Risk Perception amongst Petrol Pump Attendants and Analysis of Indiscriminate Siting of Petrol Stations in Enugu Metropolis.

Proliferation and unregulated siting of petrol stations expose petrol pump attendants to occupational hazards. This study assessed knowledge, risk perception, occupational hazards of petrol pump attendants and site-suitability of petrol stations in Enugu metropolis, Nigeria. This was a cross-sectional analytical study of 210 pump attendants from 105 petrol stations spread within the city and highways. A structured pretested, interviewer-administered questionnaire and a check-list were used to collect data. Analyses were done using descriptive and inferential statistics. Mean age of the respondents was 23.55 ± 5.43 with 65.7% being females, three-quarters (75%) had good knowledge, while 64.3% had poor risk perception of occupational hazards. The commonest hazards reported were fuel inhalation (81.0%) (always) and fuel splashes (81.4%) (sometimes). About half (46.7%) of the respondents used protective equipment. Most of petrol stations had functional fire extinguishers (99.0%) and sand buckets (98.1%) while 36.2% had muster points. Forty percent and 76.2% of petrol stations had inadequate residential and road setbacks respectively with private petrol stations and those on streets leading. Poor risk perception of hazards and indiscriminate siting of the petrol stations exposed petrol pump attendants to hazards. Adequate regulation and enforcement of petrol station operating guidelines with regular safety and health training is necessary.

La prolifération et l'implantation non réglementée des stations-service se poursuivent, exposant les pompistes à des risques professionnels. Cette étude a évalué les connaissances, la perception des risques, les risques professionnels des pompistes et l'adéquation des sites des stations-service dans la métropole d'Enugu, au Nigeria. Il s'agit d'une étude analytique transversale portant sur 210 pompistes de 105 stations-service réparties dans la ville et sur les routes. Un questionnaire structuré, pré-testé, administré par un enquêteur et une liste de contrôle ont été utilisés pour collecter les données. Les analyses ont été effectuées à l'aide de statistiques descriptives et inférentielles. L'âge moyen des personnes interrogées était de 23,55 ± 5,43 ans, 65,7 % étant des femmes, les trois quarts (75 %) avaient une bonne connaissance des risques professionnels, tandis que 64,3 % avaient une mauvaise perception des risques. Les risques les plus fréquemment signalés étaient l'inhalation de carburant (81,0 %) (toujours) et les éclaboussures de carburant (81,4 %) (parfois). Environ la moitié (46,7 %) des personnes interrogées utilisaient des équipements de protection. La plupart des stations-service disposaient d'extincteurs fonctionnels (99,0%), de seaux à sable (98,1%) et 36,2% de points de rassemblement. Quarante pour cent et 76,2 % des stations-service n'avaient pas de marge de recul suffisante par rapport aux habitations et aux routes, les stations-service privées et celles situées dans les rues étant en tête. La mauvaise perception des risques et l'emplacement des stationsservice exposent les pompistes à des dangers. Une réglementation adéquate et l'application des directives d'exploitation des stationsservice, ainsi que des formations régulières en matière de sécurité et de santé, sont nécessaires. Mots clés: Risques professionnels, Pompistes, Stations-service, Adéquation du site.

What are the Predictors of Burn out in Nigerian Bankers? A Case Study of Bankers in Enugu, Nigeria.

BACKGROUND: In developing countries such as Nigeria, due to globalization and the deteriorating economy, workers are especially vulnerable to burnout. The pressure on bank employees from tight deadlines and unrealistic targets may predispose them to burnout. Burnout has been shown to occur in workers because of failure to cope with occupational stress, especially in the banking sector which requires intensive communication and interaction with service recipients. OBJECTIVE: The aim of this study was to assess the prevalence and determinants of occupational burnout in bankers in Enugu Metropolis, Nigeria. METHODS: A cross-sectional analytical study was carried out among 370 Bankers in Enugu state, Nigeria. The Copenhagen burnout inventory was used to assess personal, work and clientrelated burnout. RESULTS: Majority of the bankers had all three components of burnout. Client related burnout was experienced more among female bankers (P=0.022), those that had spent five years or less on the job (P=0.021), bankers aged thirty-five years or less (P=0.013) and bankers who were married (P=0.018).Only bankers that had spent less than five years on the job (P=0.037) experienced personal burnout and no factor was found to be associated with work related burnout. Predictors of client-related burnout were age of 35 years or less, work experience of 5 years or less and being female. CONCLUSION: Prevalence of burnout is very high among the bankers that were studied. The management of these banks should create measures aimed at reducing the risk of exposure to burnout.

Prevalence of psychological workplace violence among employees of a public tertiary health facility in Enugu, Southeast Nigeria.

BACKGROUND: Psychological violence is the most common form of workplace violence (WPV) that can affect job performance and health of the workers. AIMS: This study sought to determine the prevalence of psychological WPV among employees working in a tertiary health institution in a South-eastern state of Nigeria. METHODS: A descriptive cross-sectional study done in 2018 among healthcare workers at the University of Nigeria Teaching Hospital Enugu State using a pretested self-administered questionnaire adapted from Workplace Violence in the Health Sector Country Case Study Questionnaire. Proportionate sampling method was used to select 412 respondents. Data were analyzed with SPSS version 23 using Chi-square test of significance and P value set at 0.05. RESULTS: Prevalence of psychological violence among the participants was 49.7%. Verbal abuse was the most form of psychological violence experienced 168 (40.8%) followed by bullying 29 (7.0%) while sexual abuse was reported by 8 (1.9%). Majority 114 (55.6%) of the perpetrators of the psychological violence were patient's relative, whereas 48 (23.4%) were staff members. In response to the violence, 58 (28.6%) of the healthcare workers took no action, while only 2 (1%) completed incident/accident form. Bullying was statistically significantly higher in healthcare workers who have spent less than 10 years (χ2 = 3.978 P = 0.046). There was a significant association between verbal abuse and frequent interaction with patients (χ2 = 4.757, P = 0.029). CONCLUSION: This study has shown that the prevalence of psychological WPV was high among healthcare workers in University of Nigeria Teaching Hospital, Enugu State. Therefore, there is need for the hospital management to develop policy interventions specific to psychological WPV.

Complement Levels in Nigeria Patients with Sickle Cell Anaemia in the Asymptomatic State.

OBJECTIVES: Significantly low serum levels of complement components have been reported in patients with Sickle cell anaemia (SCA) which may result in a high susceptibility to infections. However some studies have reported a normal or high complement level. The aim of our study was to assess some haematological parameters and Complement levels in adult patients with steady state SCA in Zaria, North western Nigeria. This will serve as a guide towards infection surveillance in the quest to reduce significant morbidity and mortality in our setting. METHODS: A cross sectional study of 40 patients with SCA in steady state and 40 healthy (non-matched) non-SCA controls at the Haematology clinic of Ahmadu Bello University Teaching Hospital Zaria, was carried out over a 6 month period in 2016. Institutional ethical approval and informed written consentwere obtained. Venous blood was analyzed for haematological parameters by an automated method and complement levels; alternative pathway was assessed by measuring C3, classical pathway by C4 and Terminal pathways by C5 levels using ELISA technique. Data was analyzed with statistical package for social science(SPSS) software version 20.0(2001) and a p value of ≤ 0.05 was considered significant. RESULTS: The age range of patients with SCA and controls were 18 to 46years and 18 to 48years respectively and these were not significantly different p > 0.05. The median levels of C3 (245µg/ml), C4 (245µg/ml) and C5 (40µg/ml) were within normal range in the study subjects but significantly higher (p < 0.05), than those of the controls C3 (165µg/ml), C4 (125µg/ml) and C5(35µg/ml). Haematological parameters showed no correlation with the levels of Complement components studied. CONCLUSION: Although Complement components C3, C4, and C5 levels in patients with SCA are significantly high, the infectious susceptibility may be due to other immunological abnormalities.

Health education: Effect on knowledge and practice of workplace personal hygiene and protective measures among woodworkers in Enugu, Nigeria.

BACKGROUND: There has been increasing incidence of occupational diseases among woodworkers due to exposure to preventable hazards in the workplace. The objective of this study was to determine the effects of health education on the knowledge and practice of workplace hygiene and protective measures among woodworkers in Enugu timber market. MATERIALS AND METHODS: This was a before and after study conducted among 290 woodworkers using interviewer administered semi-structured questionnaire and manual on workplace hazards prevention. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 17 and P-value of 0.05 was set as the significance level. RESULTS: Two hundred and ninety respondents participated in the study; 282 (97.2%) were males, most completed secondary education and had worked for less than 10 years (71% and 58.3%, respectively). The mean knowledge score of participants pre- and postintervention were 89.5% ± 9.03 and 98.5% ± 1.84, respectively (P < 0.001). Educational status had effect on knowledge of participants (P < 0.001), whereas work experience had no effect (P = 0.285). Preintervention, 37.9% of the participants used protective materials regularly, which increased to 65.8% post intervention (P < 0.001). Personal hygiene practices showed mixed responses most of which improved post intervention. The most common reason for eating in workplace was excessive workload (60.3%), while lack of PPEs (29.3%) and lack of training (23.8%) were the most common reasons for nonuse of PPEs. CONCLUSION: Majority of the participants had good knowledge of workplace hygiene but had poor use of PPEs. Health education intervention improved the use of PPEs and should be recommended.

Morbidities, concordance, and predictors of preterm premature rupture of membranes among pregnant women at the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria.

BACKGROUND: Preterm premature rupture of membranes (PPROM) is a challenging complication of pregnancies and an important cause of perinatal morbidity and mortality. Management of morbidities associated with PPROM is fraught with controversy. However, women should be informed of these complications. OBJECTIVE: This article aimed to review the morbidities, concordance, and predictors of PPROM over a 10-year period. METHODS: This was a retrospective review of morbidities, concordance, and predictors of PPROM among pregnant women at the University of Nigeria Teaching Hospital, Enugu, Nigeria between January 1, 1999, and December 31, 2008. The morbidities, concordance, and predictors of PPROM were expressed by regression analysis output for PPROM. RESULTS: Primigravidae had the highest occurrence of PPROM. Increasing parity does not significantly influence the incidence of PPROM. The concordance and predictors of PPROM are maternal age (P < 0.000), gestational age at PROM (P < 0.000), latency period (P < 0.000), and birth weight (P < 0.001). CONCLUSION: PPROM is a major complication of pregnancies and an important cause of perinatal morbidity and mortality. Management of these morbidities associated with PPROM poses a great challenge. However, women should be informed of these complications.

Prevalence of depression among health workers in Enugu, South East Nigeria.

AIMS: Determination of the prevalence and distribution of depression among health workers at tertiary level of health care delivery in Enugu South East Nigeria. SETTINGS AND DESIGN: A cross-sectional descriptive survey of depression in health workers at tertiary level. SUBJECTS AND METHODS: By proportional quota sampling, the sample size of 309 was used. Ethical issues were given full consideration. A structured self-administered questionnaire including the Zung self-rating depression scale was used to collect data. STATISTICAL ANALYSIS USED: Data entry and analysis were done using SPSS statistical package version 15. Statistical significance was considered present when P < 0.05. RESULTS: The total of 46 of the 309 workers (14.9%) were found to be depressed. Of the health workers found to be depressed, there were more females (18.0%) than males (8.7%). A feeling of sadness over family, living and working conditions was more consistent among the depressed. CONCLUSIONS: The condition of depression is present among health workers in this part of the world. Being a female health worker, may be associated with depression in South East Nigeria. Studies to investigate the determinants and effects of depression in the Nigerian health work force are necessary.

Impact of some low-cost interventions on students' performance in a Nigerian medical school.

BACKGROUND: Students' poor performance in physiology examinations has been worrisome to the university community. Reported preference of peer-tutoring to didactic lectures at the University of Nigeria Medical School has not been investigated. AIM: The aim of this work is to design/implement low-cost interventions to improve teaching and learning of physiology. MATERIALS AND METHODS: This is a postintervention retrospective review of medical Student's performance in 2 nd Bachelor of Medicine and Bachelor of Surgery examinations physiology. Data were collected and analyzed by descriptive and inferential statistics using the MedCalc Statistical software (Turkey). The odds ratio (OR) was used to determine the chances of passing before and after the intervention. The level of significance was set at P < 0.05. RESULTS: A total of 2152 students sat for the professional examination over the study period, and 1485 students passed the examination at first attempt giving an overall pass rate of 69%. The pass rate from 2008 when our interventions started was significantly higher than the pass rate before this reform (OR: 0.53; 95% confidence interval: 0.43-0.64; P < 0.0001). CONCLUSION: Results support the engagement of teachers with strong translational interests and clinicians to augment existing faculty in basic sciences, innovative alternatives to passive lecture formats and students involvement in program evaluation.

Falls among pregnant women in Enugu, Southeast Nigeria.

BACKGROUND: Falls during pregnancy are major public health issues and a common cause of maternal injury during pregnancy. There is paucity of data on prevalence and risk factors of falls during pregnancy in African population including Nigeria. OBJECTIVE: To determine the prevalence and risk factors associated with falls during pregnancy in Enugu, Nigeria. MATERIALS AND METHODS: This was a cross-sectional study of 332 consecutive pregnant women presenting in labor for delivery at the University of Nigeria Teaching Hospital Enugu, Nigeria between 1(st) May and 31(st) December, 2012. RESULTS: The mean age of the women was 32.2 ± 2.7 (range: 20-42) years. One hundred and eight women (32.5%) reported falling at least once during the index pregnancy. Women aged ≤ 30 years had twofold risk of falling during pregnancy than women aged > 30 years [41.1% (69/168) vs. 23.8% (39/164); odds ratio (OR): 2.23; 95% confidence interval (CI): 1.39-3.58; P < 0.001)]. Similarly, women ≥ 160 cm in height had significantly higher risk of falling during pregnancy than women < 160 cm in height [43.5% (70/161) vs. 22.2% (38/171); OR: 0.37; 95% CI: 0.23-0.60; P < 0.0001)]. Furthermore, primigravidae had almost threefold risk of falling during pregnancy than multigravidae [45.3% (63/139) vs. 23.3% (45/193); OR: 2.73; 95% CI: 1.70-4.37; P < 0.0001)]. CONCLUSION: Falls during pregnancy is common in Enugu, Nigeria. It is, therefore, recommended that women should be counseled during pregnancy on this public health problem and the above-identified risk factors emphasized in order to reduce the prevalence and morbidity.

Vulnerability and Knowledge of Sexually Transmitted Infections among Female Traders of Reproductive Age in Enugu; Nigeria

Background: Sexually transmitted infections (STIs) constitute major public health concern and enigma. A comprehensive knowledge of the modes of transmission is necessary to evolve an effective preventive strategy. Aim: The aim of the study is to assess the vulnerability; knowledge and prevention of STIs among female traders of reproductive age in Enugu; Southeast Nigeria. Subjects and Methods: This was a cross-sectional descriptive study carried out on female traders aged 15-49 years at Ogbete Main Market; Enugu; Southeast Nigeria. Data was analyzed using Epi-Info 2000 version 3.3.1 Centers for Disease Control and Prevention Atlanta USA) was used to analyze the data and results were presented in tabular form. Results: A total of 200 female traders of reproductive age participated in the study. The mean (standard deviation) age was 26 (7.4) years. 16 (32/200) were adolescents. Knowledge of specific STIs was highest for human immunodeficiency virus/acquired immune deficiency syndrome 90 (130/200). Parents were poor sources of information as only 28.5 (57/200) respondents heard about STIs from their parents compared with 46 (151/200); non-use of condoms 62 (124/200) and early debut 58 (116/200). Majority 67.5 135/200) were aware that STIs could be treated by a visit to the doctor while 21.5 (43/200) preferred traditional/herbal healers. Conclusion: The inclusion of health education in schools' curricula to ensure that adolescents are adequately aware of STIs; their modes of transmission; prevention and treatment before embarking on any vocation out-of-school is advocated

Non-immune hydrops fetalis.

BACKGROUND: Non-immune hydrops fetalis (NIHF) is a rare fetal condition with a very high mortality in spite of advances in prenatal diagnostic techniques, early detection, and individualized management. Despite advancement in fetal therapy and rapidly developing new knowledge about the aetiology and prenatal diagnosis, its management has remained controversial. METHODS: This is a descriptive review ofNIHF. RESULTS: NIHF is a rare fetal condition that presents in an extremely acute manner with almost 90% mortality. Fetal cardiac anomalies are the most common cause and chromosome anomalies are the second-most-common cause. The worst prognosis was related to prematurity, severe hydrops, anaemia, cardiac malformations, chromosomal disorders and congenital infections. Fetal interventions includeboth medical and surgical modalities. CONCLUSION: NIHF is a rare condition with high prenatal mortality. The exact pathophysiology is still poorly understood. It is important to detect NIHF early, diagnose the underlying cause and institute appropriate treatment. There is need for autopsy of all fetuses or neonates who die from NIHF.

A survey of women's knowledge and perception of hormone replacement therapy (hrt) in Enugu, South East Nigeria.

BACKGROUND: As a result of alteration in the physiological, biochemical and psychological environment of a woman due to menopause, there may be need for hormone replacement therapy (HRT). This concept is new in our poor resource setting, thus the knowledge and perception of HRT will be invaluable to appropriate adjustment to menopausal period. OBJECTIVE: The objective of this study was to determine the knowledge and perception of hormone replacement therapy among women in Enugu South-East Nigeria. METHOD: This was a cross sectional survey of gynaecology clinic attendees at the university of Nigeria Teaching Hospital (UNTH), Enugu. These women were randomly selected. Data were analyzed using SPSS software. The primary method used was cross tabulation. RESULT: The knowledge and perception of HR among women of South East Nigeria is poor and related to the level of education. One hundred and sixty eight women (38.9%) had knowledge of HRT and only 48 (11.1%) had taken it in the past. Currently none was using HRT despite experiencing menopausal symptoms. Majority of women were ignorant of HRT and took climacteric symptoms as part of aging process. CONCLUSION: The knowledge and perception of HRT is poor and limited. Public enlightenment would help to improve awareness of climacteric symptoms. Women at high risk for menopausal diseases should be advised on HRT.

Caesarean hysterectomy.

BACKGROUND: Caesarean hysterectomy is an obstetric emergency procedure performed to save maternal life in uncontrollable haemorrhage and few elective indications. It could be a planned procedure but more often it is an emergency operation. OBJECTIVE: To ensure adequate exposure and mastery of this emergency procedure by residents in training in Obstetrics and Gynaecology in Nigeria. METHODS: Review of the pertinent literature, selected references, and internet services through Medline search on caesarean hysterectomy. RESULTS: The incidence for emergency caesarean hysterectomy is 0.01-0.05%. The maternal death rate associated with caesarean hysterectomy from all causes is 0.7% compared to 0.05% for all caesarean sections. Porro's operation was a subtotal amputation but opinion now favours a total hysterectomy where practicable. Inexperienced surgeons may encounter identification of the lower margin of the cervix as limiting factor, for fully effaced and dilated cervix. Subtotal hysterectomy may therefore be the more prudent, safest and fastest option, but the potential problems of a residual cervical stump must always be borne in mind. CONCLUSION: Caesarean hysterectomy though a rare procedure is a life saving obstetric emergency. There is need for adequate exposure and mastery by the residents and a must for all obstetricians in their practice.

Utilization of insecticide treated nets among pregnant women in Enugu, South Eastern Nigeria.

BACKGROUND: The goal of roll back malaria partnership is to achieve universal coverage for all populations at risk using appropriate interventions for prevention and case management. OBJECTIVE: The objective of this study is to determine the use of insecticide treated nets (ITNs) and other anti-vector measures among pregnant women in an area hyper-endemic for malaria. MATERIALS AND METHODS: Questionnaires were administered to a cross-section of 832 consecutive pregnant women attending antenatal care in three hospitals in Enugu, Nigeria that have high client flow for maternity services. Data collected were analyzed using descriptive and inferential statistics by means of the Statistical Package for Social Sciences (SPSS) version 16. P-value of less than 0.05 was considered statistically significant. RESULTS: The mean age of the women was 33.2 ± 2.9 (range: 15-45) years. Three hundred and fifty nine (43.1%) women owned insecticide treated nets (ITNs), however 325(90.5%) slept under the nets during the index pregnancies; equivalent to 39.1% utilization rate among the 832 women studied. Out of the 325 (39.1%) women that used ITNs; 236 (28.4%) used it singly, while 89 (10.7%) used it in combination with other anti-vector measures. Educational status and social class of the women had strong association with the use of ITNs (P < 0.0001). Women who used ITNs were significantly less likely to have acute malaria, anaemia and babies with low birth weight than women who did not use ITNs (P < 0.05). CONCLUSION: The use of ITNs is poor among pregnant women in Enugu, but associated with favorable maternal and feto-neonatal outcome. Future measures to increase its use should consider improvement in educational level and social class of our women.

An overview of menopause associated vasomotor symptoms and options available in its management.

BACKGROUND: Vasomotor Symptoms are the most common and distressing menopausal complaint, for which women seek advice from their physician. OBJECTIVE: To review menopausal associated vasomotor symptoms and options available in its management. METHODS: Pertinent literature on menopause associated vasomotor symptoms, selected references, textbooks, journals and internet services using the PubMed and Medline databases were included in this review. RESULTS: Hot flushes are the most common and distressing symptom, for which women seek advice from their physician. It occurs in more than 75% of postmenopausal women. Management of hot flushes is problematic because the most recognized effective option oestrogen, is often contraindicated. This has resulted in extensive research exploring different therapeutic options for treatment of hot flushes. Currently, various safe and efficacious nonhormonal options exist but further research is still needed to improve on the treatment of hot flushes. CONCLUSION: The management of the most common and distressing vasomotor symptoms associated with menopause (hot flushes) is controversial. Regardless of the management strategy adopted, treatment options should be periodically reassessed as menopause-related vasomotor symptoms will abate with time even without any intervention in majority of postmenopausal women.

The prevalence of Rhesus negativity among pregnant women in Enugu, Southeast Nigeria.

BACKGROUND: Hemolytic disease of the newborn, secondary to rhesus D (Rh D) iso-immunization, contributes significantly to perinatal morbidity and mortality. Prevalence data in Nigeria, and Southeast Nigeria in particular, is very scanty. This study was carried out to provide our experience in this preventable clinical condition in Enugu, Southeast Nigeria. OBJECTIVE: To determine the prevalence and trends of Rh D negativity among pregnant women in Enugu, Southeast Nigeria. MATERIALS AND METHODS: A 5-year retrospective study of rhesus negative women was carried out at the University of Nigeria Teaching Hospital, Enugu, Nigeria, between 1 st January 2000 and 31 st December 2004. RESULT: The prevalence rate of Rh D negative women in Enugu, Nigeria, is 4.5%. Out of 6306 women who booked for antenatal care, 282 (4.5%) were Rh D negative women. One hundred and eighty-two (182) (64.5%) of the Rh D negative women were of blood group O followed by blood group A 20%, blood group B 12.1%, and blood group AB 3.2%, respectively. CONCLUSION: There is a need for adequate counseling of pregnant women on the importance of Rh D negative factor during the antenatal period in order to prevent hemolytic disease of the newborn.

Trends and determinants of episiotomy at the University of Nigeria Teaching Hospital (Unth), Enugu, Nigeria.

BACKGROUND: Episiotomy is the most commonly performed obstetric procedure. The indications and efficacy are poorly established and its practice has remained controversial. OBJECTIVE: To determine the rate and the determinants of episiotomy in the parturients at the UNTH, Enugu. METHODS: A five year retrospective review of episiotomy at UNTH Enugu between 1st January, 2000 and 31st December, 2004. RESULTS: Out of 3032 vaginal deliveries, 1201 women had episiotomy during vaginal delivery, giving a rate of 39.6%. The rate fluctuated between 38.7% in 2000 to 32.7% in 2004. The risk of receiving episiotomy is significantly higher among primigravidae than multigravidae [OR = 10.92, (95% CI = 8.98,13.28)]. Similarly, macrosomia (birth weight > 4 kg) significantly increases the risk of episiotomy [OR = 0.096, (95% CI = 0.06, 0.15)]. Women who had instrumental or destructive vaginal delivery are significantly more likely to receive episiotomy than those who had spontaneous vaginal delivery [OR = 0.13 (95% CI = 0.07, 0.26)]. The postpartum blood loss is significantly higher among women that received episiotomy than those who did not [t = 42.161, P > 0.0001]. CONCLUSIONS: The rate of episiotomy in UNTH, Enugu is high. Primigravidity, macrosomia and instrumental deliveries are factors associated with increased risk of episiotomy. Knowledge of these risk factors will guide in predicting episiotomy among paturients in labour ward.

HIV sero-prevalence among pregnant women in a resource constrained setting, South East Nigeria.

INTRODUCTION: HIV infection and AIDS is a public health problem worldwide, particularly affecting the populace in resource constrained settings like in sub-Saharan Africa. Women of reproductive age are most affected and infected with the disease. METHODOLOGY: A descriptive study of pregnant women presenting for the first time at the obstetrics booking clinic of ESUTTH, Parklane from 1st April, 2009 to 31st March, 2010. Socio-demographic characteristics, sexual behavior, pregnancy history and STI related symptoms were obtained using already prepared proforma. HIV Screening test was conducted in a serial two step approach using Determine HIV test kits and Stat- Pak HIV kits after obtaining an informed consent. Discordant results were subjected to Western blot for confirmation. Data were entered and analyzed using Epi-info statistical software. P Value < 0.05 were assessed as statistically significant at 95% confidence interval. RESULT: A total of 1306 women were recruited, 66 women were HIV positive, giving a prevalence rate of 5.1%. Their mean age was 28.79 +/- 5.06 years. Majority of them were married (9%). The mean gestational age at booking was 26.2 +/- 6.8 weeks. Alcohol intake, history of 3 or more sexual partner in the last 5 years, abnormal vaginal discharge in the last 12 months, history of genital ulcer in last 12 month, had a statistically significant association with prevalence of HIV infection (p value < 0.005). CONCLUSION: HIV infection prevalence rate in among antenatal attendants in Enugu is still high. A multi-sectoral approach is required for effective prevention and control of the disease to ensure achievement of Millennium development Goals 5&6.

Large vulvar lipoma following episiotomy: a case report.

Vulvar lipomas are rare few cases have been reported in the world literature. We document a case of large soft vulvar mass following episiotomy in a 23-year-old primipara. The mass was excised and histologic examination confirmed lipoma.

Coinfection with hepatitis B and C viruses among HIV positive pregnant women in Enugu south east, Nigeria.

BACKGROUND: Hepatitis B and C viruses coinfection in HIV positive pregnant women is a common public health problem and recognized worldwide. The consequences of this problem in our poor resource setting with the risk of mother to child transmission is obvious with increased morbidity and mortality in our environment. OBJECTIVE: To determine the prevalence of coinfection patterns of HBV and HCV among HIV positive pregnant women in Enugu Nigeria. METHODS: A retrospective survey conducted on 401 Nigeria HIV positive pregnant women seen at Prevention of Mother To Child Transmission (PMTCT) clinic at the UNTH Enugu Nigeria over a 3 year period between 1st January 2007 and 31st December 2009. RESULTS: The prevalence of hepatitis B and C viruses coinfection among HIV positive pregnant women in Enugu is 6.5%. HIV/HBV coinfection was commoner than HIV/HCV coinfection. There was no significant association between hepatitis B and C viruses coinfection and the age, ethnic group, marital or educational status of the women (P > 0.05). CONCLUSION: There is high prevalence of hepatitis B and C coinfection among HIV positive pregnant women in Enugu. This high burden of these hepatotropie virus coinfection calls for continued need to screen for these infections and vaccinate the affected babies for hepatitis B and/or C where appropriate.