Influence of pregnancy and lactation on vitamin D serum levels and antioxidant status in randomized women in Zaria.

Pregnancy and lactation are normal physiological conditions that tend to influence numerous biological processes. The aim of this study was to identify the impact of pregnancy and lactation on serum vitamin D level and antioxidant status in some women in Zaria, Nigeria. A cross­sectional descriptive study conducted at Ahmadu Bello University Teaching Hospital, Zaria for a period of three (3) months. Blood samples were collected, serum catalase, superoxide dismutase, lipid peroxidation and vitamin D, were determined using standard methods. Data were presented as mean ± SD, analysis was performed using one-way ANOVA and Pearson's correlation analysis. Values were considered significant at p ≤ 0.05. There was a significant difference (p < 0.01) serum malondialdehyde level, superoxide dismutase activity and glutathione peroxidase activity during the various trimesters of pregnancy and lactating group. However, the levels of these markers were highest in the lactating group. Furthermore, serum level of vitamin D and catalase activity was highest in the 2nd trimester and lowest in the control and lactating group respectively.  Pregnancy and lactation altered serum level of Vitamin D, CAT, SOD, MDA and GPx suggesting a variation in oxidative stress at different trimester of pregnancy and lactation. Key words: Pregnancy, lactation, oxidative stress, vitamin D.

Physiological Changes in Serum Calcium, Phosphate, Vitamin D, Parathyroid Hormone and Calcitonin During Pregnancy and Lactation in Randomised Population of Zaria Women.

Pregnancy and lactation are usual but stressful physiological conditions accompanied by changes in calcium and phosphate metabolism and their regulatory hormones which may lead to calcium-related disorders in pregnant women. This study aimed to evaluate the changes in serum levels of calcium, phosphate, vitamin D and their regulatory hormones in pregnant and lactating women in Zaria, Nigeria. A cross­sectional descriptive study was conducted at Ahmadu Bello University Teaching Hospital, Zaria for three (3) months. Blood samples were collected, anthropometric measurements (weight, height and body mass index) of 179 women were taken. Serum calcium, phosphate, vitamin D, parathyroid hormone and calcitonin were determined using standard methods. Data were presented as mean ± SD, analysis was performed using one-way ANOVA and Pearson's correlation analysis. Values were considered significant at p ≤ 0.05. There was a significant decrease in serum calcium concentration (p < 0.01) during the third trimester of pregnancy and lactation. An increase in serum concentration of vitamin D, parathyroid hormone, and calcitonin in the 2nd trimester and a decrease during the third trimester and lactation although not statistically significant when compared with the control. There was a negative correlation between serum calcium concentration and gestational age (r = 0.255) while no correlation between gestational age and serum phosphate concentration. Changes in serum calcium, vitamin D, parathyroid hormone and calcitonin during pregnancy and lactation has been demonstrated suggesting a relationship between calcium metabolism and these hormones at some stages of pregnancy.

Molecular epidemiology of hepatitis C virus (HCV) in Kadun State

Objective: To determine the distribution of hepatitis C virus (HCV) genotypes and subtypes among blood donors and outpatients attendees positive for antibody to HCV (anti-HCV). Justification: Hepatitis C virus (HCV) continues to be a major disease burden on the world and Man is the only known natural host of Hepatitis C virus (Chivaliez and Pawlotsky; 2007). There is no published data on the prevalence of the genotypes and subtypes of HCV in Kaduna State. Setting: Three hospitals one in each of the 3 senatorial zones in Kaduna State. Patients: Blood donors who reported for blood donation and outpatient department attendees. Method: Antibody detection by a third generation HCV ELISA (Biotech Laboratories; UK); HCV RNA and genotyping by Reverse Transcriptase polymerase chain reaction with genotype-specific primers. (Sacace Biotechnologies; UK). Results: of the 259 plasma specimens screened for Hepatitis C virus in this study; 20(7.7) were positive for anti-HCV antibodies by ELISA and 16(6.2) of the antibodies positive specimen were positive for HCV RNA. Of the 139 blood donors tested; 8 (5.8) were HCV RNA positive. Similarly; 120 were tested from the outpatient Department attendees and 8 (6.7) were HCV RNA positive. Hepatitis C virus genotype 1b was found in the entire HCV RNA positive sample. Conclusions: The findings of 6.2prevalence of HCV infection based on HCV RNA test confirmed that there is Hepatitis C virus in Kaduna State with genotype 1b as the predominant genotype found in all the three senatorial zones

Abdominal tuberculosis in surgical practice in northern Nigeria.

BACKGROUND: Abdominal tuberculosis is a common complication of pulmonary tuberculosis. With the rising incidence of HIV, tuberculosis has become a major public health problem particularly in developing countries. METHODS: This is a retrospective study involving patients whose surgical specimens were processed at the central histopathology laboratory of the Ahmadu Bello University Teaching Hospital (ABUTH) Zaria--Nigeria, between January 1975 to December 2006. RESULTS: There were 68 males and 49 females, aged 12-70 years (mean 28.6 yrs 11 yrs). While paroxysmal dry cough was present in about 20 patients, abdominal pain and distension were very common. Concomitant pulmonary tuberculosis was confirmed in 15 patients (14%). The findings at Surgery in 66 patients are presented in fig. 2. Multiple deposits on the peritoneum and omentum were the commonest findings (48.7% and 26.2%) respectively CONCLUSION: Abdominal tuberculosis is not uncommon and there is need to establish an early less invasive diagnostic protocol.

Abdominal Tuberculosis in Surgical Practice in Northern Nigeria

Background: Abdominal tuberculosis is a common complication of pulmonary tuberculosis. With the rising incidence of HIV; tuberculosis has become a major public health problem particularly in developing countries. Methods: This is a retrospective study involving patients whose surgical specimens were processed at the central histopathology laboratory of the Ahmadu Bello University Teaching Hospital (ABUTH) Zaria - Nigeria; between January1975 to December 2006. Results: There were 68 males and 49 females; aged 12-70 years (mean 28.6yrs 11yrs). While paroxysmal dry cough was present in about 20 patients; abdominal pain and distension were very common. Concomitant pulmonary tuberculosis was confirmed in 15 patients (14). The findings at Surgery in 66 patients are presented in fig.2. Multiple deposits on the peritoneum and momentum were the commonest findings (48.7and 26.2) respectively. Conclusion: Abdominal tuberculosis is not uncommon and there is need to establish an early less invasive diagnostic protocol

Diagnosis and Management of Ureterovaginal Fistula in a Resource-Constrained Setting: Experience at a District Hospital in Northern Nigeria

During 2007 we were invited at different times to review and manage four women with ureterovaginal fistula following caesarean section performed in different rural hospitals. We describe our experience of a simple technique of diagnosis and management of these indigent patients in a resource-constrained hospital. The condition was diagnosed by the three-swab test in all four patients; and abdominopelvic ultrasound was employed to help find the ureter involved. Transvesical ureteral implantation with a stent was carried out. Stent was removed after 2 weeks. All four patients were dry. Amidst the complexity of and sophistication of modern health care; it is important to remind ourselves of the common occurrence of this distressing condition following caesarean section and the use of a well known simple diagnostic technique and subsequent management in resource-poor communities

Ectopic (tubal) molar gestation: report of two cases.

BACKGROUND: Ectopic molar gestation is a rare event. Its malignant potential is similar to that of an intrauterine molar pregnancy. OBJECTIVE: To document two cases of tubal molar gestations seen over a 10-year period. STUDY DESIGN: Case series. RESULTS: Two young Nigerian undergraduates presented with features of ruptured tubal pregnancy. They had total salpingectomy and histopathological analysis of the tubal specimens revealed complete hydatidiform mole. HCG level normalized in both cases within three weeks of treatment. CONCLUSION: Ectopic molar gestation does occur occasional in our setting. It is pertinent that clinicians in this part of the world be aware of this and to take routine histological examination of tubal specimens in ectopic pregnancy very seriously in order to diagnosed cases of ectopic molar gestations early and mount appropriate post treatment surveillance.

Pattern of childhood gynaecological presentations in a Nigerian tertiary health facility.

BACKGROUND: Gynaecological problems in children and adolescents are often both medically and psychologically unique and require a highly skilled approach differing from those utilized for an adult female population. There is paucity of data on childhood gynaecological problems in our environment. The purpose of this study was to document the prevalence and pattern of common gynaecological problems in the prepubertal child at Ahmadu Bello University Teaching Hospital Zaria, Northern Nigeria. MATERIALS AND METHODS: This was a retrospective study involving case file-based data analysis over a 10-year period (1995-2004) of 62 children aged 1 month-12 years at the Gynaecology unit of Ahmadu Bello University Teaching Hospital Zaria, Northern Nigeria. RESULTS: Sixty-two children were seen, 17 infants, 14 under 5 years of age, and the rest (31) were aged 6-12 years. The commonest condition was labial fusion (33.9%), urethral prolapse (14.5%), and suspected sexual assault (12%). Ambiguous genitalia (9.7%), vaginitis (6.5 %), and ovarian tumour (4.8%) were also encountered. CONCLUSION: Labial fusion, urethral prolapse, and suspected sexual assault are the commonest childhood gynaecological morbidities in Zaria. Provision of gynaecological services at every level of health care system to cater for young females is advocated.

Pattern of childhood gynaecological presentations in a Nigerian tertiary health facility

Background: Gynaecological problems in children and adolescents are often both medically and psychologically unique and require a highly skilled approach differing from those utilized for an adult female population. There is paucity of data on childhood gynaecological problems in our environment. The purpose of this study was to document the prevalence and pattern of common gynaecological problems in the prepubertal child at Ahmadu Bello University Teaching Hospital Zaria; Northern Nigeria. Materials and Methods: This was a retrospective study involving case file-based data analysis over a 10-year period (1995-2004) of 62 children aged 1 month-12 years at the Gynaecology unit of Ahmadu Bello University Teaching Hospital Zaria; Northern Nigeria. Results: Sixty-two children were seen; 17 infants; 14 under 5 years of age; and the rest (31) were aged 6-12 years. The commonest condition was labial fusion (33.9); urethral prolapse (14.5); and suspected sexual assault (12). Ambiguous genitalia (9.7); vaginitis (6.5); and ovarian tumour (4.8) were also encountered. Conclusion: Labial fusion; urethral prolapse; and suspected sexual assault are the commonest childhood gynaecological morbidities in Zaria. Provision of gynaecological services at every level of health care system to cater for young females is advocated