ABSTRACT
Objectives: The objective of the study was to assess how the current COVID-19 pandemic has affected cesarean section (C-section) rates, indications, and peripartum outcomes. Methods: This was a retrospective cross-sectional study that compared a 3-month rates of and indications for C-sections at three tertiary health care institutions in Nigeria before (October 2019-December 2019) and during the first wave of COVID-19 pandemic (March 2020-May 2020). Primary outcomes were C-section rate and indications between the two periods. Data were analyzed using SPSS 26.0 IBM Corporation. Rates and odds ratios with 95% confidence intervals were used to quantify indications and peripartum outcomes and statistical significance was accepted when p value was <0.05. Results: The baseline characteristics of the two groups were similar. The C-section rate during the COVID-19 period was significantly less than the period prior to the pandemic (237/580, 40.0% vs 390/833, 46.8%; p = 0.027). The rates of postdatism (odds ratio = 1.47, 95% confidence interval = 1.05-2.05, p = 0.022), fetal distress (odds ratio = 3.06, 95% confidence interval = 1.55-6.06, p = 0.017), emergency C-section (odds ratio = 1.43, 95% confidence interval = 1.01-2.05, p = 0.042), and anemia (odds ratio = 1.84, 95% confidence interval = 1.12-3.03, p = 0.016) were significantly higher during the pandemic than prepandemic. Conclusion: The overall C-section rate during the first wave of COVID-19 was significantly lower than the prepandemic period. There were higher rates of postdatism, fetal distress, emergency C-section, and postpartum anemia. Further studies on this changing C-section trend during the pandemic are needed.
ABSTRACT
Intramuscular hematoma most commonly occurs following trauma; however, spontaneous hematomas may be seen in elderly patients due to anticoagulation. Intramuscular hematomas may not be chronically expanding, and their signs and symptoms vary, ranging from asymptomatic to swelling that may be expanding in size. In some cases, chronic hematoma may become infected as we witnessed in the case we present in this report. Our patient reported recurrent cellulitis and occasional fever with no other history of probable cause of the recurrent cellulitis. Such an atypical presentation poses a risk of delayed or missed diagnosis of a condition that can threaten the limb of a patient, as seen in our case.
ABSTRACT
OBJECTIVE: The objective of this study was to determine the proportion of the Anambra State population that had been infected by the SARS-CoV-2 virus and developed antibodies before the second wave. METHODS: The WHO-recommended health facility-based cross-sectional approach was adapted for this survey. Between 8th and 15th December 2020, 3142 participants across the 21 local government areas (LGAs) of the State, aged one year and over, attending randomly selected health facilities, were recruited. Demographic and symptom-related information were collected from the participants as well as whole peripheral blood, which was tested for SARS-CoV-2 IgG and IgM with rapid test kits. RESULTS: 425 participants tested positive for IgG only, 74 for IgM only, while 54 were positive for both IgG and IgM. Overall, 553 positives were recorded, giving a crude seroprevalence of 17.6% (95% CI = 16.26 - 18.98). It ranged widely from 31.9% (95% CI = 24.43 - 40.22) in Onitsha North LGA to 5.4% (95% CI = 2.19 - 10.78) in Awka north. Bayesian Adjustments yielded a state seroprevalence of 16.1%. CONCLUSION: One in six state residents had been infected by SARS-CoV-2 and developed antibodies before the second wave. All LGAs, age groups, sexes, and settlement types were affected by COVID-19. A large proportion of the population remained susceptible to SARS-CoV-2.
