The impact of heat source and chemical reaction on MHD blood flow through permeable bifurcated arteries with tilted magnetic field in tumor treatments.

In this research work, we investigate the influence of heat source and chemical reaction on electro-magneto-hydrodynamic (EMHD) blood flow through bifurcated arteries with external tilted magnetic field for treating tumor. The potential electric field applied along the bifurcated arterial wall, accurately described the Poisson-Boltzmann equation. We modeled the EMHD blood flow to obtain the non-dimensionalized form of the equations. We converted the modeled equations to ordinary differential equations by the use of suitable variables. Exact solutions of the converted equations are calculated by the method of undetermined coefficients and the results obtained with the aid of Mathcad software were simulated and presented graphically. From the graphical representation of results, we observed that increase in Joule heating and Eckert number, increases the temperature distribution in the affected tumor cells which prevent high thermal radiation exposure from killing the healthy cells within the tumor region. The curves of the wall shear stress seem to be greater in the converging region in comparison to the diverging region, but when the strength of magnetic field and thermal radiation parameters increase the wall shear stress decreases at the bifurcated wall where blockage may likely occur due to the development of boundary layers on the inner walls of the bifurcated region. By increasing the heat radiation parameter, we observed that the curves representing both velocity and temperature profiles increase rapidly from the origin and the velocity of blood flow varies directly for the converging, diverging and the tumor regions of the bifurcated arteries. Thus, thermal radiation effect is a result of the higher rate of heat transfer at the vessel walls. Further, combining the electromagnetic field and the heat radiation together gives new insights of the physical properties of blood flow in the body system network which is essential for health practitioners and clinicians.

Quality and outcomes of maternal and perinatal care for 76,563 pregnancies reported in a nationwide network of Nigerian referral-level hospitals.

Background: The WHO in collaboration with the Nigeria Federal Ministry of Health, established a nationwide electronic data platform across referral-level hospitals. We report the burden of maternal, foetal and neonatal complications and quality and outcomes of care during the first year. Methods: Data were analysed from 76,563 women who were admitted for delivery or on account of complications within 42 days of delivery or termination of pregnancy from September 2019 to August 2020 across the 54 hospitals included in the Maternal and Perinatal Database for Quality, Equity and Dignity programme. Findings: Participating hospitals reported 69,055 live births, 4,498 stillbirths and 1,090 early neonatal deaths. 44,614 women (58·3%) had at least one pregnancy complication, out of which 6,618 women (8·6%) met our criteria for potentially life-threatening complications, and 940 women (1·2%) died. Leading causes of maternal death were eclampsia (n = 187,20·6%), postpartum haemorrhage (PPH) (n = 103,11·4%), and sepsis (n = 99,10·8%). Antepartum hypoxia (n = 1455,31·1%) and acute intrapartum events (n = 913,19·6%) were the leading causes of perinatal death. Predictors of maternal and perinatal death were similar: low maternal education, lack of antenatal care, referral from other facility, previous caesarean section, latent-phase labour admission, operative vaginal birth, non-use of a labour monitoring tool, no labour companion, and non-use of uterotonic for PPH prevention. Interpretation: This nationwide programme for routine data aggregation shows that maternal and perinatal mortality reduction strategies in Nigeria require a multisectoral approach. Several lives could be saved in the short term by addressing key predictors of death, including gaps in the coverage of internationally recommended interventions such as companionship in labour and use of labour monitoring tool. Funding: This work was funded by MSD for Mothers; and UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a co-sponsored programme executed by the World Health Organization (WHO).

Factors responsible for discontinuation of long-term reversible contraceptives in a tertiary facility in Northeastern Nigeria

Background: The emergence of long-term reversible contraceptives (LARC) has helped in reaffirming the concept of Family Planning (FP) 2020. LARC is one of the safest and most effective methods covering both hormonal implants and intrauterine devices (IUDs). However, despite their acceptability and wide usage, they are associated with undesired effects limiting their use ranging from personal to device-related or both.Aim: This study is aimed at determining the reasons for the discontinuation of LARCs among women accessing FP services in Bauchi.Methods: The study was for 1-year period. It was a retrospective survey of 335 clients that presented to the FP unit of a tertiary institution in Northeastern Nigeria for removal of implants. Data were inputted into and analysed using SPSS version 21 and results presented in tables and charts.Results: A total of 1069 clients had one method of contraception or the other over the study periods. About 335 (31.3%) clients had removal of LARCs (53.4%, 18.2% and 28.4%, for Implanon, Jadelle and IUDs, respectively). The mean parities of the clients were 3 +_ 0.55. The most common indications for removal of implants observed in the study included, the desire for pregnancy (38.5%), expired implants and untolerable side effects (24.5%) each.Conclusions: LARCs were the most common form of contraceptives used by women during the study period. The most common reason for removal of LARCs implants discovered was for feature pregnancy, undesired effects and implants expiry

The benefit of myomectomy in women aged 40 years and above: Experience in an urban teaching hospital in Nigeria.

BACKGROUND: Abdominal myomectomy remains the mainstay of surgical management of uterine fibroids in our environment. However, its benefit in women aged 40 years and above remains debatable. MATERIALS AND METHODS: An 11-year prospective study was conducted involving 98 women, aged 40 years and above, who had abdominal myomectomy for the treatment of uterine fibroid at the University of Maiduguri Teaching Hospital, Maiduguri. They were followed up regularly for 1-6 years to detect conception, resolution of symptoms and obstetrics performance. Data were analyzed using SPSS version 13. RESULTS: The mean age of the patients was 42.6±2.9 years and 77 (78.6%) of them were nulliparous. Lower abdominal swelling was the commonest clinical presentation and the mean uterine size was 18.6±8.5 weeks. Infertility with uterine fibroids was the indication for myomectomy in majority of the cases [48 (48.9%)], while pregnancy complications accounted for 11.2% (11) of the cases Fertility restoration was 10.4% among the infertile patients. There was complete resolution of symptoms in 35.9% of those who required symptomatic relief, and term pregnancies were recorded in 72.7% of patients with pregnancy complications. CONCLUSION: Myomectomy is the recommended treatment of uterine fibroids in women aged 40 years and above with infertility and who wish to become pregnant. If there is no need for further fertility preservation, hysterectomy should be offered.

Uterine fibroids: risk of recurrence after myomectomy in a Nigerian population.

PURPOSE: To determine the recurrence rate and risk factors for recurrence following myomectomy. METHODS: Two hundred and thirty-two women who had open myomectomy were followed up for 3-10 years. Clinical features as well as pelvic ultrasound scan were used to evaluate the patients for recurrence. Recurrence rate was computed and the risk factors for recurrence were determined using Odd ratio comparing the Sociodemographic characteristics, preoperative symptoms, surgical and pathologic findings in the two groups of patients. RESULTS: The mean age and parity of the patients were 29.3 ± 3.8 years and 1.2 ± 1.1, respectively. The desire for procreation after surgery was noted in 183 (78.9%) of the patients while the rest desired resolution of symptoms. More than half of the patients had multiple symptoms. Intraoperatively, 63 (7.2%) had single fibroid removed while the rest were multiple varying from 2 to 67 pieces. The overall recurrence rate during the follow-up period was 20.7% (48/232) at 10 years and this increases with time. Positive family history of uterine fibroids, multiple uterine fibroids, and persistence or recurrence of three or more of the pre-myomectomy symptoms were significantly associated with the recurrence of uterine fibroids (OR = 21.83, 3.14, and 3.49, respectively) while pregnancy after myomectomy and the use of oral contraceptive pills (OCP) were protective. CONCLUSION: There is a high recurrence of uterine fibroid after myomectomy in our environment. The risk is higher among women with positive family history, multiple uterine fibroids, and in those with multiple symptoms. Pregnancy and use of OCP are protective.