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Pregnancy Outcome among Women with Sickle Cell Disease in a Tertiary Health Institution in Abakaliki: A Retrospective Case-Control Study

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International Journal of Clinical Medicine 2019年第8期10卷 395-403页

作者： Johnbosco Ifunanya Nwafor Darlington-Peter Chibuzor Ugoji Chukwunenye Chukwu Ibo Blessing Idzuinya Onwe victor jude uchenna onuchukwu Chuka Nobert Obi Vitus Okwuchukwu Obi Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

Background: Sickle cell disease (SCD) is associated with an increased risk of medical complications during pregnancy and they constitute a very high-risk group with associated increased maternal and perinatal morbidity and mortality especially in a low resource setting. Objective: To determine the pregnancy outcomes among women with sickle cell disease delivered at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and methods: This was a 7-year retrospective case-control study undertaken from January 2012 to December 2018 that compared pregnancy outcomes among women with and without haemoglobinopathy in pregnancy managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA). The statistical analysis was done using SPSS version 22. Results: The incidence of SCD in pregnancy was 6.9 per 1000 deliveries. The age distribution of the women ranged from 18 to 45 years of age with a mean of 26.4 ± 2.4 years. The incidence of stillbirth was higher in women with HbSS when compared with HbSC but this difference did not reach statistical significance (P = 0.05). Live birth rate was higher in women with HbAA genotype when compared with those with SCD. Caesarean section rate was higher among women with SCD when compared with control (SS versus AA, P = 0.004;SC versus AA, P Conclusion: This study showed that the maternal mortality in SS and SC patients in pregnancy was not different from those of HbAA women in our hospital, although other maternal and fetal outcomes were still poor among women with SCD when compared with women without SCD.

关键词： Pregnancy Outcome Sickle Cell Disease Abakaliki

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Pregnancy Outcome among Women with Sickle Cell Disease in a Tertiary Health Institution in Abakaliki: A Retrospective Case-Control Study

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International Journal of Clinical Medicine（临床医学国际期刊） 2019年第8期

作者： Johnbosco Ifunanya Nwafor Darlington-Peter Chibuzor Ugoji Chukwunenye Chukwu Ibo Blessing Idzuinya Onwe victor jude uchenna onuchukwu Chuka Nobert Obi Vitus Okwuchukwu Obi

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Post Episiotomy Morbidity among Parturient in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1144-1160页

作者： John Chinedu Obasi Ayodele Adegbite Olaleye Boniface N. Ejikeme John O. Egede Charles Nwambeke Edene Enemma Christian Enemma victor onuchukwu Emmanuel Onyekelu Nathan C. Ekpe Wendy Oliobi Emmanuel C. Uwakwe Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital AbakalikiNigeria

Background: Episiotomy is a very common obstetric surgery, and it could be associated with serious complications. However, these complications largely are not noticed due to the shift of attention from mother to baby, after a successful delivery. Objective: To identify the morbidities associated with episiotomies and factors associated with such morbidities. Method: This was a questionnaire based cross sectional descriptive study among women who attended the Obstetric Department of Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State, between 1st July and 31st Nov, 2023. The study population consisted of parturients who had episiotomies in their previous confinements, attending either the antenatal clinic or the postnatal clinic at Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State. Results: Macrosomia was the most common indication of episiotomy at a rate of 31.6%. The majority of episiotomies were performed on the parturients in their first confinement at a rate of 64.5% and the majority of repairs were performed by the Registrar at a rate of 65.0%. Informed consent was obtained from 45.79% of parturients while 54.21% were not informed before the episiotomy was administered. Only 55.3% of the parturient received analgesia before episiotomy was administered. The majority of the parturients had their episiotomy repaired between 10 - 15 minutes at a rate of 40.3%. Postoperative pain at the rate of 44.5% was the most common complication and dyspareunia as a form of sexual complication was the commonest at a rate of 31.3%. Conclusion: The parturient needs to be properly counselled before administration of episiotomy and adequate analgesia should be given, as episiotomy is a surgical procedure. Proper training of health workers on both the technique of administering and repairing episiotomy is important. Restrictive use of routine episiotomy in primigravidae is advised to reduce the rate of episiotomy.

关键词： Episiotomy Vulva Pains Primigravidae Morbidities Analgesia

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Evaluation of Pregnancy Outcomes among Women with Pregnancies Complicated by Diabetes Mellitus in Abakaliki, South-East, Nigeria

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Journal of Diabetes Mellitus 2019年第3期9卷 69-76页

作者： Nwafor Johnbosco Ifunanya Onwe Blessing Idzuinya Obi Vitus Okwuchukwu Ugoji Darlington-Peter Chibuzor Ibo Chukwunenye Chukwu Obi Chuka Nobert onuchukwu victor jude uchenna Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki South-East Nige-ria

Background: Pregnancies complicated by diabetes are associated with significant increase in maternal and perinatal morbidity and mortality. The management of diabetes in pregnancy is a great challenge in a low resource setting because of limited resources and facilities to care for these women. Aim: To determine the maternal and perinatal outcomes of diabetic pregnant women managed at Alex Ekwueme Federal University Teaching Hospital Abakaliki, Southeast, Nigeria. Materials and methods: This was a 7-year retrospective case-control study that compared pregnancy outcomes among women with pregnancies complicated by diabetes and those without diabetes managed at Alex Ekwueme Federal University Teaching Hospital, Abakalikibetween January 1st, 2012 and December 31st, 2018. The statistical analysis was done using SPSS version 22. Results: The incidence of diabetes in pregnancy in this study was 6.6 per 1000 deliveries. Of 126 women in diabetic arm of the study, 81 were diagnosed during pregnancy and 45 were known diabetic prior to conception. Over two-thirds of 126 women with pregnancy complicated by diabetes achieved good blood glucose control during pregnancy. Both groups differ in their mean BMI and women with diabetes in pregnancy were more likely to be obese compared with control (diabetic;30.1 ± 2.5 versus control;23.4 ± 2.1, P < 0.0001). Pregnant women with diabetes were more likely to be delivered by cesarean section when compared with non-diabetic women (86 versus 23, OR = 9.6, 95% CI: 5.35 - 17.32, P < 0.0001). Similarly, the incidence of polyhydramnious was higher in paturients with diabetes when compared with the control groups (26 versus 13, OR = 2.2, 95%CI: 1.10 - 4.63, P = 0.02). There were no differences between both study groups with regards to other maternal outcomes. The incidence of fetal macrosomia, neonatal hypoglycemia and neonatal respiratory distress syndrome were significantly higher among women whose pregnancies were complicated by diabetes when

关键词： Pregnancies Complicated Diabetes Mellitus Maternal Perinatal Abakaliki

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Tranexamic Acid versus Placebo for Prevention of Primary Postpartum Haemorrhage among High Risk Women Undergoing Caesarean Section in Abakaliki: A Randomized Controlled Trial

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Open Journal of Obstetrics and Gynecology 2019年第6期9卷 914-922页

作者： Nwafor Johnbosco Ifunanya Ibo Chukwunenye Chukwu Obi Chuka Nobert Onwe Blessing Ugoji Darlington-Peter Chibuzor onuchukwu victor uchenna Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

Objective: To evaluate the efficacy of tranexamic acid for prevention of postpartum haemorrhage among women undergoing cesarean section who were at high risk of postpartum hemorrhage. Materials and Method: This was a double blind randomized controlled trial conducted at the Alex Ekwueme Federal University Teaching Hospital Abakaliki from January 2016 to December 2017. One hundred and sixty-eight parturients at high risk of postpartum haemorrhage who underwent caesarean section were randomly assigned to receive either tranexamic acid or placebo prior to skin incision. Results: The result of the study showed that the need for additional uterotonic was higher in women in the placebo arm when compared with women in the tranexamic arm of the study (7.4% versus 33.3%, respectively). The incidence of primary post-partum hemorrhage (blood loss > 1000 ml) was significantly lower in the tranexamic acid group compared to placebo group (11.9% versus 50%, respectively, P-value Conclusion: Intravenous tranexamic acid given prior to skin incision at caesarean section reduced the need for additional uterotonics and incidence of primary postpartum among high risk women.

关键词： Tranexamic Acid Maternal Mortality Postpartum Haemorrhage

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Gestational Trophoblastic Diseases: A Review of the Clinical Presentation and Management at the Alex Ekwueme Federal University Teaching Hospital Abakaliki

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Case Reports in Clinical Medicine 2019年第6期8卷 164-171页

作者： Nwafor Johnbosco Ifunanya Obi Vitus Okwuchukwu Ibo Chukwunenye Chukwu Obi Chuka Nobert Onwe Blessing Ugoji Darlington-Peter Chibuzor onuchukwu victor uchenna Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki South-East Nigeria Nigeria

Background: Gestational trophoblastic diseases (GTD) are potentially curable with retention of reproductive function once the correct diagnosis is made and treatment is commenced early with adequate follow up. Objective: The objective of this study was to determine the incidence, clinical presentation, management and treatment outcomes of gestational trophoblastic diseases in a tertiary hospital in Abakaliki, South-east Nigeria. Materials and Methods: This was a retrospective descriptive study of gestational trophoblastic diseases managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA) over a 6-year period. The statistical analysis was done using SPSS version 22. Results: The incidence of GTD was 4.6 per 1000 deliveries. Women who were less than 20 years and more than 40 years of age accounted for 5.9% and 23.5% of cases of GTD respectively. Women who were para 5 and above accounted for 76.5% of those who presented with GTD. All the patients presented with vaginal bleeding. Suction evacuation (76.5%) was the commonest form of treatment offered to women with GTD. The commonest complication was anaemia (94.1%). Maternal death due to GTD was 8.8%. Most (58.8%) of the patients did not turn up for follow-up. Conclusion: Gestational trophoblastic diseases has remained an important cause of maternal morbidity and mortality in our hospital due to poor compliance with follow-up. Call and recall system should be introduced in the management of patients with GTD to improve compliance to management standard.

关键词： Gestational Maternal Mortality Chemotherapy Follow-Up

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Dramatic recovery from stroke following intravenous thrombolysis in a patient on prasugrel for recent percutaneous coronary angioplasty

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Neuroimmunology and Neuroinflammation 2017年第10期4卷 216-218页

作者： Salvadeeswaran Meenakshi-Sundaram Palanikumar Subburamakrishnan jude Vinoth Simon victor Rajah Sanjeevi Madhan-Rajah Somalinga Nagendran Karthik Pandi Suresh Department of Neurosciences Apollo Speciality HospitalsLake View RoadKK NagarMaduraiTamil Nadu625020India Department of Cardiology Apollo Speciality HospitalsLake View RoadKK NagarMaduraiTamil Nadu625020India Department of Emergency Services Apollo Speciality HospitalsLake View RoadKK NagarMaduraiTamil Nadu625020India.

The authors report the first case of thrombolysis in a patient already receiving both aspirin and prasugrel following a recent ischemic coronary event. A 55-year-old gentleman was treated for inferior wall myocardial infarction with aspirin, prasugrel and percutaneous angioplasty of right coronary artery. Three days following the procedure he developed acute ischemic stroke due to a left middle cerebral artery infarction with a National Institute of Health Stroke Scale (NIHSS) of 24 and was treated with alteplase. Therapy was interrupted after completion of 29 mg (for a body weight of 65 kg) dose due to oral bleeding. Fifteen minutes post thrombolysis NIHSS was 5 and dropped to zero after 12 h. This report highlights the benefits of alteplase in the context of several relative contraindications like the setting of acute myocardial infarction treated with percutaneous intervention and high NIHSS.

关键词： Intravenous thrombolysis ischemic stroke percutaneous coronary angioplasty prasugrel

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Physico-Chemical and Biological Characteristics of the Nklobisson Artificial Lake in Yaounde, Cameroon

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Journal of Water Resource and Protection 2017年第12期9卷 1547-1563页

作者： Josephine Ndjama Gideon Aghaindum Ajeagah Ndondo Gustave Raoul Nkoue Wirmvem Mengnjo jude Ngon Eric Belmond Birama Gloria Eneke Takem Eyong Andrew Ako Ako Mohamadou Bello Tchouya Romaric victorien Ntchantcho Joseph victor Hell Institute de Recherche Geo-miniere du Cameroun Yaounde Cameroun Laboratory of Hydrobiology and Environment Université de Yaoundé 1 Yaoundé 1 Cameroun Deparetement des Sciences de la terre Université de Douala Douala Cameroun

The deterioration of water quality in lakes constitutes an environmental problem faced by humanity. The Nkolbisson artificial lake which is located downstream of the Abiergue and Mintotomo streams in Yaounde is under the influence of various forms of pollution, mostly resulting from human activities. There is proliferation of algae on the lake surface that consumes the available oxygen in the lake. The main objective of the current study is to evaluate the different forms of pollutants in the lake, in order to propose efficient solutions for a suitable management strategy, basing on the physico-chemical and biological analysis. The lake retains an average of 2535.49 tons/year of suspended solids in the rainy season and 1438.05 tons/year in the dry season. The range of dissolved oxygen (5.2 - 3.8 mg/l);pH (7.8 - 6.8);temperature (23.9°C - 23.1°C);electrical conductivity (266.1 - 87.3 μS/cm);turbidity (22.3 - 10 UNT);suspended solid (240 - 40 mg/l);BOD (55 - 8 mg/l);COD (76 - 87.3 mg/l). Biologically, faecal coliforms fluctuates between (42 × 102 - 425 × 103 FCU/100 ml), faecal streptococci (8 × 103 - 158 × 103 FCU/100 ml) and total Coliform (15 × 103 - 78 × 106 FCU/100 ml) evidence that, the studied lake is highly polluted. Consequently the lake retains an average of 2888.7 tons/year of suspended matter.

关键词： Biological Physico-Chemical Pollution Artificial Lake Cameroon

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