Raised First Trimester Thyroid Peroxidase Antibodies May Predict First Trimester Miscarriage: A Case Control Study.

Miscarriages constitute a significant aspect of failed pregnancies and a source of worry for the patient and caregiver. Some of the causes of miscarriages remain unknown. Immunological conditions such as thyroid autoimmunity could play significant roles. Our objective was to determine the relationship between raised thyroid peroxidase antibodies and first trimester miscarriages in a low resource setting. This was a case control study at the Gynaecological Clinic of the University of Calabar Teaching Hospital, Nigeria; from 14th February 2020 to 13th January 2021, involving 145 cases who had first trimester miscarriages, and their matched controls who had apparently normal pregnancies, at same gestational ages. Sera of venous blood from both participants and controls were analysed for thyroid peroxidase antibodies using enzyme-linked immunosorbent assay, and analysed using SPSS version 20, and GraphPad Prism 8.4.3 statistical software. Being a civil servant and low social status had significant odds for first trimester miscarriage. Raised thyroid peroxidase antibodies in the first trimester had 10-fold odds for miscarriage. Odds ratio 10.34, 95% CI: 3.22 to 32.98, P-value = 0.0001. The test had a sensitivity of 89.66% and specificity of 54.41%. The positive predictive value was 17.93%, while the negative predictive value was 97.93% and a likelihood ratio of 1.966. Rising thyroid peroxidase antibodies in early pregnancy could be a predictor for miscarriage. This is so because patients with raised thyroid peroxidase antibodies in the first trimester had a 10-fold risk of having a first trimester miscarriage.

Bladder stone caused by misplaced intrauterine contraceptive device: a case report.

Intrauterine Contraceptive Device (IUCD) when placed in the uterine cavity is used for contraception or treatment of intrauterine adhesion, but it has become a cause of unintended bladder stone due to wrongful placement or migration. It may cause blood in urine and painful urination. Pelvic ultrasound and X-ray were used to make the diagnosis of the bladder stone with the embedded IUCD, which was removed by open vesicolithotomy through a Pfannenstiel suprapubic incision. Cases such as this are highly preventable if post procedure and routine annual pelvic ultrasonography are emphasized as standard practice following IUCD insertions.

Predictors of utilization of facility-based ante-natal care and delivery services in a Nigerian Rural Community.

Background: With maternal mortality ratio of 2,000/100,000 live births and perinatal mortality rate of 40/1,000 total births, Cross River State is one of the states with the highest maternal and perinatal deaths in Nigeria. One of the causes of these poor health indices is low utilization of facility-based maternal and child healthcare services during pregnancy and childbirth. The objective of this study was to assess the predictors of utilization of antenatal care and delivery services in Akpabuyo, a rural community in Cross River State of Nigeria. Method: This was an analytical cross-sectional survey. Data were collected from 370 pregnant women between June and July, 2013 and analyzed using SPSS version 25. Results: Binary logistic regression showed that compared with women with tertiary education, women with non-formal education were less likely to attend antenatal clinic (AOR=0.510, 95% CI=0.219-1.188) although the difference was not statistically significant. Also, compared with farmers, full-time housewives were less likely to deliver in a health facility (AOR=0.650, 95% CI=0.305-1.389) while civil servants were nearly five times more likely to deliver in the health facility (AOR=4.750, 95%CI=1.616-13.962). Conclusion: The predictors of antenatal care and facility delivery services utilization identified by the study were educational status and occupation. This raises the need for policies and programmes to ensure girl child education and the economic empowerment of women.

Sociodemographic and gynaecological factors that influence uptake of cervical cancer screening. A cross-sectional study in Calabar, Nigeria.

Background: Voluntary screening for cervical cancer has not been very effective in sub-Saharan Africa. Awareness and presence of risk factors may drive the need to screen. Objective: To characterise sociodemographic and gynaecological factors as promoters of screening uptake. Methodology: The setting was a women health rally in Calabar, Nigeria with women from different towns/ villages in Cross River State. An interviewer-administered questionnaire assessed sociodemographic and gynaecological risk factors for cervical cancer, previous Pap smear, and acceptance to screen. Data inputted in EpiInfo 7, and GraphPad Prism 7.04 statistical software's, were analysed using descriptive and inferential statistics. Results: One hundred and eighty (180) women gave consent for inclusion in the study. The age ranged from 21 to 65 with a mean of 39.8±10.3 years. With 52.22% of respondents accepting and 47.78% declining to screen, test of association showed that knowledge of cervical cancer, history of multiple sexual partners, and presence of offensive watery vaginal discharge significantly reduced the number of women who refused to screen. Previously screened women were not more likely to accept screening. Conclusion: Screening for cervical cancer was still poor. Cervical cancer knowledge and recognition of risk factors improve screening uptake.

Ebola virus disease: assessment of knowledge, attitude and practice of nursing students of a Nigerian University.

BACKGROUND: Ebola virus disease has a high case fatality rate. Health care providers have a key role to play in its management and prevention. OBJECTIVES: The aim of this study was to determine the knowledge, attitude and practice regarding Ebola virus disease (EVD) among students of Nursing in the University of Calabar, Calabar, Nigeria. METHODS: This was a descriptive cross-sectional study. A semi-structured,self-administered questionnaire was administered to 178 nursing students. The respondents were selected using systematic random sampling. RESULTS: Lecturers were the commonest source of information regarding EVD as reported by 84.5% of the respondents followed by television (76.3%). Nearly 27% of respondents indicated that the fear of EVD had dampened their interest and enthusiasm in the nursing profession. Nearly 12 % indicated that they would not take part as theatre nurses in the surgical operation of a patient who had been certified cured of EVD. A similar proportion indicated their unwillingness to attend to a woman in labour even if she had been certified cured of EVD. CONCLUSION: Majority of the students were knowledgeable about EVD. Although majority of them had favorable attitude towards EVD patients, there was evidence of stigmatizing and discriminatory attitude that needs to be addressed.

The Value of Mobile Ultrasound Services in Rural Communities in South-South Nigeria.

AIM: This paper examines the activities of mobile services units including ultrasound services in rural and urban communities in the Calabar region of South-South, Nigeria. MATERIALS AND METHODS: Consenting individuals were invited and attended five medical outreach activities in rural and urban areas of the Calabar region between January and June 2016. Abdomino-pelvic scans were done. Subsequently the results were analyzed. RESULTS: Five hundred and seventy-four (574) individuals had Abdomino-pelvic scans done, using a curvilinear probe to assess the abdomino-pelvic organs. The female to male ratio was 1.46:1. The age ranged from 1-78 years with a mean of 40.63 (standard deviation of 17.5). The commonest sonographic finding was uterine fibroids, 21 (8.1%). Fifty-four percent of the scans were normal. The commonest sonographic finding in men was prostatic enlargement. CONCLUSION: Medical outreach activities provided by mobile units provide much needed ultrasound services in poor resource settings in Nigeria. Significant clinical pathologies were identified at fairly high rates.

Obstetric outcomes of booked teenage pregnancies at University of Calabar Teaching Hospital, Nigeria.

BACKGROUND: Teenage pregnancy is high-risk and associated with complications due to adverse physiological, anatomical, and socioeconomic factors. The purpose of this study was to determine the patterns and obstetric outcomes of booked teenage pregnancies at the University of Calabar Teaching Hospital (UCTH) in Nigeria. METHODS: A retrospective comparative analysis of teenage pregnancies and mature mothers at UCTH was carried out from January 2011 to December 2011. A total of 82 teenage pregnancies and 72 mature pregnancies were compared. RESULTS: There were 145 teenage deliveries from a total of 2313 deliveries, ie, 6.3% of total deliveries. There was no statistically significant difference in the mode of delivery (cesarean section, spontaneous vaginal delivery, instrumental delivery) between the groups of mothers. There was also no difference in risk of complications, including obstructed labor, retained placenta, uterine atony, pre-eclampsia/eclampsia, and antepartum hemorrhage. However, teenage mothers had more perineal lacerations (P = 0.02) and more preterm labor (P = 0.05), and delivered more low-birth-weight babies (P = 0.02). CONCLUSION: Supervised teenage pregnancy may not be as hazardous as previously thought.