Archive 2008 - No 2

*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.