Sleep quality and new onset postpartum hypertension

Background: Chronic sleep deficiency is a stressful situation which has an association with high blood pressure. After delivery, mothers have disrupted sleep due to frequent awakenings by their infants. What is not known is how significant this relationship is in women during the postpartum period as well as other factors that may affect their Sleep quality. Sleep quality is a measure of duration and disruption. Aim and Objectives: Study is aimed at determining the relationship between Sleep quality and new onset postpartum hypertension. The specific objectives are; to determine the Sleep quality of mothers in the postpartum period using the Pittsburgh Sleep quality index (PSQI), identify factors that affect Sleep quality of mothers in the post-partum period and determine blood pressure patterns of mothers in the postpartum period. Materials and Methods: This was a longitudinal study. Using systematic random sampling, a sample size of 126 women were recruited between June and August 2016 in the Postnatal clinic of the 37 Military Hospital. Written consent was obtained from participants. Sitting blood pressure was checked and recorded and a modified form of the Pittsburgh Sleep quality index (PSQI) was used to assign a global score for Sleep quality. A global score of more than 5 indicated poor Sleep quality in that mother. Clients were first recruited at the 1st postnatal visit with follow-up at the 2nd routine postnatal visit (6weeks). Only mothers whose blood pressures were normal during pregnancy and upon discharge from hospital were included. For categorical data, Pearson's chisquare test was used for comparisons and logistic regression as used to determine significant factors that contribute to new onset hypertension in postpartum women. A P-value less than 0.05 was considered significant. Results: Majority of mothers (92.1% and 90.5% at first and second visits respectively) had poor Sleep quality. Mothers who slept away from their babies at the sixth week visit had better sleep. Mean global Sleep quality scores had no significant association with new onset hypertension but mean scores of some Age , p=0.001, OR =1.20 (C.I: 1.09-1.32) and some sleep components sleep disturbance, p=0.041, OR =1.86(C.I: 1.02-3.37), and use of sleep medicine, p=0.031, OR =1.54 (C.I:1.04- 2.29) were significantly associated with new onset postpartum hypertension. Conclusion: Global poor Sleep quality is not associated with increased odds of new onset hypertension but the Sleep quality components, sleep disturbance and increased use of sleep medicine, were significantly associated with new onset hypertension in mothers

Enteropathogens Associated with Childhood Diarrheal Cases seen at a Tertiary Hospital in Nguru, Yobe State of Nigeria.

Aim: Childhood diarrheal diseases are common clinical episodes seen among children under 5 years old in the developing countries of sub-Saharan Africa and Asia. Epidemiological information of enteropathogens associated with childhood diarrhea will provides clinical information to alliterate and enhance effective therapy management in our hospital. Study Design: Retrospective analysis of enteropathogens associated with childhood diarrheal cases. Place and Duration: The study was carried out in Federal Medical Centre, Nguru, over one year period from January to December, 2010. Methodology: Fecal specimens were collected from patients presented with childhood diarrheal symptoms seen at the tertiary hospital at Nguru, Nigeria over the study period. Standard microbiological methods were employed in the enteropathogens detection. A total of 144 diarrheic fecal specimens were examined for existence of enteropathogens. The breakdowns of associated clinical diagnosis are as follows, gastroenteritis, 14 (9.7%), diarrhea, 80 (55.6%), dysentery, 31 (21.5%) and mucoid/bloody stool, 19 (13.2%). Results: Of the 144 specimens analysed, enteropathogens were found in 89 (61.8%), 41 (46.1%) parasites and 48 (53.9%) bacterial cases respectively. Only two bacterial groups were identified, 43 (29.9%) were Escherichia coli and 5 (3.5%) belonged to Shigella spp. Among the parasites, Enteamoeba histolytica was the most prevalent (31 isolates, 21.5%), followed by Ascaris lumbricoides with 7 isolates (4.9%), Taenia saginata with 2 isolates (1.4%) and Hookworm with only 1 isolate (0.4%). Statistical significant difference was observed when the isolation frequency of enteropathogens was compared with the agegroup and associated clinical diagnosis of the patients (p<0.02). Co-infections were observed in 16 (12.2%) cases, including 10 (62.5%) cases of E. coli / E. histolytica and one case (6.3%) of A. lumbricoides and Shigella spp. Conclusion: The frequency of enteropathogens detected in this study was similar with those reported in other studies. In addition, it provides the epidemiological information on enteropathogens associated with childhood diarrhea in the studied region and serves as a guide to pediatricians towards empirical therapy.