A twenty year experience with the use of intrauterine contraceptive device (IUCD) in a university teaching hospital in South- south Nigeria

Context: Contraceptive prevalence in Nigeria is low at 17%. Amongst Nigerian women and couples who accept to use contraception, the IUCD is the most commonly used contraceptive method with variation in rates of use between geographical areas and among Health Institutions. Factors that determine decision making on IUCD use are not well understood. Aims: To study the use, effectiveness, complications and discontinuation rates for intrauterine contraceptive device received at the University of Benin Teaching Hospital from 1997 to 2016 and analyzed in January, 2019. Study Design: This was a retrospective cross sectional study. Methodology: The case notes of all 3326 new clients who accepted Copper T intrauterine contraceptive device at the UBTH Family Planning Clinic during the review period were retrieved and analyzed. Data regarding acceptors socio-demographic characteristics, side effects, effectiveness, complications, duration of use and reasons for discontinuation were extracted and entered into SPSS for windows version 22.0 and analyzed. Results: Out of the 8203 clients that accepted to commence a family planning method, 3326 (40.55%) accepted to use IUCD. The mean age of IUCD acceptors at commencement was 33.4±5.60 and the mean age of their husbands was 39.85±6.91. The mean parity was 3.73±1.87 (range 0-12), while the mean number of living children was 3.56±1.66 (range 0-10). The mean duration of use (in months) was 40.43±40.13. Women with 5 or more children (P Value 0.000) and at least a minimum of secondary education (P Value 0.000), were significantly associated with IUCD use duration of > or more than 2 years. Also, women who reported satisfaction with IUCD (P Value 0.000) and no complications (P Value 0.000) were also associated with longer duration of use. Conclusion: IUCD is a common family planning method used by women at UBTH. Its duration of use is higher among clients with more children, at least a minimum of secondary school education and no complications from its use. This information is relevant for family planning service providers to increase contraceptive uptake by women in Nigeria

Apnoea of Prematurity : Discontinuation of Methylxanthines in a Resource-Limited Setting

Background. Methylxanthines such as caffeine have been proven to reduce apnoea of prematurity and are often discontinued at 35 weeks' corrected gestational age (GA).Objective. To ascertain whether a caffeine protocol based on international guidelines is applicable in our setting; where GA is often uncertain.Methods. A prospective folder review was undertaken of all premature infants discharged home over a 2-month period.Results. Fifty-five babies were included. All babies born at less than 35 weeks' GA were correctly started on caffeine as per protocol. GA was assigned in 85.5 of cases by Ballard scoring and in 14.5 from antenatal ultrasound findings. Caffeine was discontinued before 35 weeks in 54.5 Discussion. The main reason for discontinuing caffeine early was the baby's ability to feed satisfactorily; a demonstration of physiological maturity. As feeding behaviours mature significantly between 33 and 36 weeks; the ability to feed may be a good indication that caffeine therapy can be stopped

Dispening and quality of Amoxicillin Preparations in Retail Pharmacies on Tanzania Market

A study on dispensing practice and quality of amoxycillin capsules and syrups was conducted in retail pharmacies in 5 regions of Tanzania. Data on dispensing practice was collected by interviewing 75 dispensers through structured questionnaires. Quality of amoxycillin capsule formulations and dry powder for suspension preparations from six different manufacturers was evaluated for chemical content at the Tanzania Food and Drug Authority (TFDA) in Dar es Salaam. The study showed that of all the dispensers only 17.3were pharmacists; 21.3pharmaceutical technicians and 28were nurses of different ranks. Results indicated that the most dispensed amoxicyllin was the locally produced preparation which accounted for 41.3. Affordability determined the most dispensed and lowest priced generic brand; amoxycillin by 68. Results revealed that only 46.6dispensers refused to dispense amoxycillin without a prescription while 53.4dispensed. Out of the ones who dispensed; 42.5gave patients the most expensive preparations and 22.5just dispensed according to the patients' demands. Similarly patients with prescriptions written in a generic name; the dispensers (28) issued them with the most expensive brand while others were issued the brand they specifically demanded by 32of the dispensers. For patients who came to the pharmacy with less money; results revealed that 66.7of the dispensers dispensed incomplete doses and then requested them to come back for the remainder and 13.3just gave out incomplete doses without any further counseling. Responses regarding reconstitution of the dry powder for suspension showed that only 10.7dispensers reconstituted before giving it out to patients and the rest just instructed patients on how to reconstitute at home. Further; 74.7of dispensers instructed the patients to use teaspoons to measure 5ml of the suspension. The results from the assessment of chemical contents showed that all capsules and dry powder for suspensions complied with respect to pharmacopoeial limits. It is concluded that dispensers should continually undergo continuing education on good dispensing practices