Placental Site Trophoblastic Tumour Mimicking Placenta Previa.

ABSTRACT: We present a 42-year-old Nigerian woman who had three previous caesarean sections and is being managed conservatively for placenta previa. She underwent a caesarean hysterectomy on account of uncontrollable bleeding, and histopathology revealed a placental site trophoblastic tumour.

Preoperative sonographic prediction of intra-abdominal adhesions using sliding sign at repeat caesarean section at the University of Maiduguri Teaching Hospital, Nigeria: a prospective observational study.

OBJECTIVE: To determine if the presence or absence of sonographic sliding sign preoperatively is a good predictor of the presence and type of intra-abdominal adhesions; and to determine the time taken to demonstrate this sign. DESIGN: A prospective, observational, triple-blind study using tests of diagnostic accuracy. SETTING: Single-centre tertiary health institution in north-east Nigeria. PARTICIPANTS: 67 women in the third trimester scheduled for repeat elective caesarean sections (CS) had transabdominal sonography to determine the absence or presence and degree of sliding sign. The time taken to make these decisions were noted. Surgeons blinded to the ultrasound findings graded adhesions intraoperatively and comparison between sonographic and intraoperative findings made. Women who were scheduled for emergency CS were excluded. MAIN OUTCOME MEASURES: Accuracy of preoperative ultrasound to determine no/mild, moderate and severe adhesions. Secondary outcomes were interobserver correlations and time taken to determine sliding. RESULTS: When classified as adhesion and no adhesion, the sliding sign demonstrated a sensitivity of 100.00% (CI95 85.18% to 100.00%), specificity of 100.00% (CI95 92.13% to 100.00%). In predicting presence of moderate intra-abdominal adhesions, a sensitivity of 65.0% (CI95 40.78% to 84.61%) and specificity of 82.98% (CI95 69.19% to 92.35%) was found. For predicting severe intra-abdominal adhesions, it had a sensitivity of 25.00% (CI95 0.63% to 80.59%) and specificity of 98.41 (CI95 91.47 to 99.96). Disease prevalence for mild, moderate and severe adhesions was 33.82% (CI95 22.79% to 46.32%), 29.85% (CI95 19.28% to 42.27%) and 5.97% (CI95 1.65% to 14.59%), respectively. Interobserver Cohen's kappa coefficient and PPA were 0.58 (CI95 0.39 to 0.76) and 58.82 (CI95 52.82 to 64.82), respectively. The mean duration to determine sliding sign was 7.56±2.86 s. CONCLUSION: This study supports the role of transabdominal sliding sign in preoperative prediction of intra-abdominal adhesions in women with previous CS without significant increase in sonography duration. This information can encourage planning for CS by ensuring that surgeons of appropriate seniority are deployed to undertake anticipated complex operations.

Trusted authorities can change minds and shift norms during conflict.

The reintegration of former members of violent extremist groups is a pressing policy challenge. Governments and policymakers often have to change minds among reticent populations and shift perceived community norms in order to pave the way for peaceful reintegration. How can they do so on a mass scale? Previous research shows that messages from trusted authorities can be effective in creating attitude change and shifting perceptions of social norms. In this study, we test whether messages from religious leaders-trusted authorities in many communities worldwide-can change minds and shift norms around an issue related to conflict resolution: the reintegration of former members of violent extremist groups. Our study takes place in Maiduguri, Nigeria, the birthplace of the violent extremist group Boko Haram. Participants were randomly assigned to listen to either a placebo radio message or to a treatment message from a religious leader emphasizing the importance of forgiveness, announcing the leader's forgiveness of repentant fighters, and calling on followers to forgive. Participants were then asked about their attitudes, intended behaviors, and perceptions of social norms surrounding the reintegration of an ex-Boko Haram fighter. The religious leader message significantly increased support for reintegration and willingness to interact with the ex-fighter in social, political, and economic life (8 to 10 percentage points). It also shifted people's beliefs that others in their community were more supportive of reintegration (6 to 10 percentage points). Our findings suggest that trusted authorities such as religious leaders can be effective messengers for promoting peace.

Factors Responsible for Under-Utilization of Postnatal Care Services in Maiduguri; North-Eastern Nigeria

Background: In Maiduguri; the utilization of available postnatal care services is still very low. This may be influenced by demographic; socioeconomic; cultural; and obstetric factors among others. Objective: The aim of this study is to understand the current status of utilization of maternal postnatal health care services and identify factors responsible for under.utilization of available postnatal care services in Maiduguri. Materials and Methods: A. cross.sectional; questionnaire.based study was conducted involving 350 women in their reproductive age group. (15.49. years); who had delivered previously; residing in Maiduguri and who came to access any of the available maternal health care services at the State Specialist Hospital; Maiduguri over a 3.month period. The Chi.squared statistics and multivariate logistic regression analysis were used. Results: Out of the grand total of 350 questionnaires that were distributed during the study period; 18 questionnaires were excluded from analysis due to incomplete responses; 332 with complete responses were therefore analyzed; giving a response rate of 94.9. The results showed that only 16.9 of the respondents attended postnatal care services within 42. days after delivery. Most of the mothers. (60.9) were not knowledgeable about postnatal care services. A. very high proportion of participants. (69.4) did not attend antenatal clinics; and over. 70of the study population had delivered at home. The study has identified some factors that have an important influence on utilization of postnatal care services in Maiduguri. These included awareness of postnatal care services. (odds ratio. [OR] 12.04; 95 confidence interval. [CI]: 10.26; P =. 0.000); higher educational status of the woman. (OR 7.15; 95 CI: 5.19; P =0.000); lower parity. (OR 5.22; 95 CI: 3.21; P = 0.001) and marital status. (married woman.OR 3.44; 95 CI: 2.17; P =0.002). Educational attainment of the husband also significantly affected the respondents' seeking behavior of postnatal care. (OR 2.01; 95 CI: 1.13; P =0.042). Conclusion: Utilization of postnatal care services is quite low in Maiduguri. Socioeconomic and sociodemographic factors influenced the use of postnatal care services. Government should provide culturally acceptable health educational programs and expands maternal health care services into the communities for the better; effective and efficient health care delivery

Studies on dentition and oral disorders of Camels in Maiduguri Abattoir, Borno State, Nigeria.

Camelus dromedarius dental disorders were surveyed using abattoir samples from Maiduguri, Nigeria. A total of 313 heads, were randomly examined. The age and sex of the heads were estimated using standard methods and disorders were observed following the split of the oral commissure. Heads with multiple disorders were counted once and of 313 heads, 114 (41.67 %) and 199 (58.33 %) were males and females, respectively. Heads aged <5 years was 18.21 %; 5-10 years, 44.41 %; and >15 years was 37.38 %. Whereas 22.61 % of the total heads had one disorder or another, 7.98 and 14.06 % of the disorders belonged to male and female heads, respectively. The prevalence rate of the disorders observed include dental tartar and calculus (5.42 %), inward rotation of incisors (2.87 %), fractured teeth (7.66 %), maleruption (0.31 %), oligodontia (0.31 %), gingivitis (4.15 %), ulcerated cheek(0.63 %), and presence of foreign body(0.31 %) in the mouth. Prevalence rate of oral-cavity abnormalities in relation to age of the total heads is 5.75, 5.11, and 10.54 % for animals <5, between 5 and 10 years, and 10-15 years, respectively. Furthermore, heads that were affected with various types of disorders are 31.58 % (<5 years of age), 11.51 % (aged 5-10 years), and 28.21 % (>15 years). The study serves as a call for increased oral-cavity health care of camels.

Sexual assault against female Nigerian students.

Sexual assault is a common social disorder among students in our tertiary institutions. This study ascertains the extent and effect of sexual assault among Nigerian students. Two hundred and Sixty Eight structured questionnaires were distributed to randomly selected students in 4 tertiary institutions, information on socio demography, sexual history and consequences of their exposure were obtained for analysis and interpretation. Thirty seven (13.8%) of the respondents were sexually assaulted as a student and 19 (7.1%) were assaulted by their lecturers and fellow students, Younger age at coitarche, history of forced coitarche, marriage, coitarche with relations and unknown persons, significantly influenced subsequent risks of sexual assault. Improve security, moral behaviours enforcing dress code and stiffer penalties were suggested ways to prevent sexual assault among the students. Sexual assault is still a common finding in our institutions; effort should be made by all stake holders to prevent this social embarrassment.

Sonographic determination of normal spleen size in an adult African population.

OBJECTIVE: The purpose of this study was to determine the normal range of spleen size in an adult African population, and compare the findings to published data to determine any correlation with ethnicity. MATERIALS AND METHODS: Three hundred and seventy-four African adults without conditions that can affect the spleen or splenic abnormalities were evaluated with ultrasonography. Spleen length, width and thickness were measured and spleen volume calculated. Spleen size was correlated with age, gender, height, weight, and body mass index. RESULTS: The mean spleen volume was 120 cm(3). Spleen volume correlated with spleen width (r=0.85), thickness (r=0.83) and length (r=0.80). Men had a larger mean spleen volume than women. No correlation was found between spleen volume and age, weight, height, or body mass index. CONCLUSION: Mean spleen volume in African adults is smaller than data from Western sources, and cannot be explained by difference in body habitus.

Sexual assault against female nigerian students

Sexual assault is a common social disorder among students in our tertiary institutions. This study ascertains the extent and effect of sexual assault among Nigerian students. Two hundred and Sixty Eight structured questionnaires were distributed to randomly selected students in 4 tertiary institutions, information on socio demography, sexual history and consequences of their exposure were obtained for analysis and interpretation. Thirty seven (13.8%) of the respondents were sexually assaulted as a student and 19 (7.1%) were assaulted by their lecturers and fellow students, Younger age at coitarche, history of forced coitarche, marriage, coitarche with relations and unknown persons, significantly influenced subsequent risks of sexual assault. Improve security, moral behaviours enforcing dress code and stiffer penalties were suggested ways to prevent sexual assault among the students. Sexual assault is still a common finding in our institutions; effort should be made by all stake holders to prevent this social embarrassment (Afr. J. Reprod. Health 2010; 14[3]: 189-193)

Is routine antenatal screening for syphilis in Nigeria still justified clinically and economically?

OBJECTIVE: To determine the seroprevalence and cost effectiveness of antenatal syphilis screening at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria. METHODS: A retrospective chart analysis of venereal disease research laboratory (VDRL) results among pregnant women at the UMTH, Maiduguri, Nigeria, during a 10-year period (from 1st January 1999 to 31st December 2008) was undertaken. RESULTS: A total of 18,712 women registered for antenatal care during the study period. Of these, 18,101 had serological screening for syphilis. Only 12 of the 18,101 screened were seropositive by VDRL, 9 (75%) were confirmed by Treponema pallidum hemagglutination assay (TPHA), giving a seroprevalence rate of 0.05%. Three (25%) were biological false-positive. The peak age-specific incidence of 0.02% was in the 20-24 year-age group. There was zero prevalence in the age groups 15-19 and >40 years. There was no case of congenital syphilis seen. The cost for VDRL testing per patient in UMTH is US$2. The total amount of money spent on VDRL tests over the study period was US$37,424. CONCLUSION: The seroprevalence rate of syphilis is extremely low in this study. This calls for a review of the policy of routine antenatal serology screening for syphilis in Maiduguri, Nigeria.