'Gift with a price tag': Nigerian egg donors' knowledge, experiences and motivations

Research around the world has indicated that the demand for egg donation has grown considerably among young females. This study qualitatively examines the knowledge, experiences, and motivations of young egg donors at a Nigerian health facility. Indepth interviews were conducted in Igbo and English with consenting thirty-one egg donors attending a fertility clinic in Anambra State, south-eastern Nigeria. Data were collected and analysed to generate themes with the aid of NVivo 10 software. Three themes were identified from the participants' motivations and include (a) monetary (93.6%), (b) altruistic (3.2%), and (c) both monetary and altruistic reasons (3.2%). Findings highlighted that the differences were based on a variety of reasons in Nigeria. All the participants were literate and single, and the majority received payment. The majority (77.4%) of those who received payment mentioned that the payment was not worth the donation program. The participants preferred to be anonymous because they had not discussed their donation with their family members, and the non-acceptance of egg donation program by the Nigerian society. Given that the market for egg donation has become a common method of infertility management in Nigeria, our findings have important implications for practices, policy actions, and future research. (Afr J Reprod Health 2022; 26[6]:64-79).

Thoracoabdominal compartment syndrome complicating right-sided diaphragmatic eventration with co-existent unilateral renal agenesis

Diaphragmatic eventration (DE) associated with intestinal malrotation and renal agenesis is a rare entity. The authors report a case of a 69-year-old man who had symptoms of heart failure. He had a previous imaging diagnosis of right diaphragmatic eventration and dilated cardiomyopathy. He died on the second day after the hospital admission and had a post mortem examination that confirmed complete right diaphragmatic eventration, intestinal malrotation, left renal agenesis, dilated cardiomyopathy, and anteriorly rotated right kidney and had findings suggestive of a thoracoabdominal compartment syndrome. Thoracoabdominal compartment syndrome is described as transmission of abdominal pressure through a defective diaphragm causing compression of the hemithorax viscera and mediastinal shift with a hemodynamic alteration. The association of these anomalies is rare, and the possibility of this finding in a patient with eventration should always be considered.

Hepatitis B Virus Infection and Biomarkers Correlates of Liver Injury among Healthy Blood Donors in Nigeria

Objectives: Destruction of blood cells and damage to hepatocytes arethehallmark of hepatitis B viral infection. This cross-sectional study was undertaken to evaluate some hematological parameters and biomarkers of liver injury in healthy blood donors infected with the occult and overt hepatitis B attending the University of Abuja Teaching Hospital (UATH) and Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, Nigeria Materials and Methods: A total of 20 overt and 14 occult hepatitis B virus-infected blood donors were confirmed and enrolled using Roche ® COBAS q-PCR from 212 consented pooled subjects. Hematological parameters and absolute CD4+T-cell count were determined using the Sysmex hematology analyzer and Partec cyflow counter, respectively. Determination of serum Alanine Aminotransferase (ALT) and Alpha Feto-protein (AFP) levels were done spectrophotometrically and ELISA, respectively.Results: The mean red blood cells, hematocrit, hemoglobin, white blood cells, CD4 and platelet count in the overt group were not statistically significantly different from the occult group p>0.05. However, of the 34 infected subjects, 7 (20.6%), 6 (17.7%), 2 (5.9%), 13 (38.2%), 2 (5.9%) and 4 (11.8%) had abnormally low blood values for red blood cells, white blood cells, hematocrit, hemoglobin, CD4 and platelets respectively. The mean ALT and ALP values from the occult and overt groups were not also significantly different (p>0.05).Conclusion: This study found a decrease in the values of some blood cells. However, no significant changes in the liver enzymes were found. These infected individuals should be managed to prevent transmission of HBV infection to other people and subsequent destruction of blood cells and damage to liver cells. Future studies couldfocuson patients with chronic liver diseases/Hepatocellular carcinoma caused by HBV to determine the effects on the liver biomarkers and hematological parameters

Evaluation of Zinc, Vitamin C and Vitamin E Levels in Male Subjects with Type 2 Diabetes Mellitus

Aim: The aim of this study was to determine the serum/plasma levels of zinc, vitamin C and E in male subjects with type 2 diabetes mellitus to establish their concentration pattern.Place and Duration of Study: Medical outpatient clinic, Chemical Pathology Laboratory of Enugu State University of Science and Technology Teaching Hospital, between January and December 2016.Methodology: This prospective cohort study enrolled 40 male individuals with type 2 diabetes mellitus and 40 apparently healthy control, within the age range of 45-75 years. Zinc, vitamin C, vitamin E, and fasting blood glucose levels were determined at pre-treatment, six months and 12 months into treatment. Results: The mean values of zinc, vitamin E and fasting blood glucose were significantly higher at pre-treatment compared to apparently healthy control values (147. 76 +/-32.95 vs 114.31+/-15.58 μg/dl,11.88+/-3.13 vs 3.42+/-0.21mg/dl and 8.08 +/-3.22vs 5.25+/-0.35 mmol/l respectively) (p=<0.001, <0.001, and <0.001 respectively). At 6 month into treatment in comparison to pre-treatment values, there were significant decreases in vitamin C (3.90+/-0.97 vs 5.15+/-1.43 mg/dl) (p= 0.04). At 12 month into treatment in comparison to pre-treatment values, there were significant decreases in vitamin C (3.25+/-0.16 vs 5.15+/-1.43 mg/dl) (p= <0.001). At pre-treatment, vitamin C significantly decrease from 6.49+/-0.96mg/dl in age group 45-64 years to 4.10+/-0.76mg/dl in age >65 years (p=0.01).Conclusion:The levels of vitamin C were lower at six months, but lowest at 12 month into treatment. Also vitamin C levels were found to be lower in age >65 years.

Oxidative stress markers and lipid profiles of patients with polycystic ovary syndrome in a Nigerian tertiary hospital

OBJECTIVE: To determine the activities of oxidative stress markers and lipid profiles of patients with polycystic ovary syndrome (PCOS) in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria. METHODS: This was a nested case-control study consisting of 50 PCOS patients and 50 healthy women of the same age range without any evidence of PCOS. The study measured the levels of malondialdehyde (MDA), activity of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), total antioxidant capacity (TAC); concentrations of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C), as well as high-density lipoprotein cholesterol (HDL-C) using standard spectrophotometric methods. Anthropometric indices were also assessed. P-values of <0.05 were taken to be statistically significant. RESULTS: There were significantly higher levels of MDA (P=0.002), lower activity of SOD (P<0.001), and lower TAC (P=0.001) in PCOS patients when compared with the controls. There were higher concentrations of TC (P=0.017) and LDL-C P=0.012) in PCOS patients than in controls. Significant differences were not observed between the 2 groups in terms of the activity of GSH-Px, as well as the concentrations of HDL-C and TG. The body mass index, waist circumference, and waist-hip ratio were all significantly higher in PCOS patients. CONCLUSION: This study revealed higher levels of MDA, as well as lower activity of SOD and TAC, among PCOS patients. Furthermore, there were higher levels of TC and LDL-C among the PCOS patients. Hence, monitoring these parameters may improve the clinical management of PCOS.

Relationship among HbA1c and Some Markers of Endothelial Damage in Type 2 Diabetes Mellitus

Background: A number of processes regulating the thrombolytic balance are impaired in diabetic patients as a result of dysfunction of endothelial cells leading to a hypercoagulative state. Von Willebrand factor (VWF) is an important marker of endothelial dysfunction. Plasminogen activator inhibitor-1 antigen (PAI-1-Ag), the major physiological inhibitor of tissue plasminogen activator (tPA), is mainly produced by endothelium. The aim of this study is to measure plasma levels of von Willebrand factor, Plasminogen activator inhibitor-1 antigen in type 2 diabetes mellitus patients and to correlate with glycated haemoglobin (HbA1c). Study Design: This prospective cohort study was conducted on 30 diagnosed type 2 DM patients who were about to start treatment. Place and Duration of Study: Medical outpatient (MOP) clinic of Enugu State University of Science and Technology Teaching Hospital (ESUTTH), between January and December 2016. Methodology: We included 30 patients (13 men, 17 women; age range 40-80 years) with type 2 diabetes mellitus. Blood samples were drawn from the patients before they commenced treatment, six months into the treatment and at twelve months of the treatment. Blood samples were also drawn from 25 age matched non diabetic patients. Plasma von Willebrand factor and Plasminogen activator inhibitor-1 antigen levels were determined by Enzyme linked immunosorbent assay. Glycated haemoglobin (HbA1c) and fasting blood sugar (FBS) levels were also evaluated along with them. Results: This study was conducted on 30 type 2 DM patients consisting of 13 males and 17 females. At treatment naïve, mean levels of vWF were significantly increased (45.48 +/- 6.46) in male type 2 Diabetic patients compared to the control (20.45 +/- 0.26). Six months into treatment mean levels of vWF were significantly increased (48.18 +/- 4.99) in female type 2 Diabetic patients compared to the control (37.64 +/- 7.93). The plasma levels of vWF were significantly and positively correlated with HbA1c at six months into treatment in male type 2 DM patients. The plasma levels of vWF were also significantly and positively correlated with PAI-1 at six and twelve months into treatment in both genders. Conclusion: There was strong significant positive correlation between plasma levels of vWF and PAI-1 in type 2 diabetes mellitus patients.

First detection of FOX-1 AmpC beta-lactamase gene expression among Escherichia coli isolated from abattoir samples in Abakaliki, Nigeria

Objectives: Gram-negative bacteria represent the most relevant reservoir of resistance to antibiotics in the environment. The natural selection of resistant clones of bacteria in the environment by antimicrobial selective pressure is a relevant mechanism for spreading antibiotic resistance traits in both the community and hospital environment. This is in scenarios where antimicrobials are used irrationally, and even in the propagation of livestock, poultry birds, and for other veterinary purposes. This study sought to detect the prevalence of FOX-1 AmpC beta-lactamase genes from abattoir samples

Methods: The isolation of Escherichia coli, antimicrobial susceptibility testing, and beta-lactamase characterization was carried out using standard microbiology techniques. The production of AmpC beta-lactamase was phenotypically carried out using the cefoxitin-cloxacillin double-disk synergy test [CC-DDST], and FOX-1 AmpC genes was detected in the E. coli isolates using multiplex polymerase chain reaction

Results: Forty-eight E. coli isolates were recovered from the anal swabs of cows and 35 [72.9%] isolates were positive for the production of beta-lactamase. Notably, high percentages of resistance to cefoxitin [91.7%], ceftriaxone [83.3%], imipenem [85.4%], ceftazidime [87.5%], ofloxacin [81.3%], and gentamicin [85.4%] were found. FOX-1 genes were detected in three [6.3%] of the 48 E. coli isolates phenotypically screened for AmpC enzyme production

Conclusions: Abattoirs could represent a major reservoir of resistance genes especially AmpC beta-lactamase, and this could serve as a route for the dissemination of multidrug-resistant bacteria in the community. Thus, the molecular identification of drug-resistant genes is vital for a reliable epidemiological investigation and the forestalling of the emergence and spread of these organisms through the food chain in this region

Sensitivity of computed tomography-guided transthoracic biopsies in a Nigerian tertiary institution

Introduction: The indications for open biopsies for intrathoracic lesions have become almost negligible. This development was made possible by less invasive maneuvers such as computed tomography-guided (CT-guided) biopsy, thoracoscopy or video-assisted thoracoscopy, and bronchoscopy. CT-guided percutaneous lung biopsy was first reported in 1976. Aim of Study: The aim of the study is to report our experience with CT-guided transthoracic biopsy. Materials and Methods: Patients with clinical and radiological evidence of intrathoracic mass were counseled and consent obtained for the procedure. They were positioned in the gantry, either supine or prone. A scout scan of the entire chest was taken at 5 mm intervals. The procedure was carried out by the consultants and senior registrar. Following visualization of the lesion, its position in terms of depth and distance from the midline was measured with the machine in centimeter to determine the point of insertion of the trucut needle (14­18-G). The presumed site of the lesion was indicated with a metallic object held in place with two to three strips of plasters after cleaning the site with Povidone-iodine. After insertion, repeat scans were performed to confirm that the needle was within the mass. A minimum of 3 core cuts was taken to be certain that the samples were representative. The results were analyzed by the determination of means and percentages. Results: Twenty-six patients underwent this procedure between 2011 and 2015. There were 15 males and 11 females (M:F = 1.4:1). The age range was between 30 and 99 years with a mean of 55 years. Histological diagnosis was obtained in 24 of the patients giving sensitivity of 92.3%. There were 3 mild complications giving a rate of 11.5%. The complications included a case of mild hemoptysis and two patients who had mild pneumothoraces which did not require tube thoracostomy. Conclusion: CT-guided biopsy is a reliable procedure for obtaining deep-seated intrathoracic biopsies with high sensitivity and minimal complication rate

Early experience with laparoscopic management of nonpalpable undescended testes

Background: Nonpalpable undescended testes (NPT) constitute 20%­30% of undescended testes, and its management has been a challenge both in diagnosis and treatment. Worldwide, laparoscopy is the current gold standard of management. In Nigeria, the management of NPT has largely been by open surgery with consequent high morbidity. In Nigeria, the trend is changing from a largely open management with its attendant high morbidity, to laparoscopic management which is the current worldwide gold standard of care. Aim: This study aims to classify the laparoscopic features of NPT and determine the outcome of managed cases in our center. Methodology: Prospective data were collected from consecutive patients who had laparoscopy for NPT at the Paediatric Surgical Unit of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from June 2014 to July 2016. Results: A total of 15 patients with 23 testes were treated. There were eight patients with bilateral NPT; four had left and the remaining three right NPT. The age ranged from 1.2 to 29 years with a median of 5 years. Eleven out of the 22 internal inguinal rings were open. The position of the testes was canalicular (2), peeping (2), low abdominal (6), high abdominal (6), blind-ended vas (1), absent vas and vessels (5). No further intervention was needed for the six agenetic/atrophic testes. Standard open orchiopexy was done for the two canalicular testes. Eight testes were brought down by one stage laparoscopic orchiopexy while four were brought down by staged laparoscopic Fowler-Stephens procedure. Laparoscopic orchiectomy was done in two patients (a grossly dysmorphic testes [nubbin] and a high abdominal testis in a 29-year-old). Orchiopexy was successful in 11 out of 15 fixed testes. Of the unsuccessful ones, three testes were atrophic (volume less than what it was initially) while two were high scrotal (one testes has both complications). There was no conversion to open abdominal surgery. All patients were discharged within 24 h of surgery.Conclusion: Laparoscopy provides for a better management of NPT by combining diagnosis and intervention in the same sitting with a good success rate and minimal postoperative morbidity

First Report of blaCTX-M-15 Extended Spectrum Beta-Lactamase (ESBL) Producing E. Coli Isolated from Cloacal Swabs of Birds in South Eastern Nigeria

Introduction: In this study, we investigated the presence of some beta-lactamases namely SHV, TEM and the most widely spread extended spectrum beta-lactamase (blaCTX-M-15) genes in E. coli isolated from four different bird species including ducks, pigeons, weaverbirds and bats in Ebonyi State, Nigeria. Methodology: Genes for ESBL production was determined based on PCR amplification of the genes encoding the enzymes including TEM, SHV and CTX-M-15 using specific primers. One hundred and fifty cloacal swabs each from ducks and pigeons and 100 each from weaverbirds and bats were respectively collected using sterile swab sticks. Antibiotic susceptibility test on the isolates was conducted using disc diffusion method while the phenotypic determination of ESBL was carried out using Double Disc Synergy Tests (DDST). Observations: Results from this study showed that E. coli was present in all the 4 bird species investigated. Of the 117 isolates screened for ESBL production, only 3(5.56 %) and 9(16.67 %), respectively were positive from ducks and pigeons while none was positive from bats and weaverbirds. Results of the molecular studies showed that the ESBL producing E. coli from pigeons were negative for SHV genes, positive for TEM and CTX-M-15 while those from ducks did not harbour any of the beta-lactamase and ESBL genes investigated.  Conclusion: The detection of similar types of beta-lactamase and ESBL genes (TEM and CTX-M-15) in pigeon samples indicates the possible involvement of some bird species in the spread of multidrug resistant genes across human population. This is the first report of CTX-M-15 ESBL in bird species from Southeast Nigeria.

Evaluation of Thyroid Hormones Changes and CD4+ T-cell Count during Menstrual Cycle in Pulmonary TB Infected Women in Nnewi, Nigeria.

Background: Tuberculosis remains a disease of major public health importance worldwide including Nigeria. Endocrine abnormalities have been reported among Tuberculosis patients with the thyroid inclusive. Aims of Study: The present study was designed to evaluate the thyroid hormones changes and CD4+ T-cell count during menstrual cycle in women infected with Pulmonary Tuberculosis in Nnamdi Azikiwe University Teaching Hospital, Nnewi, south east Nigeria. Materials and Methods: The study comprised 90 premenopausal females aged 15-45 years randomly recruited at Direct Observed Therapy (DOT) Clinic at NAUTH, Nnewi from 2013-2014. 30 participants were Symptomatic TB infected females who were not yet on drugs at the time of sample collection while 30 were Symptomatic TB infected females on Anti tuberculosis therapy. The remaining 30 were apparently healthy hospital staff with regular menstrual cycle. After due consent, a detailed medical history was obtained and routine investigations of pulmonary tuberculosis and confirmation using Ziehl Neelsen and sputum culture techniques for AFB and chest x-ray were done. Blood samples were collected at follicular and luteal phases of their menstrual cycle for analysis of Thyroid hormones (T3, T4 and TSH) using Enzyme Linked Immunosorbent Assay (ELISA) method. CD4 T-cell counts was determined using cyflow SL Green Cytometer. Results: Result showed significantly lower T3 and CD4 T-cells with normal TSH values in Symptomatic TB compared with control females at both phases of menstrual cycle (P=.05 respectively). TSH value was significantly lowered in Symptomatic TB than Symptomatic TB on ATT while T3 and CD4 T-cell count were significantly higher in Symptomatic TB on ATT compared to Symptomatic TB at both phases of menstrual cycle (P=.05). Conclusion: Euthyroid sick syndrome was observed among Symptomatic TB females which showed some level of improvements with administration of ATT. A new national strategic plan for TB control is advocated to include routine thyroid function check with special attention paid to the reproductive function.

Birth Preparedness and Complication Readiness: Attitude and Level of Preparedness among Pregnant Women in Benin City, Edo State, Nigeria.

Lack of advance planning for use of skilled attendants at birth contributes significantly to delays in receiving obstetric care. This study assessed attitude and level of birth preparedness and complication readiness (BPACR) plan among pregnant women in Benin City, with a view to improving utilization of skilled attendants at birth and health facility deliveries. Materials and Methods: A community based analytical cross sectional study was conducted, involving interviewer administration of pretested structured questionnaires to 252 consenting pregnant women in Benin City, Edo State. Results: The mean age of pregnant women studied was 28.9±4.9 years. Two hundred and thirty eight (94.4%) respondents had positive attitude towards BPACR. Furthermore, 197 (78.2%) and 218(94.4%) of respondents were well prepared with regard to intended and actual birth plans respectively. Awareness of BPACR (OR=0.337; 95%CI=0.128-0.891; p=0.028) and Antenatal Care (ANC) registration (OR=0.016; 95%CI=0.002-0.127; p˂0.001) were significant predictors identified that influenced BPACR plans. Conclusion: Majority of pregnant women studied had positive attitude towards BPACR and were well prepared with regards to intended and actual birth plans respectively. There is need to strengthen Antenatal Care (ANC) registration practices to sustain the improved utilization of skilled attendants at birth and health facility deliveries identified among pregnant women in Benin City, Edo State.

Assessment of Methaemoglobin and Carboxyhaemoglobin Levels among Pregnant Women Infected with Hepatitis B Virus.

Aims: The goal of this research is to determine plasma levels of MetHb and COHb in pregnant women with hepatitis B, which might enhance oxidative stress and hypoxemic condition of this state if it is not ameliorated on time. Study Design: Prospective case-control study. Place and Duration of Study: Antenatal clinic at Primary Health Centres, Sagamu, Ogun State, Nigeria between February, 2015 and August, 2015. Methodology: Blood levels of MetHb, COHb and bilirubin were determined in ninety four (94) participants (aged 18-40 years), divided into three groups: 33 pregnant women infected with hepatitis B virus, 30 apparently healthy pregnant women and 31 age matched non pregnant women apparently healthy controls. Blood levels of MetHb, COHb and bilirubin were determined using standard spectrophotometric method. Results: There was progressive increase and decrease in mean blood levels of (TBil, and MetHb) and mean blood levels of COHb respectively from controls through pregnant subjects with HBV. PCV and DBil had no specific pattern of differences across the groups. Conclusion: This study showed a slight increase in blood levels of MetHb in pregnant women with hepatitis B and apparently healthy pregnant women compared to non-pregnant controls, which might enhance oxidative stress and hypoxemic condition of this state. It would also be helpful to incorporate MetHb screening as routine tests for better management of pregnant women especially with HBV.

Reticulocyte Count Of Nigerian Children With Malaria Infection In The University Of Calabar Teaching Hospital.

Abstracts: Background: This work was sets out to assess the reticulocyte count of Nigerian Children infected with malaria in the University of Calabar Teaching Hospital, comprising of fifty malaria infected children and forty six apparently healthy children. The malaria infected children comprised of 25 males and 25 females aged 1-10 years. Blood samples were collected and analysed for reticulocyte count using the 1% new Methylene Blue supra vital staining method and malaria parasites using, 2% Giemsa stain. The mean reticulocyte count in the malaria infected children (2. 17 ± 0.3%) was significantly higher (P<0.01) than that in the apparently healthy children (1.03 ± 0.3 %). The mean parasites density in infected children was 30,428.76 ± 11,876.85 ul. A comparism of reticulocyte level of infected male (2.204 ± 0.32%) and female children (2.133 ± 0.3 6%) showed no significant difference (p>O.O5). Equally, the reticulocyte levels of infected children between 1-5 years of age (2.1 5 ± 0.34%) was not significantly different (P> 0.05) from that of children aged between 6-10 years (2.18 ± 0.32%). The level of reticulocytosis is a reflection of parasite density in the malaria infected children.

Contraception Usage: Knowledge, Attitude and Associated Factors among Women of Reproductive Age Attending a Health Facility in Benin City, Nigeria.

Background: Contraceptive usage remains a challenge in developing countries. Despite high contraceptive awareness and knowledge, studies have shown disappointingly very low contraceptive usage. The 2013 Nigeria Demographic and Health Survey (NDHS) report places modern contraceptive usage in Nigeria at 10%, amounting commutatively as a 6% increase over a 24 year period. This study was conducted to assess knowledge, attitude, contraceptive usage and associated factors among women of reproductive age attending a health facility in Benin City, with the goal of developing programs and interventions to improve contraceptive usage. Methods: A health facility based descriptive cross sectional study design was utilized for this study, involving researcher administration of semi-structured questionnaires to 161 consenting women (15-49 years) attending immunization clinics in a health facility in Benin City. The data collected were analyzed using IBM SPSS version 21.0 statistical software with statistical significance set at p< 0.05 and 95% Confidence Interval. Results: One hundred and thirty eight (85.7%) women studied were aware of contraception with 128 (92.8%) having correct knowledge of contraception. One hundred and fourteen (82.6%) women had positive attitudes towards contraception use while (17.4%) had negative attitudes. Furthermore, the per cent of contraceptive users was calculated to be 64.5% (n=89) among women studied. Multivariate analysis following bivariate analysis identified being single (OR=0.136; 95% CI = 0.026 - 0.719; p=0.019) and having negative attitude (OR=0.367; 95% CI = 0.147 - 0.917; p=0.032) towards contraception to be negatively associated with contraception usage when compared to being married and having positive attitude towards contraception. Conclusion: The level of awareness and knowledge on contraception among women studied was high, with gaps identified to exist between knowledge, attitude and contraceptive usage. There is need to develop interventions to sustain and improve contraception usage among women in Benin City, Edo State.

The Effect of Repeated Blood Donations on the Iron Status of Male Blood Donors in Enugu State, Nigeria.

Background: One of the biggest challenges in blood donation particularly in Nigeria is the recruitment and retention of voluntary non-remunerated, low cost blood donors. Aims: The aim of this study is to determine the effect of repeated blood donations on iron stores and the prevalence of iron deficiency anaemia among the male blood donors in the Enugu State, Nigeria. Study Design: In this case-control study, two hundred and twenty three randomly selected male blood donors, were grouped into six categories according to the number of units of blood donated in one year, two years, three years and the last group were on their 4th year. Place and Duration of Study: Haematology and blood bank laboratory unit, Enugu State University of Science and Technology Teaching Hospital, Enugu, Enugu State, Nigeria: April 2012 to December 2012. Methodology: Prior to blood donation, blood samples of 202 directed/regular male blood donors and twenty one apparently healthy men with no previous history of blood donation (aged 18- 40years) were collected. Donors were grouped into 0, ≤ 3, 4-6, 7-9, 10-12 and > 13 categories based on the number of units of blood donated. Results: Iron depletion was seen in 1.3% in group 2 (1-3 times) and also in 13.3% of group 4 (7-9 times), iron deficiency was present in 4.4% of group 3 (4-6 times) and in 20% of group 6 (13-15 times) and iron deficiency anaemia was discovered in 4.4% of group 3 (4-6 times). Blood donors with more than seven times instances of blood donation (P<0.05) showed a significant relationship between iron depletion and iron deficiency. Conclusion: This study showed that iron deficiency anaemia in blood donors can occur as a result of increase in number of units of blood donated and also based on iron status of individual at time of donation. Based on findings of this study ferritin test should be done on all male blood donors in Enugu before donating any unit of blood to find out the appropriate time to start iron supplement.

Determinants of Post-Caesarean wound Infection in Nnewi, Nigeria.

Background: Delivery by caesarean section has been reported as the single most important risk factor for maternal wound infection. Wound infection is not only a leading cause of prolonged hospital stay but a major cause of widespread aversion to caesarean delivery in developing countries. Despite all these, the determinants of post-caesarean wound infection in Nnewi have remained largely uninvestigated. Objective: This study was to determine the factors that predispose to post- caesarean wound infection at a tertiary institution in a developing country. Design: This was a cross sectional study. Place and Duration of Study: Labour ward, Theatre and Post natal ward of NAUTH Nnewi between April to November 2012. Methodology: All women who had caesarean section, met the inclusion criteria and gave consent were included in the study. They were divided into two groups (Group A and Group B) each comprising 60 women. Group A comprised women who had emergency caesarean section, while those in group B had elective caesarean section. The outcome of their post-caesarean wound was assessed. Statistical analysis (Logistic regression) of identified risk factors in patients who developed wound infection was performed at a 95% confidence interval. Results: The incidence of post caesarean wound infection was 12.5%. While the infection rate was twelve (20.0%) among women who had emergency caesarean section, it was 3 (5.0%) among those who had elective caesarean section. The identified independent risk factors for wound infections were the duration of membrane rupture more than 24 hours (OR=0.11: 95% CI 0.03- 0.47: P =0.003), labour duration more than 12 hours (OR =0.07: 95% CI 0.01-0.32: P =0.001) and the use of subumbilical, midline incision (OR=0.21: 95% CI 0.05-0.91). Conclusion: The post caesarean wound infection rate in NAUTH was high. Efforts should be geared towards the prevention of prolonged labour by health education, early intervention and use of partograph. Timely intervention for prolonged rupture of membranes would drastically reduce the incidence of wound infection in our area.

Assessment of Breast Cancer Screening Practices among Women of Reproductive Age in Benin City, Edo State.

Breast cancer is becoming very prevalent in developing countries including Nigeria which is now being bedeviled by the twin public health challenge of both communicable and non-communicable diseases. Aims: This study was conducted to assess breast cancer knowledge and screening practices among women of reproductive age in Benin City, with a view to improving breast cancer screening practices and minimize late presentation and attendant consequences. Study Design: A descriptive cross sectional study design was utilized for this study. Place and Duration of Study: This study was carried out in Central Hospital in Benin City, Edo State between September and December, 2013. Methodology: This study was health facility based involving researcher administration of semistructured questionnaires to 235 consenting women of reproductive age (15-49years) attending immunization clinics in Benin City. The data collected were analyzed using IBM Statistical Package for Sciences (SPSS) version 22.0 with statistical significance set at p< 0.05 and 95% Confidence Interval. Results: The mean age and parity of respondents studied were 28.8±7.4 years and 2.19±1.85 children respectively. Two hundred and seventeen (92.3%) of the women studied, were aware of breast cancer with majority 201(92.6%) having poor knowledge of breast cancer. Furthermore, the practice of breast examination was 143 (65.9%) among respondents studied with self-breast examination accounting for 106(74.1%). In relation to breast cancer screening practice, primary level of education (OR=0.323; 95% CI=0.141 – 0.742) was the only significant predictor identified that less likely influenced the practice. Conclusion: This study identified a high awareness with poor level of knowledge on breast cancer among women of reproductive age. The practice of breast examination was high with level of education identified as a significant predictor for breast cancer screening practice. There is need to create and strengthen breast cancer awareness campaign through all available media platforms and in schools not only for improved breast cancer screening practices but very importantly to improve knowledge on its presentation, risk factors and benefits of early detection and treatment for better health outcome.

Catheter-Associated Urinary Tract Infection Following Caesarean Section in Nnewi, Nigeria: A Prospective Comparative Study.

Background: Urinary tract catheterization is a major risk factor for urinary tract infections (UTIs). Catheter associated urinary tract infections (CAUTIs) still remain a major reservoir of antibiotic resistant pathogens with attendant increase in morbidity and mortality. Objective: To determine and compare the incidence of catheter associated urinary tract infections following immediate and 24-hour postoperative removal of urethral catheters for caesarean section. Design: The study was a prospective, comparative study. Place and Duration of Study: Labour ward, Theatre and Postnatal wards of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi between August 2012 to April 2013. Methodology: The study involved 156 women admitted for caesarean section where the urethral catheters were removed 24-hour post operatively (group A) or immediately after caesarean section (group B). Urine samples were collected. Outcome measures included pre-operative and 72 hour postoperative urine microscopy, culture and sensitivity, urinary frequency, dysuria, urgency, fever and duration of hospital stay. The patients’ data were coded, computed and analyzed using SPSS version 16. A P-value of <0.05 was considered significant. Results: Of the 79 patients in group A, 9 (11.4%) had significant bacteriuria in the 72 hour post operative urine culture while 5 (6.5%) had significant bacteriuria in group B, (OR=1.85: 95% CI 0.59-5.80, P=0.28). The overall incidence of catheter associated urinary tract infection in NAUTH was 14(9.0%). Escherichia coli were mostly isolated 4 (44.4%). The lowest level of resistance was seen with Amoxycillin- clavulanic acid (Augmentin). Conclusion: The present study showed that significant bacteriuria in Group A almost double the incidence in Group B, however, the difference was not statistically significant. Further studies should be carried out to compare catheterization with non- catheterization for caesarean section.

Effect of HIV Infection and Antiretroviral Therapy Duration on Reticulocyte Count and Red Cell Indices.

Aim: To determine the Red cell indices and Reticulocyte count values in HIV-positive patients under antiretroviral treatment and those not under antiretroviral treatments with varying durations of HIV infection and antiretroviral treatments. Study Design: Case-control study. Place and duration of Study: The study was carried out at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria from March to August 2013. Methodology: 181 subjects were recruited consisting; Sixty (30 males and 30 females) HIV subjects under antiretroviral therapy (ART) with an HIV infection and ART duration of <1–5 years, >5 –8 years and >8–17 years; Sixty (25 males and 35 females) HIV subjects not under ART (non-ART) with an infection duration of <1–3 years, >3–6 years and >6–11 years; and Sixty-one (31 male and 30 female) apparently healthy seronegative control subjects. The Reticulocytes count, Packed cell volume (PCV), Haemoglobin (HGB), Red blood cell count (RBC), Mean cell volume (MCV), Mean cell haemoglobin (MCH), Mean cell haemoglobin concentration (MCHC) and Human Immunodeficiency virus (HIV) status of the study subjects were determined. Results: MCV and MCH for ART and non-ART subjects were significantly increased compared with control group (P<.05) and the differences with varying durations of HIV infection and antiretroviral therapy were not significant (P>.05). Moreover, there was a significant decrease in the mean HGB, RBC, MCHC of ART and non-ART compared with control (F=8.51; 133.85; 33.32; P<.05 respectively) and their differences with varying durations of infection and antiretroviral therapy were not significant (P>.05). MCV were significantly higher in ART compared with non-ART (P<.05). Conclusion: There is no significant variation in Red cell indices and Reticulocyte count values in HIV patients with differences in duration of HIV infection and antiretroviral therapy.