Prenatal Screening for Down Syndrome: How Acceptable is it among Pregnant Nigerian Women?

BACKGROUND AND OBJECTIVE: Down syndrome is the most common chromosomal anomaly found among newborns. Prenatal screening can inform pregnant women and their partners of the risk of their baby having Down syndrome. The study aimed to determine the awareness and attitude of Nigerian pregnant women towards prenatal screening for Down syndrome. METHODS: This was a prospective observational study among pregnant women who attended antenatal clinics at two teaching hospitals in Nigeria between January and June 2018. Data on their awareness and attitude towards Down syndrome screening were collected using a semi-structured questionnaire and analysed with SPSS version 23.0. Level of significance was set at p<0.05 and 95% confidence interval (CI). RESULTS: Four hundred and four women participated in the study and their mean age was 30.8±4.87 years. Overall, 65.1% were aware of Down syndrome and the media (54.4%) was their main source of information. Less than half (44.3%) of them had a positive attitude towards Down syndrome screening. Respondents with primary (AOR=0.20, 95% CI=1.175-21.687) and secondary education (AOR=0.34, 95% CI=1.494-5.867) were less likely to be aware of Down syndrome, while having a positive attitude towards Down syndrome screening (AOR=2.07, 95% CI=0.314-0.745) and being engaged in skilled occupation (AOR=3.26, 95% CI=0.135-0.697) predicted awareness. A positive attitude towards Down syndrome screening was predicted by being engaged in skilled (AOR=2.51, 95% CI=0.185-0.858) and semi-skilled (AOR=2.37, 95% CI=0.205-0.870) occupation. CONCLUSION: Though majority of pregnant women had good awareness of Down syndrome; however, less than half of them had a positive attitude towards the screening test. The awareness and positive attitude exhibited by the women in this study were influenced by their level of education and occupation.

CONTEXTE ET OBJECTIF: Le syndrome de Down est l'anomalie chromosomique la plus fréquente chez les nouveau-nés. Le dépistage prénatal peut informer les femmes enceintes et leurs partenaires du risque que leur bébé soit atteint du syndrome de Down. L'étude visait à déterminer la sensibilisation et l'attitude des femmes enceintes nigérianes à l'égard du dépistage prénatal du syndrome de Down. MÉTHODES: Il s'agissait d'une étude observationnelle prospective parmi les femmes enceintes qui ont fréquenté les cliniques prénatales de deux hôpitaux universitaires au Nigéria entre janvier et juin 2018. Les données sur leur sensibilisation et leur attitude à l'égard du dépistage du syndrome de Down ont été recueillies à l'aide d'un questionnaire semi-structuré et analysées avec SPSS version 23.0. Le niveau de signification a été fixé à p<0,05 et à un intervalle de confiance (IC) de 95%. RÉSULTATS: Quatre cent quatre femmes ont participé à l'étude et leur âge moyen était de 30,8±4,87 ans. Dans l'ensemble, 65,1 % d'entre elles connaissaient le syndrome de Down et les médias (54,4%) étaient leur principale source d'information. Moins de la moitié (44,3%) d'entre eux avaient une attitude positive à l'égard du dépistage du syndrome de Down. Les répondants ayant suivi un enseignement primaire (AOR=0,20, IC 95 %=1,175-21,687) et secondaire (AOR=0,34, IC 95 %=1,494-5,867) étaient moins susceptibles de connaître le syndrome de Down, tandis qu'une attitude positive à l'égard du dépistage du syndrome de Down (AOR=2,07, IC 95 %=0,314-0,745) et l'exercice d'une activité professionnelle qualifiée (AOR=3,26, IC 95 %=0,135-0,697) étaient des facteurs prédictifs de la connaissance du syndrome de Down. Une attitude positive à l'égard du dépistage du syndrome de Down était prédite par l'exercice d'une profession qualifiée (AOR=2,51, IC à 95 %=0,185-0,858) et semiqualifiée (AOR=2,37, IC à 95 %=0,205-0,870). CONCLUSION: Bien que la majorité des femmes enceintes aient une bonne connaissance du syndrome de Down, moins de la moitié d'entre elles ont une attitude positive à l'égard du test de dépistage. La connaissance et l'attitude positive des femmes de cette étude ont été influencées par leur niveau d'éducation et leur profession. Mots-clés: Syndrome de Down ; Connaissance, Attitude, Test de dépistage, Femmes enceintes.

The synergism of hepatitis B and aflatoxicosis in hepatocellular carcinoma development: A mini-review

Hepatocellular carcinoma (HCC) is the twelfth most common cancer and the fifth leading cause of worldwide cancer related death. Chronic hepatitis B infection, caused by the hepatitis B virus (HBV) and exposure to aflatoxins is fundamental in the formation of HCC in developing countries. This review of scientific publications aims to establish the detrimental effects of aflatoxin-contaminated foods and highlights the correlation between aflatoxin and hepatitis B viral-associated hepatocellular carcinoma. Research has shown a significant increase in the occurrence of HCC in HBV-infected individuals exposed to fungal toxins. HBV demonstrates the ability to integrate and bind to p53 protein in the host DNA and propagate hepatocyte vulnerability through carcinogenic aflatoxin B1 (AFB1) damage. Although there has been clear evidence about the synergistic interaction of exposure to AFB1 and HBV infection in the induction of HCC, other literature has shown otherwise, mainly because incomplete and vague findings and hypotheses were made in regions where AFB1 and HBV pose a public health risk. Vaccination against hepatitis B and measures such as robust food safety systems to avoid hepatotoxicity and hepatocellular carcinogenesis induced by AFB1 is the most effective methods in the prevention of HCC induced by HBV and AFB1

A RARE METACHRONOUS COLONIC VOLVULUS.

Introduction: Colonic volvulus is a common cause of large bowel obstruction with the sigmoid colon most commonly affected. Volvulus of the transverse colon is an uncommon occurrence. Rarer still is a transverse colon volvulus developing after surgery for a sigmoid colon volvulus. Early diagnosis is critical as delay in detection and intervention is associated with the risk of complications - perforation, peritonitis, and death. Case presentation: We report the case of an 86-year-old man who presented with features of large bowel obstruction 14 months following a sigmoid colectomy for a sigmoid colon volvulus. Conclusion: A metachronous transverse colonic volvulus is uncommon. Preoperative diagnosis is challenging as there are no defining radiographic features compared to the volvulus of the sigmoid colon with the classical omega sign. Most cases are diagnosed intra-operatively. Bowel resection and anastomosis in a single stage is a safe option.

ASYMPTOMATIC BACTERIURIA AS A PREDICTOR OF PRE-ECLAMPSIA: A CASECONTROLLED STUDY.

Background: Pre-eclampsia, an important cause of maternal and perinatal morbidity and mortality world-wide has been linked to subclinical infections, with maternal infection and inflammation postulated in its aetio-pathogenesis including asymptomatic bacteriuria which is common in pregnancy. The Obejctive of the study is to determine the relationship of asymptomatic bacteriuria as a risk factor for pre-eclampsia. Methodology: A hospital-based case-control study among 28 pre-eclamptic pregnant women (cases) and 56 healthy pregnant women (controls) at gestational age of at least 28 weeks at the University College Hospital, Ibadan, between January 2019 and August 2019. Controls were matched with cases in age, parity and gestational age. Asymptomatic bacteriuria was determined with mid-stream urine analysis for microscopy and culture and data collected using an interviewer administered questionnaire with other details from medical records extracts. Chi- square, and multivariate regression analysis were used to assess statistical significance, odds ratio and adjusted odds ratio respectively, with P-value <0.05 and 95% confidence interval (CI). Results: There was a significant association between asymptomatic bacteriuria and pre-eclampsia. The rate of asymptomatic bacteriuria was about three times higher in women with pre-eclampsia compared to those without pre-eclampsia and 1.23 times higher after adjusting for confounders (OR: 2.9, AOR:1.23). There was no significant relationship between sterile pyuria and pre-eclampsia (p-value: 0.92). Conclusion: This study supports the proposition that asymptomatic bacteriuria is a risk factor for pre-eclampsia. It has not however shown whether the association is causal or casual. Further studies will be needed to explain this.

PUERPERAL SEPSIS AT UNIVERSITY COLLEGE HOSPITAL, IBADAN: A 10-YEAR REVIEW.

Background: Puerperal sepsis is one of the leading causes of pregnancy-related maternal morbidity and mortality in developing countries. This study explored the complications, treatment modalities, and management outcomes of puerperal sepsis. Methods: A 10-year retrospective review of women managed for puerperal sepsis at University College Hospital, Ibadan, Nigeria between January 2009 and December 2018. Information on their socio-demographic and obstetrics characteristics, presenting complaints, treatment modalities, complications, and outcomes were obtained from the medical records. Data was analyzed with SPSS version 20. Descriptive statistics was done and results were presented in tables and chart. Results: The prevalence of puerperal sepsis during the period reviewed was 0.83%. The mean age of the women was 29.0±6.7 years. The primiparous women 53(33.5%) were mostly affected. Klebsiella spp 25(15.8%) was the most common organism isolated and most sensitive to the third generation of Cephalosporin and Quinolones. Anaemia 90(56.8%) was the most common complication and all the women had intravenous antibiotics while about half (46.5%) of those with abdominopelvic collections were managed surgically via laparotomy. The case fatality rate was 16.5%. Conclusion: Despite the low prevalence of puerperal sepsis within the period reviewed, a high case fatality was recorded. Cephalosporin and Quinolones should be considered in managing puerperal sepsis in our facility but more importantly prevention of maternal sepsis is essential.

Co-existing sickle cell anaemia and inflammatory bowel disease: case report and review of the literature.

Sickle cell anaemia (SCA) is a chronic haemolytic anaemia associated with vaso-occlusive painful crises which may affect several systems including the gastro-intestinal system, resulting in abdominal pain. The concurrence of inflammatory bowel disease and haemoglobinopathy is rare. No previously reported concurrent cases of both SCA and ulcerative colitis (UC) in sub-Saharan Africa were found in the literature. A 16-year-old girl with concurrent SCA and UC is presented. She was admitted to University College Hospital, Ibadan with a 1-year history of recurrent peri-umbilical pain and bloody stools. These symptoms were mainly attributed to SCA at the referring hospital, and she was managed for chronic tropical diarrhoea without a remarkable clinical response. This case illustrates the concurrent presentation of SCA and ulcerative colitis which led to the missed and delayed diagnosis of ulcerative colitis.

Significance of African Diets in Biotherapeutic Modulation of the Gut Microbiome.

Diet plays an essential role in human development and growth, contributing to health and well-being. The socio-economic values, cultural perspectives, and dietary formulation in sub-Saharan Africa can influence gut health and disease prevention. The vast microbial ecosystems in the human gut frequently interrelate to maintain a healthy, well-coordinated cellular and humoral immune signalling to prevent metabolic dysfunction, pathogen dominance, and induction of systemic diseases. The diverse indigenous diets could differentially act as biotherapeutics to modulate microbial abundance and population characteristics. Such modulation could prevent stunted growth, malnutrition, induction of bowel diseases, attenuated immune responses, and mortality, particularly among infants. Understanding the associations between specific indigenous African diets and the predictability of the dynamics of gut bacteria genera promises potential biotherapeutics towards improving the prevention, control, and treatment of microbiome-associated diseases such as cancer, inflammatory bowel disease, obesity, type 2 diabetes, and cardiovascular disease. The dietary influence of many African diets (especially grain-base such as millet, maize, brown rice, sorghum, soya, and tapioca) promotes gut lining integrity, immune tolerance towards the microbiota, and its associated immune and inflammatory responses. A fibre-rich diet is a promising biotherapeutic candidate that could effectively modulate inflammatory mediators' expression associated with immune cell migration, lymphoid tissue maturation, and signalling pathways. It could also modulate the stimulation of cytokines and chemokines involved in ensuring balance for long-term microbiome programming. The interplay between host and gut microbial digestion is complex; microbes using and competing for dietary and endogenous proteins are often attributable to variances in the comparative abundances of Enterobacteriaceae taxa. Many auto-inducers could initiate the process of quorum sensing and mammalian epinephrine host cell signalling system. It could also downregulate inflammatory signals with microbiota tumour taxa that could trigger colorectal cancer initiation, metabolic type 2 diabetes, and inflammatory bowel diseases. The exploitation of essential biotherapeutic molecules derived from fibre-rich indigenous diet promises food substances for the downregulation of inflammatory signalling that could be harmful to gut microbiota ecological balance and improved immune response modulation.

Skin cancers in skin types IV-VI: Does the Fitzpatrick scale give a false sense of security?

The Fitzpatrick scale has been in use for skin colour typing according to the tanning potential of skin since its inception in 1975-1976. Thomas Fitzpatrick developed the scale to classify persons with 'white skin' in order to select the correct amount of UVA in Joules/cm2 for PUVA treatment for psoriasis. Since then, it has been widely used in Dermatology to gauge the skin's reaction to UV exposure, tanning potential, assessment of sunburn risk and amount of sun protection required for individual patients. However, the use of this scale has been of limited utility because of different self-perception in different areas of the world, particularly among those with skin of colour. Skin cancer risk is loosely inversely correlated with the initial genetic/inherent amount of melanin (most research has focused on eumelanin) present in the skin, although the pattern of exposure and amount of UV radiation required causing DNA damage varies widely according to different cancers. In this review, we have shown that the Fitzpatrick scale is neither correct nor adequate to reflect sunburn and tanning risk for skin of colour. Therefore, it may give both patients and physicians a false sense of security that there is little risk that people of colour can develop skin cancers. We have reviewed the small but not insignificant risk of skin of colour developing skin cancers and emphasise that there remains much research that needs to be done in this field.

Covid-19 dermatoses: Acral vesicular pattern evolving into bullous pemphigoid.

Bullous pemphigoid (BP) appears to be rising in incidence across the Western World, especially in the elderly. Some of the pathogenetic mechanisms involving antigen mimicry and antibody cross-reactivity have been elucidated for cases associated with neurological disease and certain drugs. There have been reports of cutaneous manifestations of Covid-19 (SARS-Cov2 infection) as the pandemic has raged across the world. We report here a case of prolonged Covid-19, symptomatic with dermatoses only, which was seen to evolve initially from a maculo-papular exanthema with acral vesicular dermatitis, into classical BP disease. This was confirmed histologically by positive skin autoantibody serology, direct IMF on peri-lesional skin and also salt-split IMF. Although possible that the development of BP could be a purely co-incidental finding during Covid-19, we suggest that it is more likely that prolonged SARS-Cov2 infection triggered an autoimmune response to the basement membrane antigens, BP 180 and 230. To our knowledge, this is the first case of BP developing during concurrent Covid-19 disease. It will be necessary to continue dermatological surveillance as the pandemic continues, to collate data on BP incidence and to test these patients for Covid-19 disease. As the pandemic continues, even potential and rare associations such as this will be clarified eventually. What's already known about this topic? Covid-19 disease has been associated with a spectrum of dermatosesCommon presentations in up to 20% of patients include exanthema, pseudo-chilblain like acral lesions 'Covid toes', livedo-/retiform purpuric/necrotic vascular lesions, acute urticarial lesions, and vesicular/varicella-like lesionsA multi-system inflammatory syndrome in children akin to Kawasaki syndrome has been described What does this study add? To our knowledge, this is the first description of classic Bullous Pemphigoid evolving from vesicular lesions caused by prolonged SARS-Cov2 induced skin inflammation.

MANAGEMENT OUTCOME OF PREMATURE RUPTURE OF MEMBRANES IN A TERTIARY HEALTH FACILITY IN SOUTH WESTERN NIGERIA.

Background: Pre-labour Rupture of Membranes (PROM) contributes immensely to the potential risk of maternal morbidity and mortality. Objective: To explore the incidence and management outcome of PROM at Ladoke Akintola University of Technology Teaching Hospital (LTH), Ogbomoso, Nigeria. Methods: A retrospective study of 61 cases of PROM managed at LTH, Ogbomoso over a 3-year period. Information on the socio-demographics and obstetrics characteristics, management instituted, and outcomes were obtained using a structured proforma. Data were analysed using SPSS version 20. Level of statistical significance was set at <0.05 and 95% confidence interval. Results: The incidence of PROM was 4.1% with a perinatal mortality rate of 0.18 per 1000 deliveries. Twenty (33%) were pre-term while 41 (67%) were term PROM with 10% of the perinatal death occurring among those with preterm PROM. The mean age of the women was 36.9 (SD=2.1) years and median parity of 1(range 1-5) children. There was a significant association between the women's gestational age at which PROM occurred with the latency period (p< 0.001). Fetal birth weight, APGAR score and Neonatal Intensive Care Unit (NICU) admission were all significantly associated with the gestational age at which PROM occurred (p<0.05). There was a significant difference between the intervention instituted and mode of delivery (p=0.009). Conclusion: The incidence of PROM at term was high and conservative/ expectant management was effective. The latency period and fetal outcomes such as birth weight, apgar score and NICU admission were determined by the gestational age at which PROM occurred.

The Assessment of Copeptin and Brain Natriuretic Peptide Levels as Biomarkers in Hypertensive Disorders of Pregnancy.

BACKGROUND: Hypertensive disorders of pregnancy associated with potentially fatal outcomes are common obstetrics occurrences. Early diagnosis, management and prediction of outcomes are challenges to be surmounted especially in developing countries. Biomarkers are emerging as useful tools for diagnosis and prognostication in varying health conditions. Elevated levels of serum copeptin and Brain Natriuretic Peptide (BNP) are associated with adverse perinatal outcomes and may serve as potential biomarkers utilized during routine antenatal care. OBJECTIVE: To determine the level and clinical value of copeptin and BNP as biomarkers of hypertensive disorders of pregnancy among Nigerian pregnant women. METHODS: This case-control study comprised 156 consenting pregnant women equally grouped into those with chronic hypertension (CH), gestational hypertension (GH), and preeclampsia (PE) as cases and normotensives as controls. Pregnant women were recruited from the antenatal clinic, University College Hospital, Nigeria. Blood pressures were measured and blood (10ml) was drawn from patients, serum and plasma obtained accordingly while other data were collected using interviewer administered questionnaire and medical records. Serum copeptin and plasma BNP levels were measured using enzyme-linked immunosorbent assay. Data was analysed with SPSS version 20.0 and statistical significance was set at p < 0.05. RESULTS: The mean levels of SBP and DBP were significantly higher in CH (155.41±2.14; 102.36±2.0 mmHg), GH (150.49±0.82; 98.67±0.56 mmHg), and PE (153.92±1.47; 98.92±0.61 mmHg), compared to controls (101.85±1.9; 66.77±1.24 mmHg). Mean serum copeptin and plasma BNP were significantly higher in women with GH (21.25±1.31pmol/L; 223.05±14.95pg/mL) and PE (22.47±1.01pmol/L; 253.99±17.69pg/mL) compared with controls (9.05±1.01pmol/L; 48.63±2.50pg/mL) (p<0.05). There was no significant difference in the mean levels of copeptin and BNP in CH compared with controls (p>0.05). The ROC curve for copeptin gave an AUC of 0.829 (p= 0.000) with a cut off value of 10.15pmol/ L while the AUC for BNP was 0.902 (p= 0.000) with a cut off value of 50.81pg/mL. CONCLUSION: Serum copeptin and plasma BNP levels were significantly higher in GH and PE and may be used as markers of hypertensive disorders of pregnancy among Nigerian pregnant women.

Factors affecting utilization of obstetric ultrasound: a study of semi-urban pregnant women in a developing nation

Background: Ultrasound scanning presently forms an integral part of antenatal care around the globe. It is a common investigative tool in most public and private health facilities in developing countries. Routine obstetric ultrasound has been one of the most important advances in antenatal care worldwide. It is also useful in the early detection and monitoring of the conditions that give rise to fetal and maternal compromise and has become an indispensable adjunct to the management efforts of practitioners in this regard. Therefore, utilization of this innovation by pregnant mothers is paramount toward good outcome. Objective: The objective is to determine the factors affecting utilization of ultrasound by pregnant mothers attending antenatal care in Zaria Local Government, Kaduna State, Northern Nigeria. Materials and Methods: This cross­sectional descriptive was used to carry out the study among 200 pregnant mothers selected through multistage sampling technique. This study was conducted over a period of 6 months from November 6, 2017, to May 6, 2018, after approval was given by the ethical committee of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. A structured interviewer­administered, validated questionnaire was administered to each participant to ascertain the factors affecting utilization of obstetric ultrasound by pregnant women in Zaria Local Government, Kaduna State. Data were analyzed using IBM SPSS 22. Results: The data obtained from the questionnaire were scored for proper evaluation. Furthermore, all collected data were carefully tallied, various frequencies, ranges, and mean (standard deviation) were determined. Most (29.5%) of the respondents aged 20­24 years, majority (95.5%) were homemakers that are not gainfully employed. Majority of the respondents were Hausa (94.5) and Muslims (96.5%). The findings of this study have shown that educational status, husband occupation, and knowledge affect the utilization of ultrasound by respondents. Conclusion: The common factors that affect the utilization of obstetric scan in Zaria were knowledge, education background, and husband occupation. Attitude, age, and the occupation of the respondents do not affect the utilization of obstetrics scan in Zaria

Callus and etiolation induction data from explants of Solanecio biafrae (Olive & Hierne) C. Jeffrey cultured in the dark.

Different types of explant (leaf, nodal and petiole explant) from in vitro grown plant maintained on Murashige and Skoog (MS) medium, were cultured on MS medium supplemented with various concentrations of 2, 4-Dichlorophenoxy acetic acid(2, 4-D) (0, 0.5, 1.0, 1.5 and 2.0 mg/l) in dark condition. Data on callus formation was recorded on 10 days after culture. Number of explants forming callus, callus colour and type were recorded. The plant growth regulator-free media which served as the control induced etiolation resulting in long hypocotyls from the nodal explants.

The Influence of Shuttle-Shape Emodin Nanoparticles on the Streptococcus suis Biofilm.

Biofilm is one of the most important physiological protective barriers of the Streptococcus suis (S. suis), and it is also one of the primary causes of hindrance to drug infiltration, reduction of bactericidal effects, and the development of antibiotic resistance. In order to intervene or eliminate S. suis biofilm, shuttle-shape emodin-loaded nanoparticles were developed in our study. The emodin nanoparticles were prepared by emodin and gelatin-cyclodextrin which was synthesized as drug carrier, and the nanoparticles were 174 nm in size, -4.64 mv in zeta potential, and exhibited a sustained emodin release. Moreover, the delivery kinetics of nanoparticles were also explored in our study. The confocal laser scanning microscopy and colony forming unit enumeration experiment indicated that nanoparticles could increase drug infiltration and uptake by biofilm. The flow cytometry system analysis showed that nanoparticles could be up taken by 99% of the bacteria cells. TCP assay and scanning electron microscopy showed that the nanoparticles had better effect on biofilm inhibition and elimination when compared with emodin solution. These results revealed that the emodin nanoparticles had a better therapeutic effect on the S. suis biofilm in vitro.

CASE REPORT: RETRIEVAL OF AN INTRA-UTERINE CONTRACEPTIVE DEVICE PENETRATING THROUGH THE WALL OF THE RECTUM.

A Copper T intrauterine contraceptive device (IUCD) is a commonly employed method of reversible contraception for women. Its use has been associated with complications such as bleeding, perforation and migration to adjacent organs or peritoneum. Uterine wall erosion and subsequent perforation by an IUCD is not unusual; however the subsequent intraperitoneal migration, to and perforation of the rectum is uncommon. We present a case of 31-year-old female with an IUCD migrating through the uterus possibly into the peritoneal cavity and subsequently eroding into the posterior rectal wall. It was removed easily without complications through the rectum during an examination under anesthesia.

Resting Serum Concentration of High-Sensitivity C-Reactive Protein (hs-CRP) in Sportsmen and Untrained Male Adults.

There is an inverse relationship between regular physical activity and concentration of serum inflammatory markers, with variations in resting CRP in trained and untrained subjects. The effect of acute and prolonged exercises has been studied on inflammatory markers with dearth of information and controversies on the resting serum values of high sensitivity CRP (hs-CRP). Therefore, this study sought to identify and compare variations that occur in serum levels of high sensitivity CRP in groups of sportsmen (6) and physically active untrained subjects. Eighty-one healthy male participants made up of 21 untrained (control), 10 footballers, 10 athletes, 10 karates, 10 volleyballers, 10 basketballers, and 10 baseballers voluntarily participated in the study. Participants rested while in sitting position for about 30 minutes during which blood pressures and heart rates were taken. 5 mls of venous blood was withdrawn from the antecubital vein of the participants (aseptically) between 7:00 and 10:00 am into lithium heparin bottles following an overnight fast. The supernatant was decanted and centrifuged at 3000 rpm, serum was collected and stored at -20ºC prior to biochemical assay which was done with the use of enzyme linked immunosorbent assay (ELISA) kits for hs-CRP. Differences in the means within the sporting groups were analysed using one-way ANOVA while the difference between the trained sportsmen and untrained young adults was analysed using the independent T-test. Statistical significance was set at p < 0.05. The Mean ±SEM age, weight, height, and BMI of the participants were 22.0±0.8 years, 64.1±2.2 kg, 1.74±0.3 m, and 20.6±0.2 kg/m2 respectively. The resting concentration of hs-CRP (µg/ml) was 1.0±0.2 in the untrained, 2.6±0.7 in footballers, 3.6±2.1 in track athletes, 2.4±0.5 in basketballers, 2.2±0.5 in volleyballers, 2.4±1.3 in baseballers, and 1.7±0.5 in karate respectively. There was no significant difference in the resting hs-CRP amongst the sporting groups, and in the sportsmen and untrained group. Resting serum levels of hs-CRP falls within normal range, and varies insignificantly in groups of sports, and in sportsmen and untrained young male adults. This may suggest that the types of sporting activities or participation in sports has no impact on the resting serum hs-CRP.

Lassa Fever in Pregnancy: Report of 2 Cases Seen at the University College Hospital, Ibadan.

Lassa fever (LF), an acute viral haemorrhagic fever, is an endemic zoonotic viral infection in West Africa countries with up to 15% case fatality rate. Though a rodent-borne infection, it can also be transmitted from person to person during the care of sick relations or more commonly in health care settings as a nosocomial infection. Vertical transmission from mother to child has been documented. We report 2 cases of LF among pregnant women which were managed at the University College Hospital, Ibadan, between September and October 2014. Both patients were in their early 20s with only one surviving the disease. Both had supportive therapy but none had antiviral therapy. This report emphasized the importance of early presentation, high index of suspicion, prompt diagnosis, and early commencement of supportive therapy in the management of patients suspected with LF especially in the era of other viral haemorrhagic infections.

Awareness and attitude towards HPV and its vaccines among market women in Bodija Market, Ibadan.

Background: Cervical cancer, commonest among cancers of the female genital tract continued to pose major challenge to women of reproductive age in developing countries though infection by its causative agent, human papilloma virus (HPV) is preventable.This study aimed to assess awareness and attitude of market women concerning HPV and its vaccines in prevention of cervical cancer. Materials and Methods: A cross sectional study involving 329 market women, using multistage sampling technique. Instrument was an Interviewer--administered questionnaire on socio-demographic characteristics, knowledge and awareness of HPV and its vaccine, sexual history and attitude towards HPV vaccines. Data analysis was done using SPSS version 20.0 with statistical significance level set at p<0.05. Results: Mean age of respondents was 29.49 ± 3.65 years. All respondents were sexually active with majority (94.8%) having multiple sexual partners. Awareness of HPV vaccine and Pap smear test was among 1.2% and 9.4% respectively. Attitude towards HPV vaccination was good in 304 (92.4%) with 302 (91.8%) willing to take the HPV vaccines. There was significant association between attitude towards HPV vaccine and willingness to take HPV vaccine x2=111.8, p<0.01). Conclusions: Awareness of HPV and its vaccines is low among market women in our community. Policies and actions to step up information dissemination are urgently needed in order to stem the scourge of cervical cancer in our society.

Laparoscopic supracervical hysterectomy and uterine morcellation: A case report from Asokoro District Hospital, Abuja, Nigeria.

Advanced gynecological laparoscopic surgery is an evolving subspecialty that requires specialized skills, expertise and equipment. This is more challenging and daunting, especially in sub Saharan Africa. Laparoscopic supracervical hysterectomy (LSCH) is an advanced gynecological procedure that has hitherto been seen as difficult because of the big size uteri seen in Nigerian women. We present thefirst LSCH and uterine morcellation done in Nigeria in a 45-year-old multipara on account of symptomatic uterine fibroid of 16 weeks size, at the Asokoro District Hospital, Abuja. Nigeria. She fared well postoperatively and highly satisfied with the procedure at the gynecological clinic review. Our case report has demonstrated clearly that the uterine size is not a limitation to laparoscopic hysterectomy. With proper port placement and adequate skills, LSCH of big size uteri, which is typical in sub Saharan Africa, can be safely achieved. We, therefore, recommend capacity building of Gynaecologists and peri-operative nurses in the field of minimal access surgery and improvement in the equipment in our various facilities to the modern standard.