Feto-maternal outcomes of caesarean delivery in Federal Medical Centre, Asaba: a two year review

Background: The upward trend of caesarean section and its associated morbidity/mortality especially in low- and middle-income areas make regular appraisal of the procedure necessary. Objective: To evaluate caesarean section; its rate, indications, and maternal and fetal outcomes in Asaba. Methods: A retrospective study of all caesarean sections carried out at the obstetrics unit of the Federal Medical Centre, Asaba, between July 1, 2018, and June 31, 2020. Data was analyzed using SPSS version 20. Results: There were 2778 deliveries during the period, out of which 705 had caesarean sections, giving an overall caesarean section rate of 25.4%. There were 456 (64.7%) emergency caesarean sections. The commonest indication for caesarean section was repeat caesarean section 196 (27.8%), while cephalo-pelvic disproportion 87 (12.3%) was the commonest indication for emergency caesarean section. Majority of the babies had low APGAR score at 1min and 5mins, 126 (27.6%) and 50 (11.0%) from emergency than elective caesarean section 16 (6.4%) and 5 (2.0%) at 1min and 5mins respectively (x2=17.963, P<0.001). There were 31 (4.2%) perinatal deaths out of which majority 28 (6.1%) were from emergency caesarean sections (x2=9.412 P=0.002). The commonest post-operative complication was postpartum anemia (140 (19.9%) while caesarean section case fatality was 0.6%. Conclusion: This study showed a caesarean section rate of 25.4% with repeat caesarean section and Cephalopelvic disproportion being the most common indication for elective and emergency caesarean section respectively. Emergency caesarean section accounted for most of the cases and is associated with a higher risk of maternal and perinatal morbidity and mortality

Factors Associated with Drug Counterfeit in Nigeria: A Twelve Year Review.

Background: Drug counterfeiting poses a great danger to every society. The actual prevalence of counterfeit drugs is difficult to ascertain presently but just like other crimes, drug counterfeiting is an underground business that often comes to light mostly when death occurs. About 10% of drugs circulating worldwide are fake drugs with enormous associated health risk. Preventing the problem is a primary duty of every responsible nation in order to save lives. Objective: This paper aims at studying the factors associated with drug counterfeiting, its consequences and possible solutions. Methods: This article reviews relevant literatures published from 2004 to 2015 from medical journals, health survey reports, books, Google search and health-related websites such as World Health Organization. Results: Several researchers have identified corruption and conflict of interest, poor health seeking behavior of Nigerians, high prices of locally manufactured drugs due to high taxes and tariffs, inadequate legislation, unordered drug distribution system, inadequate cooperation from government agencies and discriminatory regulation by exporting countries as the major factors associated with drug counterfeiting in Nigeria. Conclusion/ Recommendations: Drug counterfeiting is one of the greatest atrocities of our time and it affects both developing and developed countries. There is an urgent need for the government as well as professional bodies to ensure massive public enlightenment and the effective enforcement of the existing drug laws in Nigeria.