforts need to be made to increase the coverage which could subsequently lead to reduction in cervical cancer related deaths..

Tukur MA* Chama C** Enyikwola O*

Correspondence to: Dr (Mrs) M. A. Tukur Department of Human Physiology University of Maiduguri PMB 1069 Maiduguri Borno State.

Background: There is paucity of data in respect of full blood count, which include the PCV, Hb, RBC in pregnant women in Maiduguri North- Eastern region of Nigeria. Methodology: A cross-sectional study was carried out at the Ante-natal Clinic of the University of Maiduguri Teaching Hospital. The control group was constituted by women from the family planning clinic who had weaned their babies. Blood samples were taken from 200 pregnant women and 150 nonpregnant controls. Results: Eight of the pregnant women were in 1st trimester, 119 in 2nd 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 a significant 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, 2nd and 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 trimesters were 22.0 ±7.4, 21.0 ±5.3 pg, and 22.0 ±6.2 pg, respectively. The corresponding values for the non-pregnant women were: MCV 81.4 ± 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 lower in pregnant than in the non-pregnant women (p<0.05). Conclusion: Our finding showed that there is a significant fall in Hb, PCV, and RBC in pregnancy. Further studies are needed to determine the normal pregnancy values for our population.

*Zailani SB *Gadzama GB +Abba AM **Onipede AO **Aboderin AO.
Correspondence to: Dr. SB Zailani Department of Medical Microbiology and Parasitology College of Medical Sciences University of Maiduguri. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Background: Urinary tract infections (UTI) are a common source of morbidity and mortality in all age groups in both sexes. Areas of concern in the treatment of UTI include the emergence of drug resistant uropathogens. Hence, the selection of drug resistant pathogens in both community acquired and nosocomial infections are of major concern world-wide. Objective: This retrospective study was aimed at determining the sensitivity profile of some uropathogens to antibiotics in urological patients attending Obafemi Awolowo University Teaching Hospital located in Southwestern part of Nigeria. Method: The microscopy, culture and sensitivity results of unselected mid stream urine specimens totaling 1015 received by the medical microbiology laboratory in the year 2000 were reviewed. Of these, 666 had all the information required for the study. Results: The total number of isolates in this study was 430(64.6%) out of which Gram-negative bacilli accounted for 40.5 % . The largest of this group being Klebsiella 13.7%, others were Pseudomonas 11.1% and E.coli 8.3%. Gram positive isolates represented 11.6% of organisms cultured. S. aureus 9%, being predominant. C. albicans made up 0.9 Conclusion: There was a generally high level of resistance of isolates to beta lactams, macrolides, and amino glycoside antibiotics compared to the third generation cephalosporins and quinolone antibiotics. The paper also underscores the importance of filling out request forms properly.