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A five - year review of gestational trophoblastic diseases in Port Harcourt, Nigeria
TK Nyengidiki, G Bassey, NM Inimgba, NC Orazulike, C Amadi
January-April 2016, 10(1):18-24
Gestational Trophoblastic Diseases (GTD) are a spectrum of inter-related but histologically distinct tumours originating from the placenta with good prognosis when diagnosed early.
To determine the prevalence, clinical presentations, management of gestational trophoblastic disease at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
A retrospective analysis of women treated for gestational trophoblastic disease from 1st January 2008 to 31
December 2012. The information from patients records: age, occupation, educational level, husband's occupation, parity, presenting symptoms, uterine size, mode of treatment and management options were collated and analysed. The Chi-square test was used to compare categorical variables with a p value of ≤ 0.05 as significant.
A total of 38 cases of GTD were treated with a prevalence of 2.3 per 1,000 deliveries. The mean age and parity were 31 ± 6.3 years and 2 ± 1.6 respectively. Maternal age less than 35 years and low socioeconomic status were significantly associated with GTD (p=0.0000). The mean gestational age at presentation was 16.24 ± 5.4 weeks. The commonest clinical presentation was amenorrhoea in 100% of patients. Twenty-five(65.8%) cases of hydatidiform mole and 13(34.2%) cases of choriocarcinoma were observed. Twenty-two (57.9%) patients had suction evacuation only for hydatidiform mole, 3(7.9.%) had suction evacuation and cytotoxic therapy for hydatidiform mole and subsequent persistent trophoblastic disease while 8(21.1%) had chemotherapy for choriocarcinoma. Five patients with advanced choriocarcinoma did not receive definitive treatment before demise. Twenty (52.6%)defaulted in their follow up schedule.
There is high prevalence of GTD in Port Harcourt with high mortality among patients with malignancy. Most of the patients defaulted in their follow up; thus there is a need for education and sensitization of the populace on GTD, as well as proper counseling of patients treated on the benefits of follow up visits.
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Evaluation of cardiovascular risk factors in patients with chronic kidney disease
Ehimen Phyllis Odum, Esther Okiemute Udi
May-August 2017, 11(2):60-66
Patients with chronic kidney disease (CKD) have a high prevalence of cardiovascular risk factors. Cardiovascular disease is the leading cause of death in patients with CKD.
The aim of this study is to determine the prevalence of the various cardiovascular risk factors in CKD patients and compare with that of healthy controls.
A case-controlled study. The study sample included 94 diagnosed CKD patients above the age of 18 years without symptoms of cardiac disease and 70 controls. Fasting plasma glucose, lipid profile, creatinine, albumin, glomerular filtration rate and urinary albumin-creatinine ratio were estimated in participants. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 20.0.
The cardiovascular risk factors found in CKD patients versus controls were hypertension (62.7% vs. 11.4%), diabetes (13.8% vs. 7.1%), dyslipidaemia (50.0% vs. 31.4%), obesity (14.9% vs. 20.0%), hypoalbuminaemia (19.1% vs. 0%), microalbuminuria (55.3% vs. 20.0%) and macroalbuminuria (21.3% vs. 0%). However, only the prevalences of hypertension (
< 0.001), hypertriglyceridaemia (
= 0.007), low high-density lipoprotein (HDL) (
= 0.050), hypoalbuminaemia (
= 0.007), microalbuminuria (
< 0.001) and macroalbuminuria (
< 0.001) were statistically significant. Patients on maintenance haemodialysis had higher prevalence of hypertension (
= 0.018) and hypoalbuminaemia (
= 0.001) than pre-dialysis patients.
Prevalences of hypertension, hypertriglyceridaemia, low HDL, hypoalbuminaemia, microalbuminuria and macroalbuminuria were significantly higher in CKD patients than in controls.
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Prevalence of anaemia in the antenatal booking population at Ahmadu Bello University teaching hospital, Kaduna, Nigeria
Polite I Onwuhafua, Ijeoma C Ozed-Williams, Abimbola Omolara Kolawole, Marliya S Zayyan, Joel Adze
January-April 2018, 12(1):23-27
Anaemia has been associated with poor materno-foetal performance among pregnant women in Nigeria. The objective, therefore, of this study is to determine the prevalence of anaemia at the time of antenatal booking and the associated factors in the hospital.
Four hundred and seventy-seven women were studied prospectively over 3 months in the antenatal booking clinic, and their characteristics compared with their haemoglobin (Hb) levels.
Age range was 15–46 years, and mean Hb concentration was 10.76 g/dl. Nearly 53.05% of the study population had Hb <11.0 g/dl, but only 20.76% had Hb <10.0 g/dl. Nearly 1.89% had severe anaemia (Hb <8.0 g/dl) while 20.12% had Hb of 12.0 g/dl or more. The strongest association was last obstetric event occurring <1 year before current pregnancy (
6.17, odds ratio 3.97 and
= 0.01). Older women (35 years or more) had a higher prevalence (30.95%) than younger women (19.77%). Only two of the 15 teenagers (13.33%) were anaemic. Six women (1.26%) had sickle cell Hb and it seemed the presence of Hb C tempered the anaemia. Parity and social class were not significant associations. With a mean booking gestational age of 22.49 weeks for the group, 77.77% of the anaemic women booked earlier than 28 weeks. Only two (2.03%) booked later than 34 weeks.
Anaemia is still highly prevalent in the society, and the existing mechanisms for its correction should be reassessed for effectiveness and adequate utilisation in the antenatal clinic. Most anaemic women booked early, therefore, allowing enough time for correction before delivery.
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