Abdominal Pain in Adult Sickle Cell Disease Patients: A Nigerian Experience

Background: Abdominal pain is a relatively frequent occurrence in sickle cell disease. The aetiology of abdominal pain in sickle cell disease is often difficult to diagnose clinically. Despite the frequent occurrence; diagnostic dilemma; and the need for an accurate; early diagnosis; abdominal pain in sickle cell disease has not been rigorously studied. Objective: We therefore sought to describe the different presentations and patterns of abdominal pain in persons with sickle cell disease. Methods: A prospective case series of 20 patients was done in which data was collected on demographic characteristics; hemoglobin electrophoresis patterns; a description of the abdominal pain including sites; severity; and type of pain; packed cell volume and the provisional and final diagnosis. Results: Haemoglobin S patients were 17 in number constituting eightyfive percent (85) of our study population whilst the rest 3 were Hb S+C. Most patients (70) had one site of abdominal pain. The pain was mainly colicky or tightening; moderate to severe in nature and; in some cases; associated with vomiting. We did not find any significant difference between the steady state PCV and the PCV during the acute abdominal pain episodes. The final diagnosis showed that only 38.8of the patients had vasoocclusive crises and the reliability index between the provisional diagnosis and the final diagnosis was 67. Conclusion: Abdominal pain in sickle cell disease may present in different ways and it is important to recognize that the possible diagnoses are numerous. Not all cases are due to vasoocclusive crises. Early diagnosis and prompt treatment can be life saving

Pattern; Indications and Review of Complications of Neonatal Blood Transfusion in Ibadan; Southwest Nigeria

Background and objectives: There is a huge need for blood transfusion in the newborn particularly due to the reduced marrow activity in the neonatal period. Despite widely use of blood products in the neonatal period; there is paucity of local data on the pattern; indications and reactions to blood transfusions in Nigerian newborns. This study evaluates the blood transfusion indications and patterns in special care baby unit and C12nd of University College Hospital; Ibadan; Nigeria. Methodology: A cross sectional study was carried on the recruited newborns and structured questionnaires were used to obtain bio data; medical problems; indications for blood transfusion; type of blood products transfused and clinical signs. Urinalysis was performed out before and after the transfusion. Results: A total of 100 neonates were recruited into the study with a male: female ratio of (M: F= 1:1). The age range was 2-34 days and their weight ranged between 0.8kg to 3.6 kg with a mean weight of 1.64 kg. The main indications for transfusion were anaemia from prematurity et neonatal sepsis(NNS) 46; (red cell replacement); NNS; Disseminated intravascular coagulation(DIC) et anaemia 24; (partial exchange + top up + Fresh frozen plasma); neonatal jaundice(NNJ) et anaemia 14; (whole blood); NNJ; NNS + anaemia 6(Blood transfusion + Fresh frozen plasma); NNS + anaemia 10(whole blood). Conclusion: Blood transfusion is still frequent in the study area and prematurity; neonatal sepsis and jaundice rank high in the indications. Transfusion reactions are rare in the evaluated neonates

Risk of anaemia in HIV positive pregnant women in Ibadan, south west Nigeria

UNLABELLED: Anaemia in pregnancy is an important cause of maternal and neonatal mortality. It is a recognized co-morbidity of HIV infection. This study aimed to determine the risk of anaemia in HIV positive pregnant women. METHODOLOGY: This is a cross sectional study of healthy pregnant women attending Adeoyo Hospital, a secondary health centre in South-western Nigeria over a 1-month period (January 2007). During the study period, 2737 eligible women presented for antenatal care. About 98% (2682) of these women consented to HIV testing. Over all, their mean (+ S.D) packed cell volume was 30.96% (+/- 4.13). The prevalence of HIV infection was 2.9% (95% CI 2.3% - 3.6%) and the overall prevalence of anaemia was 33.1%. Frequency of anaemia was significantly higher in HIV +ve women (57.3% vs. 42.7%, p = 0.00. OR = 2.81., CI = 1.72-4.58). HIV +ve women presented more frequently with moderate or severe anaemia. In the logistic regression analysis only HIV infection (OR = 2.4, 95% CI = 1.37-4.21) and primigravidity (OR = 1.25, 95% CI = 1.04-15.2) remained independently associated with anemia. Anaemia is common in HIV positive pregnant women in this environment. Care providers must endeavor to determine the HIV status of every pregnant woman especially if she presents with anaemia with a view to providing appropriate interventions