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Objectives:To determine the pattern of ocular disorders among stroke patients in Federal Teaching Hospital, Lokoja (FTHL).Materials and Methods:Consecutive new stroke patients seen at the Federal Teaching Hospital, Lokoja over a 3-month period were studied. Data was collected with the use of a structured questionnaire divided into four major sections: bio-data, visual history, results of ocular assessment and NEI VFQ-25 quality of life questionnaire. Data analysis was done using SPSS for Windows, version 23.0. Univariate analyses were presented in the form of frequencies, percentages, means, ranges, and standard deviations, charts and tables.Results:Eighty-three patients were recruited with an age range of 40-71 years, a mean age of 55.3(±7.1) years. Thirty-nine patients (47.0%) were between the ages of 51 and 60 years. Thirty-four (41.0%) patients were females while 49(59.0%) were males. Of 46 (55.4%) patients that had neuro-imaging, stroke was ischaemic in 37(80.4%) and haemorrhagic in 9(19.6%). Of the 63 patients with left sided stroke, 2 (2.4%), 4(4.8%) and 57(68.7%) had severe, moderate and mild and normal visual impairment respectively while of the 20 patients with right sided stroke, 3(3.6%) each had severe and moderate visual impairment and 14(16.9%) had normal or mild visual impairment. Other ocular abnormalities included corneal anaesthesia and macular hole in 2(1.2%).Conclusion:Anterior and posterior segments, together with neuro-ophthalmic disorders were found among stroke patients in this study. Many of the ocular abnormalities are as a result of long-standing uncontrolled hypertension which caused the stroke. It is recommended that awareness should be created among the populace about uncontrolled hypertension. It is also advised that internists should refer hypertensive patients for routine ophthalmic screening.
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Humanos , Masculino , Femenino , Tamizaje Masivo , Calidad de Vida , Hospitales de EnseñanzaRESUMEN
BACKGROUND: The human immunodeficiency virus (HIV) pandemic has brought about a resurgence in tuberculosis (TB), especially in developing countries. Previous studies on TB lymphadenitis (TBLN) in South-Eastern Nigeria were done before the advent of the HIV pandemic making a review pertinent. AIM: To evaluate the role of TBLN as a cause of superficial lymphadenopathy in the post-HIV/acquired immune deficiency syndrome (AIDS) era of South-Eastern Nigeria. MATERIALS AND METHODS: This is a 15 years (2000-2014) retrospective review of all superficial lymph node biopsies (SLNBs) received at the Department of Morbid Anatomy, University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu, Nigeria. RESULTS: One hundred and seventy-two cases of TBLN were identified in this study constituting 14.6% (172/1,180) of SLNBs received at our Hospital's Morbid Anatomy Department during the 15 years period under review. Twenty-eight cases of TBLN were clinically screened for HIV, 23 of which tested positive, representing 82.1% (23/28) of clinically screened cases. Acid fast bacilli demonstration was positive in 15.1% (26/172) of cases using Ziehl-Neelsen stain. 48.8% (84/172) of TBLN cases were males, and 51.2% (88/172) were females with most (22) cases received in 2012 and least (5) cases in 2000. Most TBLN occurred in the 21-25 years age group with a total of 21.5% (37/172) of cases and a male to female ratio of 1:1.5 The most common biopsy site for TBLN was the cervical group followed by the axillary and inguinal groups with 73.8% (127/172), 14% (24/172), and 4.7% (8/172) of cases, respectively. CONCLUSIONS: There is a remarkable decline in the prevalence of TB lymphadenitis in South-Eastern Nigeria indicating a change in trend from the pre- to the post-HIV/AIDS era with slightly more females now presenting with TBLN and most TB lymphadenitis patients now presenting with associated HIV/AIDS disease. There is an urgent need to provide modern diagnostic facilities in our medical laboratories.
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BACKGROUND: Renal impairment is routinely assessed using the estimated glomerular filtration rate (eGFR) and it may be helpful to obtain certain clinical or laboratory markers, which show relationship with glomerular filtration rate (GFR) in sickle cell disease (SCD). AIM: To assess the relationship between important clinical and laboratory parameters in SCD, and the eGFR. PATIENTS AND METHODS: Steady state clinical and laboratory data were obtained from 228 homozygous SCD patients seen over a 7-year period. The GFR was estimated using (isotope dilution mass spectrometry) traceable modification of diet in renal disease (MDRD) and Cockroft-Gault methods. The correlation coefficient and independent t-test were done to assess the level of significance between the eGFR_MDRD and the known indicators of disease severity. RESULTS: The serum alkaline phosphatase (ALP) and serum direct bilirubin levels both showed significant inverse relationship with eGFR_MDRD P = 0.012 and P = 0.24, respectively. The patients' age, Hb, leukocyte count, platelet count, serum direct bilirubin and aspartate transaminase did not show a significant correlation. The eGFR_MDRD was more discriminatory revealing that 20.3% of the patients had suboptimal GFR. Proteinuria in steady state was observed in 20.3% of the patients. CONCLUSION: High serum direct bilirubin and ALP are associated with a deteriorating eGFR_MDRD. Other clinical and laboratory indicators of disease severity in SCD do not show the relationship with the GFR. MDRD_GFR estimation seemed to be a more appropriate method of estimating GFR in SCD.
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Fosfatasa Alcalina/sangre , Anemia de Células Falciformes/sangre , Anemia de Células Falciformes/diagnóstico , Bilirrubina/sangre , Creatinina/sangre , Tasa de Filtración Glomerular/fisiología , Adulto , Anemia de Células Falciformes/complicaciones , Aspartato Aminotransferasas/sangre , Biomarcadores/sangre , Femenino , Homocigoto , Humanos , Pruebas de Función Renal , Masculino , Espectrometría de Masas , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
BACKGROUND: Anticoagulation is an essential lifesaving management practice indicated for arterial, venous and intracardiac thromboembolism. AIM: This study was undertaken to examine the utilization of anticoagulation services in University of Nigeria Teaching Hospital, Enugu (UNTH) Nigeria. MATERIALS AND METHODS: This retrospective study involved assessing data from folders of subjects on anticoagulation and monitoring in UNTH, Enugu. Patients' profile, risk factors, diagnosis, indication for oral anticoagulation, anticoagulant used; target, monitoring, outcome and complications of anticoagulation were recorded. RESULTS: A total of 26 patients over a period of 5 years were on anticoagulation and laboratory monitoring done in UNTH. The mean age of the patients was 53.4 years and more females than males were on anticoagulation and monitoring (F14:M12). The most common indications for anticoagulation include deep venous thrombosis/pulmonary embolism, congestive heart failure with atrial fibrillation and mitral valve disease with atrial fibrillation. Desired clinical outcome was achieved in eight patients 8/26 (30.8%). Minor bleeding was the only complication reported in three patients 3/26 (11.5%). CONCLUSION: The absence of diagnostic tools and anticoagulation monitoring clinics and the apprehension of adverse effects have combined to make this lifesaving treatment inaccessible to many patients in Nigeria.
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AIM: In developing African nations, late presentation and occurrence of complications adversely affects survival. This study aims at identifying initial clinical and basic laboratory features of multiple myeloma (MM), which will aid the physician to entertain a high index of suspicion and therefore target his investigations in order to prevent late presentation and avert complications. MATERIALS AND METHODS: A retrospective analysis of 32 patients diagnosed and managed in Nigeria, West Africa was done. Information on the clinical, laboratory, and radiological data as well as response to treatment was obtained at presentation, 3, 6, 12, and 24 months and analyzed. RESULTS: The median age at diagnosis was 62 years, 17 (53.1%) males and 15 (46.9%) females. The median duration of follow-up was 24 weeks (range, 2-288 weeks). The average percentage of bone marrow plasmacytosis at diagnosis was 38%. Clinical features at presentation were anemia (71.9%) and bone pains (78.1%), while pathological fractures were found in 69%, and nephropathy in 13.8%. The longest duration of survival of 288 and 252 weeks were recorded in patients on melphalan and prednisolone with or without thalidomide. CONCLUSION: Presence of bone pain and anemia in elderly patients should alert the clinician to investigate along the lines of MM. Majority of patients have osteolytic lesions on X-ray and pathological fractures, and benefit from melphalan based combinations in situations where facilities for transplant are not available.
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Biomarcadores de Tumor/análisis , Mieloma Múltiple/epidemiología , Vigilancia de la Población/métodos , Adulto , Anciano , Anciano de 80 o más Años , Terapia Combinada , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Mieloma Múltiple/diagnóstico , Mieloma Múltiple/terapia , Nigeria/epidemiología , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia/tendenciasRESUMEN
BACKGROUND: Sickle cell anemia is associated with a hypercoagulable state that may lead to alterations in a coagulation profile. Measurements of coagulation factors are known to have some predictive value for clinical outcome. OBJECTIVES: To determine the coagulation profile of children with SCA in steady state and crisis and compare it with those with normal HbAA genotype. MATERIALS AND METHODS: This is a prospective observational study involving 50 children with SCA in steady state, 50 in crises, and 50 with HbAA genotype, carried out from June to October 2009. All the values of coagulation profile were matched for age and sex. RESULTS: The mean Prothrombin time (PT) (12.5 ± 1.2 secs), Activated partial thromboplastin time (aPTT) (41.6 ± 1.0 secs), and Thrombin time (TT) (12.3 ± 1.2 secs) of subjects with SCA in steady state as well as those during crises [PT (12.6 ± 1.8 secs), aPTT (45.6 ± 1.3 secs), TT (12.5 ± 1.7 secs)] were significantly prolonged compared to those of subjects with HbAA genotype. The mean bleeding time (BT) of 3.4 ± 1.0 mins was significantly shorter in children with SCA in steady state compared to those with HbAA genotype (3.7 ± 1.1 mins), (P < 0.038). CONCLUSION: Coagulation profile of patients with SCA is prolonged both in steady state and during crisis and when compared to those with HbAA genotype, though all values are within normal range.
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Anemia de Células Falciformes/sangre , Trombofilia/sangre , Adolescente , Anemia de Células Falciformes/complicaciones , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Pruebas Hematológicas , Hospitales de Enseñanza , Humanos , Masculino , Nigeria , Trombofilia/complicacionesRESUMEN
BACKGROUND: Assessment of patients prior to cytotoxic chemotherapy usually includes absolute neutrophils count. Other cellular markers of susceptibility to infection as well as immunocompetence include the T Helper lymphocyte count. In cancer patients, decrease in these lymphocytes has been observed to be associated with decreased overall survival. AIM: To assess the degree of CD4 lymphopenia encountered during cytotoxic chemotherapeutic treatment for cancer and evaluate the differences observed for the various drug combinations. SUBJECTS AND METHODS: Eighty patients with various histologically diagnosed malignancies had their CD4 lymphocyte counts carried out at days 0 and 12 of the first cycle of their various chemotherapeutic regimens. They were adult patients who had been diagnosed with breast cancer 36/80 cases (45%), non-Hodgkin's lymphoma 8/80 cases (10%), Hodgkin's lymphoma 13/80 cases (16.3%), multiple myeloma 7/80 cases (8.8%), colorectal carcinoma 6/80 cases (7.5%), and other malignancies 10/80 cases (12.5%). CD4 lymphocyte count was done using the Partec Cyflow(®) 2000 CD4 cell counter, and their socio-demographic data of the patients were assessed using a questionnaire. RESULTS: The mean (sd) CD4 lymphocyte count pre- and post-chemotherapy was observed to be 567 (341) cells/µLand 349 (207) cells/µL while the median values were 454 cells/µLand 349 cells/µL respectively. There were significant differences in CD4 lymphocyte counts after chemotherapy compared to the pre-chemotherapy values. CONCLUSION: Epirubicin combinations used in breast cancer patients as well as (Adriamycin, Bleomycin, Vinblastine, Dacarbazine) ABVD regimen used in treatment of Hodgkin's lymphoma were found to be significantly less lymphotoxic than other chemotherapeutic combinations. These drugs or their combinations may be less immunotoxic than other known regimen used for these malignancies.
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Médula Ósea/patología , Trasplante de Células Madre Hematopoyéticas , Síndromes Mielodisplásicos/patología , Adulto , Anciano , Femenino , Humanos , Leucemia Mielomonocítica Crónica/patología , Leucemia Mielomonocítica Crónica/cirugía , Masculino , Persona de Mediana Edad , Síndromes Mielodisplásicos/cirugía , Acondicionamiento PretrasplanteRESUMEN
BACKGROUND: Hemolytic disease of the newborn, secondary to rhesus D (Rh D) iso-immunization, contributes significantly to perinatal morbidity and mortality. Prevalence data in Nigeria, and Southeast Nigeria in particular, is very scanty. This study was carried out to provide our experience in this preventable clinical condition in Enugu, Southeast Nigeria. OBJECTIVE: To determine the prevalence and trends of Rh D negativity among pregnant women in Enugu, Southeast Nigeria. MATERIALS AND METHODS: A 5-year retrospective study of rhesus negative women was carried out at the University of Nigeria Teaching Hospital, Enugu, Nigeria, between 1 st January 2000 and 31 st December 2004. RESULT: The prevalence rate of Rh D negative women in Enugu, Nigeria, is 4.5%. Out of 6306 women who booked for antenatal care, 282 (4.5%) were Rh D negative women. One hundred and eighty-two (182) (64.5%) of the Rh D negative women were of blood group O followed by blood group A 20%, blood group B 12.1%, and blood group AB 3.2%, respectively. CONCLUSION: There is a need for adequate counseling of pregnant women on the importance of Rh D negative factor during the antenatal period in order to prevent hemolytic disease of the newborn.
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Sistema del Grupo Sanguíneo ABO/sangre , Eritroblastosis Fetal/epidemiología , Isoinmunización Rh/epidemiología , Sistema del Grupo Sanguíneo Rh-Hr/sangre , Adulto , Eritroblastosis Fetal/diagnóstico , Eritroblastosis Fetal/prevención & control , Femenino , Humanos , Recién Nacido , Nigeria , Embarazo , Atención Prenatal , Prevalencia , Estudios Retrospectivos , Isoinmunización Rh/diagnóstico , Isoinmunización Rh/prevención & controlRESUMEN
BACKGROUND: Despite therapeutic approach that combines rituximab-containing chemotherapy, followed or not by autologous stem cell transplantation (auto-SCT), mantle cell lymphoma (MCL) patients experience relapses. Reduced-intensity conditioning allogeneic stem cell transplantation (RIC-allo-SCT) at time of relapse may represent an attractive strategy. PATIENTS AND METHODS: We report a multicenter retrospective analysis. Seventy MCL patients underwent RIC-allo-SCT in 12 centers. RESULTS: Median age at transplantation was 56 years and median time from diagnosis to transplantation was 44 months. The median number of previous therapies was 2 (range, 1-5) including autologous transplantation in 47 cases. At time of transplantation, 35 patients were in complete remission, 20 were in partial response and 15 in stable disease or progressive disease. The median follow-up for living patients was 24 months. The 2-year event-free survival (EFS) and overall survival (OS) rates were 50% and 53%, respectively. The 1- and 2-year transplant-related mortality rates were 22% and 32%, respectively. The statistical analysis demonstrated that disease status at transplantation was the only parameter influencing EFS and OS. CONCLUSIONS: These results suggest that RIC-allo-SCT may be an effective therapy in MCL patients with a chemo-sensitive disease at time of transplantation, irrespective of the number of lines of prior therapy. Studies are warranted to investigate the best type of RIC regimen.
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Linfoma de Células del Manto/cirugía , Trasplante de Células Madre , Acondicionamiento Pretrasplante , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Estudios RetrospectivosRESUMEN
BACKGROUND: Hepatitis B and C viruses coinfection in HIV positive pregnant women is a common public health problem and recognized worldwide. The consequences of this problem in our poor resource setting with the risk of mother to child transmission is obvious with increased morbidity and mortality in our environment. OBJECTIVE: To determine the prevalence of coinfection patterns of HBV and HCV among HIV positive pregnant women in Enugu Nigeria. METHODS: A retrospective survey conducted on 401 Nigeria HIV positive pregnant women seen at Prevention of Mother To Child Transmission (PMTCT) clinic at the UNTH Enugu Nigeria over a 3 year period between 1st January 2007 and 31st December 2009. RESULTS: The prevalence of hepatitis B and C viruses coinfection among HIV positive pregnant women in Enugu is 6.5%. HIV/HBV coinfection was commoner than HIV/HCV coinfection. There was no significant association between hepatitis B and C viruses coinfection and the age, ethnic group, marital or educational status of the women (P > 0.05). CONCLUSION: There is high prevalence of hepatitis B and C coinfection among HIV positive pregnant women in Enugu. This high burden of these hepatotropie virus coinfection calls for continued need to screen for these infections and vaccinate the affected babies for hepatitis B and/or C where appropriate.
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Infecciones por VIH/complicaciones , Hepatitis B/complicaciones , Hepatitis C/complicaciones , Adulto , Distribución de Chi-Cuadrado , Coinfección , Demografía , Ensayo de Inmunoadsorción Enzimática , Femenino , Infecciones por VIH/epidemiología , Hepatitis B/epidemiología , Hepatitis C/epidemiología , Humanos , Nigeria/epidemiología , Reacción en Cadena de la Polimerasa , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , PrevalenciaRESUMEN
A total of eighty patients with various malignancies seen between September 2008 and April 2009 at the University of Nigeria Teaching Hospital, (UNTH) Ituku-Ozalla Enugu Nigeria had their haemogram values done at Days 0 and 12 of the first cycle of their various chemotherapeutic regimens. They were adult patients who had been diagnosed of various malignancies, consisting of Breast cancer 36 patients (45%), Non-Hodgkin's iymphoma 8 (10%), Hodgkin's lymphoma 13 (16.25%), Colorectal carcinoma 6 (7.5%), Multiple myeloma 7 (8.75%), Cervical carcinoma 1 (1.25%) and other malignancies 9 (11.25%). Haematological indices evaluated include: packed cell volume, haemoglobin concentration; total white blood cell count, platelet count and erythrocyte sedimentation rate. The socio demographic data of the patients were assessed from a questionnaire. There were 27 males (33.75%) and 53 females (66.25%). The age of the patients ranged from 18-80 years with a median of 45 years. Haematological parameters which were found to be significantly reduced include: haemoglobin concentration, packed cell volume and total white cell count.
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Antineoplásicos/efectos adversos , Recuento de Eritrocitos , Hemoglobinas/efectos de los fármacos , Recuento de Leucocitos , Neoplasias/sangre , Recuento de Plaquetas , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Hematócrito , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/diagnóstico , Neoplasias/tratamiento farmacológico , Nigeria , Valores de Referencia , Factores Socioeconómicos , Adulto JovenRESUMEN
A total of eighty patients with various malignancies seen between September 2008 and April 2009 at the University of Nigeria Teaching Hospital (UNTH) Ituku Ozalla, Enugu, Nigeria, had their absolute neutrophil counts, done at Days 0 and 12 of the first cycle of their various chemotherapeutic regimens. They were adult patients who had been diagnosed of various malignancies, consisting of Breast cancer 36 (45%), Non-Hodgkin's lymphoma 8 (10%), Hodgkin's lymphoma 13 (16.25%), Colorectal carcinoma 6 (7.5%), Multiple myeloma 7 (8.75%), Cervical carcinoma 1 (1.25%) and other malignancies 9 (11.25%), Manual counting of absolute neutrophil count was done using Turks solution and improved Neubauer counting chamber and Galen 2000 Olympus microscope. The socio demographic data of the patients were assessed from a questionnaire. There were 27 males (33.75%) and 53 females (66.25%). Their ages ranged from 18 - 80 years with a median of 45 years. The mean absolute neutrophil count of the respondents pre-and post chemotherapy was 3.7 +/- 2.1 x 10(9)/L and 2.5 +/- 1.6 x 10(9)/L respectively. There were significant differences in both the absolute neutrophil count (p=0.00) compared to the pre-chemotherapy values. Chemotherapeutic combinations containing cyclophosphamide and Adriamycin were observed to cause significant reduction in absolute neutrophil.
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Antineoplásicos/efectos adversos , Neoplasias/tratamiento farmacológico , Neutropenia/inducido químicamente , Neutrófilos/efectos de los fármacos , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Factores Socioeconómicos , Encuestas y Cuestionarios , Resultado del Tratamiento , Adulto JovenAsunto(s)
Leucemia Mielomonocítica Crónica/terapia , Trasplante de Células Madre/métodos , Adulto , Anciano , Alelos , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Estudios Retrospectivos , Acondicionamiento Pretrasplante/métodos , Trasplante Homólogo/métodos , Resultado del TratamientoRESUMEN
BACKGROUND: Childhood cancers constitute important causes of morbidity and mortality in Nigeria. There is a need for us to continue to analyse the patterns of these neoplasms. OBJECTIVE: To review the major studies on childhood malignancies in Enugu, Nigeria and identify trends in paediatric malignancies in this environment. METHODS: We compared the results of four major studies on childhood malignancies in Enugu, Eastern Nigeria between 1976 and 2004 and assessed the patterns in the frequencies of paediatric cancers in this environment. RESULTS: Lymphomas were the most common childhood malignancy in this environment with Burkitt's lymphomas being the most common specific paediatric cancer. Nephroblastomas and sarcomas have been on the increase. The pattern of changes in the relative percentage frequencies of leukaemias, retinoblastoma and neuroblastomas has not been consistent. Leukaemias appear to be on the decline but occurrences of retinoblastomas and neuroblastomas have been fluctuating. CONCLUSION: Since Burkitt's lymphoma is associated with high prevalence of malaria, Epstein Barr Virus infection, and malnutrition, its persistent high rates suggest strongly that the control of these infections and malnutrition should be intensified.
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Neoplasias/epidemiología , Niño , Humanos , Morbilidad/tendencias , Nigeria/epidemiología , Estudios RetrospectivosRESUMEN
Fatal problems encountered in allogeneic stem cell transplantation include EBV reactivation and post transplant lymphoproliferative disorders (PTLDs) with high mortality rates. We performed a retrospective analysis in all consecutive adult and pediatric EBV reactivations and PTLD during a period of 8.5 years. There were 26 patients with EBV reactivation/PTLD out of a total of 854 transplantations giving an overall incidence of 3.0%. Specifically, the incidence of EBV-PTLD was 1.3%, whereas that of EBV reactivation was 1.8%. Median age was 46.0 and 11.0 years in the adult and pediatric patients, respectively. There were high rates (54%) of concomitant bacterial, viral, fungal and parasitic infections at the time of EBV manifestation. Variable treatment regimens were applied including in most cases an anti-CD20 regimen often in combination with virustatic compounds, polychemotherapy or donor lymphocytes. The mortality rates were 9 of 11 (82%) in patients with EBV-PTLD and 10 of 15 (67%) in patients with reactivation. Only 7 of 26 patients (27%) are alive after a median follow-up of 758 days (range 24-2751). The high mortality rates of EBV reactivation and of EBV-PTLD irrespective of multimodal treatment approaches emphasize standardization and optimization of post transplant surveillance and treatment strategies to improve control of these often fatal complications.
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Infecciones por Virus de Epstein-Barr/epidemiología , Herpesvirus Humano 4/crecimiento & desarrollo , Trasplante de Células Madre/efectos adversos , Activación Viral , Aciclovir/uso terapéutico , Antivirales/uso terapéutico , Infecciones Bacterianas/epidemiología , Niño , Infecciones por Virus de Epstein-Barr/tratamiento farmacológico , Enfermedad Injerto contra Huésped/epidemiología , Prueba de Histocompatibilidad , Humanos , Terapia de Inmunosupresión , Persona de Mediana Edad , Micosis/epidemiología , Enfermedades Parasitarias/epidemiología , Donantes de TejidosRESUMEN
BACKGROUND: Pregnancy in patients with sickle cell disease (SCD) is associated with increased maternal and foetal morbidity and mortality. The objective of this study was to review the pregnancy outcomes in patients with SCD as seen at the University of Nigeria Teaching Hospital (UNTH), Enugu, South-eastern Nigeria. METHODS: This is a retrospective study. The data extracted from the patients' case files include the age, parity, gestational age at booking and complications of disease and pregnancy during the antenatal period, labour and puerperium. Fetal outcomes were also reviewed. RESULTS: During the 30-year period under study (1975-2004), only 10 pregnant women with sickle cell disease were documented to have been attended to. Pregnancies were characterized by high maternal and fetal morbidity and mortality. Maternal complications identified were maternal mortality, lobar pneumonia, HIV and recurrent malaria infections, candidiasis, bone pain crises, haemolytic crises, pseudotoxaemia and pre-eclampsia. Fetal complications included intra-uterine fetal deaths, still births, low birth weights, and breech presentation. CONCLUSION: From this study, it seems that female SCD patients present more rarely with pregnancy in South-eastern compared to South-western Nigeria. However, the spectrum of complications seen is similar to that recorded in other studies.
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Anemia de Células Falciformes/complicaciones , Complicaciones del Embarazo/etiología , Resultado del Embarazo , Adulto , Anemia de Células Falciformes/epidemiología , Femenino , Hospitales de Enseñanza , Humanos , Bienestar Materno , Nigeria/epidemiología , Embarazo , Complicaciones del Embarazo/epidemiología , Estudios Retrospectivos , Factores de RiesgoRESUMEN
BACKGROUND: Pregnancy in patients with sickle cell disease (SCD) is associated with increased maternal and foetal morbidity and mortality. The objective of this study was to review the pregnancy outcomes in patients with SCD as seen at the University of Nigeria Teaching Hospital(UNTH), Enugu, South-eastern Nigeria. METHODS: This is a retrospective study. The data extracted from the patients' case files include the age, parity, gestational age at booking and complications of disease and pregnancy during the antenatal period, labour and puerperium. Fetal outcomes were also reviewed. RESULTS: During the 30-year period under study (1975-2004), only 10 pregnant women with sickle cell disease were documented to have been attended to. Pregnancies were characterized by high maternal and fetal morbidity and mortality. Maternal complications identified were maternal mortality, lobar pneumonia, HIV and recurrent malaria infections, candidiasis, bone pain crises, haemolytic crises, pseudotoxaemia and pre-eclampsia. Fetal complications included intra-uterine fetal deaths, still births, low birth weights, and breech presentation. CONCLUSION: From this study, it seems that female SCD patients present more rarely with pregnancy in South-eastern compared to South-western Nigeria. However, the spectrum of complications seen is similar to that recorded in other studies.
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Anemia de Células Falciformes/complicaciones , Complicaciones del Embarazo/etiología , Resultado del Embarazo , Adulto , Anemia de Células Falciformes/epidemiología , Femenino , Humanos , Nigeria/epidemiología , Embarazo , Complicaciones del Embarazo/epidemiología , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a benign self-limiting disorder of unknown aetiology, which is frequently mistaken for lymphoma. There is no consensus as to the proper management of this disorder. In the past, potentially harmful treatments, such as antineoplastic drugs, have been advocated. We describe a 25-year-old woman with RDD who has had a remarkably favourable response to oral prednisolone therapy. Our observation strengthens the conclusions of previous case reports as to the effectiveness of corticosteroids in this condition. This article is aimed at creating awareness among clinical oncologists about this pseudolymphomatous disorder and emphasizing the therapeutic role of corticosteroids.