Kwari SD, Chama CM, Audu BM, Bako B

Background: Hypertension is a common medical disorder seen in pregnancy and it is responsible for signicant maternal and perinatal morbidity and mortality, especially in developing countries. A direct correlation has been observed between maternal serum uric acid levels and adverse fetal outcomes. An assay of uric acid may influence the foetus's delivery timing to avoid further intrauterine complications. Objectives: To determine the relationship between maternal serum uric acid level and perinatal outcomes in women with hypertensive disorders in pregnancy and normotensive pregnant women and to determine the critical value of serum uric acid for the occurrence of adverse perinatal outcomes in women with hypertensive disorders in pregnancy. Method: This was a hospital-based cross-sectional study in the Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria, from 1st December 2010 to 30th April 2011. Patients were recruited consecutively as they were admitted into the labour ward with a hypertensive disorder in pregnancy. Socio-demographic variables, clinical characteristics, and perinatal outcomes were obtained. An assay of maternal serum uric acid and degree of proteinuria were carried out and recorded on a predesigned proforma. Results: The majority of the hypertensive group were unbooked 119(74.4%) and had no formal education 85(53.1%). Twenty-two-point-ve percent 36(22.5%) of the hypertensive group were delivered by caesarean section compared to 33(10.3%) of the normotensive group, P 0.008. The hypertensive group delivered earlier (37.1±2.2weeks vs 38.6±0.9) and their babies weighed less (2.45±0.7 vs 3.15±0.5kg) (P <0.001). Hyperuricaemia was significantly associated with adverse perinatal outcomes such as prematurity (P <0.001), low birth weight (P <0.001), intrauterine growth restriction (P <0.001) foetal distress (P <0.001), and early neonatal death (P <0.001). The critical value of maternal serum uric acid was 455umol/l and it was signicantly associated with low birth weight (P <0.001), intrauterine growth restriction (P <0.001), intrauterine fetal death (P 0.001) and admission to special care baby unit (P 0.017), among the hypertensive group after regression analysis for confounders. Conclusion: Elevated maternal serum uric acid level is signicantly associated with poor perinatal outcomes in women with hypertensive disorders in pregnancy and a critical value of 455umol/l can be used to time delivery and avert adverse perinatal outcomes. 

Keywords: Correlation, Hypertensive disorders in pregnancy, maternal serum uric acid, perinatal outcome

Obirija SE^[1], Rasheed MW²,³, Eze KC⁴, Orji MO⁵, Eni UE⁶, Okonkwo JE⁷, Oji CC⁸, Muhammed MF⁹

Background: Abdominal ultrasonography is an essential imaging modality in diagnosing patients with acute appendicitis. Its major advantages include high diagnostic accuracy, availability, affordability, and excellent safety prole relative to other imaging modalities with few limitations in children. Clinical diagnosis of acute appendicitis and the modied Alvarado scoring system (MASS) have good sensitivity, but low specicity. Methods:  This was a prospective comparative study at Federal Teaching Hospital, Abakaliki which lasted for 1 year and eight months from April 2018 to December 2019 which involved 50 patients with clinical presentations of acute appendicitis who were evaluated clinically using the MASS and by ultrasonography before surgical treatment and nal diagnosis with histology. The following were recorded for data analyses:  socio-demographic data, clinical features and laboratory ndings (modified Alvarado Score), ultrasonographic score, clinical diagnosis, and nal (histological) diagnosis. The data were analyzed using a statistical package for social sciences for Windows version 22 (IBM, USA, 2015). Results: The age of the participants ranged from 4-70 years with a mean age of 31.5±17.2 years. The majority of the participants, 39 (78%) patients were within 31-40 years. The gender distribution showed that more males-29 (58%) than females-21 (42%) participated in the study. The sensitivity, specicity, and diagnostic accuracy of ultrasonography were 95.5%, 83.3%, and 94% respectively which were signicantly better than the corresponding indices of modied Alvarado score: 86.4%, 44.4%, and 84% respectively. The optimum (cut-off) ultrasonographic score of 3.75 yielded sensitivity and specicity of 95.5% and 100% respectively.   Combined ultrasonographic and modied Alvarado score of 11.75 (optimum score) yielded a sensitivity of 84.1% and a specicity of 100% in diagnosing acute appendicitis. Conclusion: Ultrasonography has a high diagnostic yield in the evaluation of acute appendicitis and should be adopted as the modality of choice in our environment. Ultrasonographic scoring system improved the diagnostic yields of ultrasonography and should be incorporated as a tool in the ultrasonographic evaluation of patients with acute appendicitis. More importantly, the surgical specimens should be submitted for a denitive histopathology examination. 

Keywords: Ultrasonography, Diagnostic accuracy, Acute appendicitis

Musa AZ¹, Mustapha SS¹, Adamu SA¹, Bawa IA², Abdussalam ML³ 

Keywords: Neonatal jaundice, Male, Sepsis, Outcome 

Ebeigbe J.A, Okungbowa N.E, Obahiagbon E.A and Okoro C.C

Background: Several studies have shown that University students experience high levels of mental health problems such as stress, anxiety and depression. The universal and increasingly competitive nature of higher education can exacerbate common academic stressors which contribute to mental health issues among University students. Objective: This study assessed the prevalence and possible correlates of depression, anxiety and stress among students in the Department of Optometry, University of Benin. Method: This cross-sectional descriptive study was conducted among 383 undergraduates. A convenience sample of Optometry students were interviewed using a questionnaire to record their socio-demographic data and their responses to the 21question version of the Depression, Anxiety Stress Scale (DASS 21) questionnaire. The female respondents made up 57.4% (220) of the sample population. Age range for the sample was 18 to 33 years with a mean age of 25.48 (6±2.1 SD) years. Results: Prevalence of depression (40.2%), anxiety (51.2%) and stress (35.5%) of varying degrees was recorded. There was no signicant difference in depression, anxiety or stress between genders (p>0.05). Living arrangements, academic performance, having to repeat a class, parents’ marital status and family economic situation had positive association with depression, anxiety and stress. Statistical differences across these parameters were signicant p<0.05. Conclusion: Results could be helpful in designing strategies for the early identication of mental health disorders, as well as psychological and other interventions that promote mental health and wellbeing among university students. 

Keywords: Depression, anxiety, stress, mental health, students

Osazee K¹, Ogwah CE²

Background: Cervical cancer is the most common genital tract malignancy in developing countries. It is one of the few preventable human cancers based on screening, early diagnosis, and treatment of its precancerous lesions. Screening modalities include the Papanicolaouu test (Pap Test), the High-risk Human Papillomavirus (HPV) test, and visual inspection with acetic acid and Lugol iodine. Awareness, Knowledge, and uptake of these various modalities are still poor in our environment. Methods: It is a sectional analytical study of women who visited the gynaecological clinic of the University of Benin Teaching Hospital, Benin City. This study aimed to determine the factors associated with awareness and Knowledge of cervical cancer screening with the use of Pap smear. The sample size was determined using the Leslie Kish formula, and 230 participants were recruited for the study. A self-administered structured questionnaire was used to obtain information from the participants. The data were presented in tables and pie charts and analysed using the Statistical Package for Social Science (SPSS) version 22. The associated factors were tested using the Chi-Square, and Fischer exerts, and p values <0.05 were considered signicant. Results: Out of the 230 respondents, 70% were aware of cervical cancer, but only 43.9% were aware of Pap smear; of the 43.9%, only 19.8% had good Knowledge of Pap smear. The majority of the respondents had their information from health workers. Level of education, marital status and parity were signicantly associated with awareness of Pap smear (p < 0.001). However, no sociodemographic factor was signicantly associated with Knowledge of Pap smear in the study. Conclusion: Awareness and Knowledge of Pap smears is still suboptimal in our environment. Education of the girl child and appropriate dissemination of accurate health information via health staff, mass media, and religious and traditional institutions will help to improve awareness and Knowledge of and acceptance of Pap smear screening tests.   

Keywords: Cervical cancer, Pap Smear, Screening, Awareness, Knowledge

SA Gaya¹, ZD Ahmed¹, S Mukhtar²

Keywords: Pap smear, Post natal clinic 

Palmer OH, Dattijo LM, Oranuka KP, Adeleke OP, Musa, AD, Aminu BM 

Background: Antepartum hemorrhage especially abruptio placentae remains one of the leading causes of materno-foetal morbidity and mortality globally, more especially in middle and low-income countries like Nigeria. It is one of the common causes of foetal loss and severe maternal morbidity at Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), Bauchi. This study seeks to determine the incidence, common risk factors and foeto-maternal outcomes in ATBUTH, Bauchi. Objectives: To determine the incidence, common risk factors, and foeto-maternal outcomes of pregnancies complicated by abruptio placentae in (ATBUTH) Bauchi. Study design: This was a retrospective study of cases with abruptio placentae that presented to ATBUTH, Bauchi over 5 years between 1st January 2015 and 31st December 2020. Results: The incidence of abruptio placentae in this study was 0.93% with an age distribution of 17-47 years and a mean maternal age of 28.5 years. Majority of the patients were multi-gravida, unbooked, and married. More than half of the patients had no formal education. Risk factors identied were hypertension in 86 (50.6%) of cases, previous history of abruptio placentae in 73 (42.9%), and multiparity in 144 (84.7%) of cases. Clinical features were similar to those of other studies. Complications observed in this study included maternal shock, post-partum haemorrhage, and maternal death. Foetal complications included premature deliveries, intra-uterine fetal death (IUFD), and a high perinatal death of 103 (60.6%). Conclusion: Abruptio placentae is common in Bauchi and is a leading cause of both maternal and fetal morbidity and mortality. 

Keywords: Antepartum hemorrhage, abruptio placentae, foeto-maternal outcome. 

Abiodun MT^1, Ayinbuomwan E² 

Background: Point-of-care tests (POCTs) can shorten the time taken to arrive at denitive diagnoses in many paediatric illnesses including surgical disorders. Therefore, POCT is a veritable tool in the investigation and management of acutely-ill children in emergency departments (EDs). Objective: To evaluate the perception, practice and determinants of point-of-care testing by clinical staff attending to acutely-ill children and adolescents in our centre. Methods: This study adopted a cross-sectional design. Data were collected with a semi-structured questionnaire. Participants’ overall perception of POCT adequacy was assessed on a 100mm uncalibrated visual analogue scale (VAS). Frequency of POCT device usage and actual point-of-care testing in the preceding 24 hours were documented. Inferential analysis assessed factors inuencing participants’ perception. P-value < 0.05 was considered signicant. Results: Altogether, 134 healthcare workers participated in the study; they were mainly from the Children Emergency Room 39 (29.1%), Medical Emergency department 30 (22.4%) and Surgical Emergency department 22 (16.4%). Their mean (SD) age was 33.2 (6.3) years. A majority 98 (85.2%) of them agreed that POCT shortens the time-to-diagnoses in their patients. POCTs recently used in the EDs were pulse oximeter 91 (67.9%), glucometer 85 (63.4%), urinalysis 52 (38.8%) and malaria rapid diagnosis test (mRDT) 43 (32,1%). Professional cadre signicantly inuenced POCT perception and usage (p=0.02). Participants’ overall VAS score on POCT adequacy in the EDs was satisfactory (63.0±24.4) and similar in both gender (t =1.780; p= 0.078). Conclusion: Point-of-care testing is favourably perceived and practiced in the evaluation of acutely-ill children and adolescents. There is a need to improve the availability of POCTs in paediatric acute care setting.   

Keywords: Point-of-care testing, perception, practice, clinical staff, children, emergency 

Kabir A,¹ Dahiru A M,² Farouk H U,³ Bukar A Z,¹ Lawan A I,⁴ Abdullahi Y M ⁴ 

Background: Cancer of the ovary being the second most common gynecological malignancy in Nigeria and most countries in the world, is a major cause of morbidity and mortality. The aim of this study is to determine the frequency of ovarian cancers and analyse their clinico-pathological characteristics at a tertiary health institution in Gombe. Methods: This study was a retrospective review of all cases of histologically conrmed ovarian cancers at the Department of Histopathology, Federal Teaching Hospital Gombe over a period of 10 years. Relevant information was extracted from the histology request forms and patients’ medical case records. Data were analysed statistically using SPSS Version 20.0 and results were presented in tables and charts. Results: One hundred and seven (107) cases of ovarian cancer were diagnosed, which constituted 14.7% of gynaecological malignancies (730) and 2.7% of total cancers (3993). Patients were aged between 11 and 80 years. The modal age group was 31–40 years. The three most common clinical presentations included abdominal distension, abdominal pain and weight loss; while the commonest stage at presentation was stage III. Surface epithelialstromal cancers were the most common histological class, with high-grade serous carcinoma being the most common histological variant. The most common treatment modality was surgery and chemotherapy. Conclusion: This study shows a predominance of ovarian cancer cases in younger, reproductive women, and at advanced stage of presentation. Similarly, the preponderance of high-grade serous carcinoma in this female population is a major health concern and demands proactive measures to address it. 

Keywords: Ovary, Cancer, Clinical features, Histological types 

Umar UH¹, Farate A¹, Yunusa DM², Lawan MM¹, Goni MA¹, Ahmadu MS¹, Ahidjo A¹ 

Background: Stroke is a major cause of morbidity and mortality worldwide and is worsening in sub-Saharan Africa. Neuroimaging plays a vital role in its conrmation and ruling out stroke mimics. Brain CT scan is the workhorse in the management of patients with acute stroke where time matters. Method: This was a retrospective cross-sectional study of patients with clinical stroke and conrmed on CT scans from January 2020 to December 2023 that were conducted at departments of Radiology, University of Maiduguri Teaching Hospital and State Specialist Hospital, Maiduguri, North-eastern Nigeria. Data were retrieved and recorded from the archives which included biodata and CT scan patterns (stroke subtype and site, vascular territory, and number of lesions).  Data were analyzed using Statistical Package for Social Sciences version 26 (IBM, 2019, Illinois, USA). Results: A total of 328 patients of the study population were recorded, of which 187 patients 

(57%) were males and 141 (43%) were females. The age ranged from 20 - 98 years, with a mean age (± SD) of 59.1 ± 14.9 years and a male-to-female ratio of 1.3:1 and the majority of the patients (55%) were aged ≥ 60 years. Ischaemic stroke was seen in 245 patients (75%) and haemorrhagic stroke (HS) was seen in 83 patients (25%). The most frequent stroke subtype was ischaemic stroke in both male and female patients. The relationship between the stroke subtype and age group was statistically signicant (p=0.0001). Ischaemic stroke was the most observed subtype in all age groups than HS. Lobar location in particular the parietal lobe was the most commonly involved site in this study. The commonest vascular territory was the middle cerebral artery and the majority of stroke cases (88%) were solitary lesions. Conclusion: Neuroimaging differentiates infarction from haemorrhage and guides the treatment of acute stroke patients. Ischaemic stroke was the most frequent subtype in all genders and age groups with lobar location accounting for most stroke sites in this study. Noncontrast brain CT scan is the ideal imaging modality in the management of acute stroke. 

Keywords: Stroke, Brain CT, Subtype, Site, Vascular Territory 

MK Usman¹, AS Baba², KB Ali², YM Yakubu³, BB Daggash³, AB Shettima³, NG Zango³, DI Mohammed ³, AA Abdullahi⁴, Y Mohammed⁵, GB Gadzama², SB Zailani³ 

Keywords: Cryptosporidium, Maiduguri, HIV 

Baba MM¹, Musa MS², Mohammad IH³

Background: Pulmonary thromboembolism is a life-threatening medical emergency occurring as a result of sudden occlusion of the pulmonary artery or its branches by a thrombus originating from the right heart or the deep veins. Case Summary: The patient is a 55-year-old lady with poor financial background developed sudden onset of breathlessness, cough with haemoptysis associated with chest pain while on admission for biventricular heart failure secondary to myocardial infarction. No previous history of deep venous thrombosis, pulmonary embolism or recent surgery. However, she was bedridden at home for two months prior to the hospitalisation. Wells clinical score was 7 with high-risk stratication,  computerised tomography pulmonary angiography confirmed the diagnosis of pulmonary thromboembolism. Unfractionated heparin and Apixaban were used in the treatment of pulmonary thromboembolism in this patient. Conclusion: Diagnosis and management of pulmonary thromboembolism posed a signicant challenges in a resource poor setting, therefore high index of suspicion, timely assessment for the likelihood of PTE and prompt risk stratification are crucial. While thrombolytic therapy is the recommended treatment option for high risk patient, however the use of unfractionated heparin is an alternative. 

Keywords: Pulmonary thromboembolism, Myocardial infarction, Heart failure. Resource poor setting