Prevalence of Perinatal Asphyxia Using Apgar Scores and Cord Blood pH and the Relationship between the Two Methods: A Study of FMC Umuahia.

BACKGROUND: Perinatal asphyxia contributes significantly to neonatal morbidity and mortality. It occurs worldwide, and the Apgar score is the most widely used method of diagnosis. Recently, umbilical cord arterial pH has been reported as the most objective way to assess fetal acidosis at birth as it predicts the adverse outcome of perinatal asphyxia. It is imperative to establish the concordance between these two diagnostic methods to reinforce the practicality of the Apgar score as the preferred diagnostic tool for perinatal asphyxia in developing nations, such as Nigeria. AIM: To determine the prevalence of perinatal asphyxia by using the Apgar score and arterial cord blood pH and the relationships between these methods at the Federal Medical Center (FMC), Umuahia. MATERIALS AND METHODS: This cross-sectional study enrolled 245-term newborns. Perinatal asphyxia was diagnosed using both Apgar scoring and arterial cord blood pH measurements. Data obtained were analyzed using SPSS version 20 and a P value < 0.05 was considered significant. RESULTS: Perinatal asphyxia was reported in 33.1% and 31.4% by using the Apgar score and arterial cord blood pH, respectively. There was a moderate agreement between the two methods for diagnosing perinatal asphyxia (κ = 0.44), and no statistically significant difference was observed in the prevalence of perinatal asphyxia between these methods (McNemar's χ2 = 0.27, P = 0.699). Furthermore, a strong positive correlation was observed between the Apgar score at 1 and 5 minutes of life and arterial cord blood pH (rs = 0.87, P ≤ 0.001 and rs = 0.80, P ≤ 0.001 respectively). CONCLUSION: The prevalence of perinatal asphyxia by the two methods was high, and there was no significant difference between both methods of assessing perinatal asphyxia. Thus, the diagnosis of perinatal asphyxia can effectively be made using either the Apgar score or arterial cord blood pH, affirming the practicality and reliability of the Apgar score in resource-limited healthcare settings.

Incomplete Filling of Laboratory Request Forms: A Look at the Practice at a Federal Medical Centre in South Eastern Nigeria.

BACKGROUND: Laboratory request forms serve as a medium for communication between clinicians managing medical cases and the pathologist. Improperly filled forms impairs the ability of pathologists to generate sound and valuable reports. This research focused on finding out the extent to which doctors in Federal Medical Centre, Umuahia properly fill laboratory request forms. METHODOLOGY: A total of 1,509 laboratory request forms directed to the electrolyte bench, already filled out by various doctors in the hospital between May and October, 2018 were retrospectively studied. The completeness of information supplied by requesting physician based on some parameters were analysed. RESULTS: In descending order, the most frequently provided data were as follows; name of patient, 1,509[100.0%]; gender,973[64.5%]; provisional diagnosis,866[57.4%]; age,639[42.4%]; hospital number,428[28.4%]; clinical summary,47[3.1%]. 26[2%] forms were completed in their entirety per the 6 variables assessed. CONCLUSION: Proper and adequate filling of laboratory request forms is very poor in this hospital. Therefore, continuous medical education on the need for adequate completion of request forms is absolutely necessary.

The prevalence of metabolic syndrome in persons with type 2 diabetes at the Lagos University Tteaching Hospital, Lagos, Nigeria.

BACKGROUND: Over the past decade, Lagos state has witnessed greater industrialization and increased economic prosperity. Lifestyle has become increasingly westernized, characterised by intake of excesscalories and physical inactivity. It is possible that these changes would lead to increases in the prevalence of metabolic syndrome and type 2 diabetes which are known cardiovascular risk factors. It became important therefore to study the prevalence of metabolic syndrome in type 2 diabetes in Lagos, Nigeria as at the present time and compare it with previous prevalence rates as well as rates from other centres as a way of assessing current cardiovascular risk burden in this population. OBJECTIVES: This study is to determine the prevalence of metabolic syndrome in type 2 diabetes and to correlate the presence of microalbuminuria with glycaemic control. METHODS: One hundred subjects with type 2 diabetes were selected by simple random sampling from patients attending The Diabetic Clinic at the Lagos University Teaching Hospital, Lagos, Nigeria.Age and sex matched controls were recruited from members of staff of the hospital.Clinical data was obtained by interviewing the participants. Anthropometric measurements were made and blood and urine specimens were collected for analysis. The World Health Organisation (WHO) criteria which is specified for the diagnosis of metabolic syndrome in the setting of type 2 diabetes was used to determine the prevalence of metabolic syndrome in this population. RESULTS: Central obesity had the highest prevalence (79%) among persons with diabetes,followed by hypertension (69%), low HDL (50%), general obesity (40%), microalbuminuria (24%) and hypertriglyceridemia (10%). The prevalence of metabolic syndrome was 86%in this group. The commonest occurring metabolic syndrome component among patients with type 2 diabetes and metabolic syndrome was obesity (91.9%). There was a moderate positive correlation(r=0.52; p=0.01) between HbA1c values and microalbuminuria in persons with diabetes and the metabolic syndrome. CONCLUSION: The prevalence of metabolic syndrome is very high among patients with type 2 diabetes in The Lagos University Teaching Hospital, Lagos, Nigeria.