Oxidative stress and lipid profile among hypertensive patients at a tertiary centre in Kano, Northwest, Nigeria

Background: Hypertension as a global public health challenge is a major risk factor for cardiovascular (CVD) and coronary heart diseases (CHD) because of its chronic sequelae. It is accompanied by dyslipidemia and oxidative stress leading to increase in lipid peroxidation. This study aimed to measure the fasting serum lipid profile and malondialdehyde (MDA) and determine the atherogenic index as well as the cardiovascular risk ratio among hypertensive patients in Kano, Nigeria. Patients and Methods: Two hundred subjects (100 hypertensive patients vs. 100 normotensive controls) were recruited for the study. The fasting serum lipid profile and MDA were assayed using routine laboratory methods. Lipid ratios that predict and identify an individual's increased risk for cardiovascular diseases were then determined from the results of the profile. Results: The serum total cholesterol (7.0±0.5 vs 4.1±0.4 mmol/L), triglycerides (2.9±0.2 vs 2.0±0.3 mmol/Lg/dl), LDL cholesterol (3.8±0.4 vs 2.6±0.4 mmol/L), VLDL cholesterol (3.0±0.2 vs 2.1±0.2 mmol/L) and MDA (TBARS) (9×10-5±1.4×10-5 vs 3×106±0.9×10-6 mol/l) were significantly (p<0.05) increase in hypertensive patients compared to normotensive controls. HDL cholesterol was significantly higher (p<0.05) in normotensive controls compared to hypertensive patients (31.4±8 vs 23.9±6 mg/dl). A statistically significant (p<0.05) positive correlation was observed between LDL cholesterol and MDA only. Both the atherogenic index (AI) ratio and the CardioRisk ratio were significantly higher in Hypertensives than Normal controls (10.4 vs 4.1; 11.7 vs 5.1 respectively). Conclusion: This study demonstrated an increased occurrence of atherogenic lipid profile and oxidative stress among hypertensive patients. It further showed a strong correlation between dyslipidaemia and oxidative stress. Therapeutic lifestyle changes and use of statins should be considered an integral part of the treatment for hypertensive patients in Nigeria

A ten year review of female sterilization at the university of Maiduguri teaching hospital, Maiduguri, Nigeria

Background: In most developing countries like Nigeria, female sterilization is not a popular method of contraception. Objective: The objective of this study was to determine the prevalence of female sterilization and socio-demographic characteristics of women who had sterilization in our setting.Methodology: This was a retrospective study carried out between 1st January 1997 and 31 December 2006.A total of two hundred and one female sterilisation operations were performed but ten case notes were incomplete and therefore, one hundred and ninety one 191 were analyzed. Information retrieved from the case notes included the age, parity, religion, literacy, and type of bilateral tubal ligation. The data collected were analyzed using SPSS Version 16.0 statistical package and the results represented in simple tables and percentages.Results: There were 16,319 deliveries during the study period and 201women had bilateral tubal ligation (BTL), giving a prevalence of 1.2%. The mean age at BTL was 30.18, while the mean parity was 4±0.6. Women between the ages of 30-39 constituted majority of the patients. In most of the women 138 (72.3%) bilateral tubal ligation was performed during caesarean section, while few women 16 (8.4%) had the procedure at laparotomy. The rest, 37(19.4%) women opted for interval BTL. Significantly more literate women (73%) sought for interval tubal ligation compared to non literate (23%) ones. A large number of the Muslims (87.5%) had BTL at laparotomy compared to the Christians (12.5%). P=0.002.Conclusion: The prevalence of bilateral tubal ligation in this study is low. There is need to encourage the uptake of female sterilization in our environment

Prevalence and outcome of pregnancy among elderly primigravida in Aminu Kano teaching hospital, Kano: a 5 year review

Background: As women increasingly delay child bearing, the proportion of women having their first delivery at ''advanced maternal age'' is expected to rise. These elderly primigravidae have traditionally been considered to be at increased risk of adverse maternal and perinatal outcomes compared to their younger counterparts, because of associated pregnancy and labour complications. Objectives: To determine the prevalence of elderly primigravidae and compare their pregnancy outcome with that of younger primigravidae in Aminu Kano Teaching Hospital, Kano. Materials And Methods: This was a retrospective case control study comparing the pregnancy outcome of primigravid mothers aged 35 years and above (elderly primigravidae) with those of younger primigravidae aged 20-25 years, who delivered at Aminu Kano Teaching Hospital between January 2009 and December 2013. Results: There were 18,452 deliveries during the period under review, out of which 295 were primigravidae aged 35 years or above giving a prevalence of 1.6%. There was statistically significant higher preterm delivery rate ( X2= 10.30, P= 0.001) and caesarean delivery rate (X2= 12.15, P= 0.0001) among the elderly primigravidae compared to younger primigravidae. The elderly primigravidae were more prone to hypertensive disorders in pregnancy (X2=23.96, P=0.0001) and diabetes (X2=4.689, P=0.030) compared to the younger primigravidae. The prevalence of antepartum haemorrhage (X2=6.434, P=0.011) and uterine fibroids (X2=5.549, P=0.019) were also statistically significant among the elderly primigravidae compared to the younger primigravidae. There was no significant difference in the other maternal and foetal outcome measures. Conclusion: The prevalence of elderly primigravidae in this study was 1.6%. The prevalence of obstetric complications such as preterm delivery, antepartum haemorrhage, uterine fibroids coexisting with pregnancy and medical conditions like hypertensive disorders in pregnancy and diabetes mellitus are higher among elderly primigravidae compared to younger primigravidae. The elderly primigravidae were also more liable to have caesarean deliveries than the younger primigravidae. However there was no difference in the fetal outcome in the two groups

Review of Intrauterine Adhesiolysis at the Aminu Kano Teaching Hospital; Kano; Nigeria

Background: Hysteroscopic adhesiolysis is shown to significantly improve the outcome of intrauterine adhesions (IUA). The Minimally Invasive Surgical Unit (MISU) of our Department recently acquired a hysteroscope which is being used for hysteroscopic adhesiolysis among others. Materials and Methods: There were 57 patients diagnosed to have IUA of which 54 case notes were available for analysis; giving a retrieval rate of 95. The information extracted includes age; parity; and menstrual pattern; predisposing factors; treatment option; outcome; complications and the year of the procedure. The data extracted were analyzed using Epi info Version 3.4.1. Chi squared test (Fisher's exact test) was used to test for statistical difference in the outcome of the modalities of treatment. P value of less than 0.05 was considered significant. Results: There were 57 cases of IUA out of 4160 gynecological patients seen; giving a prevalence of 14/1000. The mean age was 28.9 years (SD 4.5) and mean parity was 1.4 (SD 1.4). Etiologic factors include Dilatation and curettage (D and C) (33.3); Caesarean section (C/S) (31.5); manual removal of placenta and Pelvic Inflammatory Disease (PID) (7.4each); and unexplained (3.7). Mode of presentation was secondary amenorrhoea (50); oligomenorrhoea (22.2); and hypomenorrhoea (10). As for the management; 68had blind procedure while 25.9had hysteroscopic procedure. Lippes loop was used in all except three patients who had pediatric Foleys catheter instead. Upon follow-up 59.3resumed normal menses; 11.1had oligomenorrhoea; hypomenorrhoea 13and amenorrhoea 5.6. There was no statistical difference in the outcome of treatment between hysteroscopic adhesiolysis and the blind procedure when return to normal menses is considered as the end point; OR=2.27; CI 0.45-12.65; Fisher exact test (one-tailed) P=0.2184818. Conclusion: There was no significant difference between the blind and hysteroscopic procedures. Dilatation and curettage was found to be the commonest cause of IUA