Analyzing Trio-Anthropometric Predictors of Hypertension: Determining the Susceptibility of Blood Pressure to Sexual Dimorphism in Body Stature.

BACKGROUND: Several studies had suggested that complex body stature could be a risk factor of hypertension. OBJECTIVES: We aim to correlate body mass index (BMI), waist-hip ratio (WHR), and waist-height ratio (WHtR) of rural dwellers in Afikpo community, Ebonyi State, Nigeria, with blood pressure parameters. Furthermore, we aim to ascertain how each of the anthropometric variables affects blood pressure in men and women, respectively. MATERIALS AND METHODS: A sample of 400 (200 males and 200 females) adults aged 18-89 years were selected for the correlation cross-sectional study. Data for weight, height, waist, and hip circumferences were collected by means of anthropometric measurement protocol with the aid of a calibrated flexible tape and health scale and mercury sphygmomanometer for measurement of blood pressure. A participant was classified as being hypertensive if systolic blood pressure (SBP) was >140 mmHg and diastolic blood pressure (DBP) >90 mmHg. Pulse pressure was recorded as the numeric difference of SBP and DBP. RESULTS: The result revealed that male BMI and WHR were higher than those of females while female WHtR was higher than that of males (P < 0.01). The prevalence of hypertension failed to correlate with sex among participants in the study (χ 2 = 0.567; P < 0.05). Variation in SBP and DBP of both sexes was dependent on BMI, WHtR, and waist and hip circumference, but not on WHR. The SBP of both sexes and female pulse pressure did correlate with age (P < 0.001). Waist circumference, BMI, and WHtR correctly predicted the variations in SBP, DBP, and pulse pressure. CONCLUSION: The strength of association of BMI, WHtR, and waist girth with SBP and DBP of both sexes was robust and similar, but inconsistent with WHR. Thus, a simple estimation of the trio-anthropometric predictors could serve as a means for routine check or preliminary diagnosis of a patient with hypertension.

Estimation of fetal weight: a comparison of clinical and sonographic methods.

Fetal weight estimation is important in the management of labour and delivery. This study aimed to compare the accuracy of the clinical and ultrasound methods of fetal weight estimation. This was a prospective study involving 110 term cephalic singleton pregnancies delivered within 24 hours of clinical fetal weight estimation using Johnson's and Dare's formulae and ultrasound estimation at a Tertiary hospital in Abakaliki, Nigeria. The data were analysed with Stata 11 software. The sonographic estimation within 10% of the actual birth weight (ABW) of 68.2% was significantly greater than the accuracy of Johnson's (23.6%), Dare's (26.4%), and the combined clinical formulae (27.1%). The clinical methods overestimated the fetal weight. Both methods showed a positive correlation with the ABW. In conclusion, the sonographic method had a better accuracy than the clinical methods. However, fetal weight overestimation by clinical methods warrants their usefulness in resource-poor settings such that the clinical determination of a normal weight foetus will exclude fear of complications from macrosomia. Impact statement What is already known on this subject? An accurate estimation of fetal weight is important in the management of labour and delivery. However, there is limited evidence that any of the available methods of fetal weight estimation is more accurate than the others. What do the results of this study add? This study showed that the clinical methods using Johnson's and Dare's formulae had a significantly higher mean percentage and absolute mean percentage error compared to the sonographic estimation of fetal weight. The sonographic estimation within 10% of actual birth weight (ABW) of 68.2% was significantly greater than that of Johnson's and Dare's formulae with 23.6% and 26.4%, respectively. All of the methods showed a positive correlation with the ABW. What are the implications of these findings for clinical practice and/or further research? This implies that the sonographic method has a better accuracy than the clinical methods in estimating the fetal weight. However, the overestimation of fetal weight by the clinical methods warrants their usefulness in resource-poor settings such that the clinical determination of a normal weight foetus will exclude the fear of complications from macrosomia.

TERATOMA IN A TERTIARY HOSPITAL IN SOUTH-EAST NIGERIA: A FIFTEENYEAR RETROSPECTIVE STUDY AT FETHA, ABAKALIKI, EBONYI STATE.

Any neoplastic growth within a tissue or an organ harboring components derived from more than one germ layer is called a teratoma. Teratoma may be monodermal or polydermal in origin and they can also be classified as mature or immature teratomas. In a retrospective study of teratomas histologically diagnosed in the Department of Pathology, Federal Teaching Hospital Abakaliki (FETHA), Ebonyi State, the entire specimens received at the Department for histological assessment over a fifteen-year period (2000-2014), was 6,548. However, only 28 (0.4%) of the entire specimens represented teratoma. Twenty five (89.3%) of the teratomas were females and only 3(10.7%) were males, giving a male to female gender ratio of 1:8.3. The most common site of occurrence was the ovary accounting for 18(64.3%) followed by the sacrococccyx representing 4(14.3%) cases. All the 28(100%) cases of teratomas were benign neoplasm (mature cystic teratomas) containing two or three germ cell layers with one of the cases noted as a giant teratoma. We observed an important bimodal age distributions; with a first peak occurring between 0-10 years (in the first decade of life) and a second peak (in the 3rd decade) between 20-30 years of age.

Prevalence and antimicrobial susceptibility of asymptomatic bacteriuria among women with pelvic organ prolapse in Abakaliki, South-East Nigeria.

BACKGROUND: Pelvic organ prolapse (POP) is the herniation of pelvic organs from its anatomical confines, and it is of considerable importance to the practicing gynaecologist in middle and low income countries. It is commonly associated with, urinary tract infection (UTI), both symptomatic and asymptomatic due to anatomical and physiological changes. The aim of this study was to determine the prevalence of asymptomatic bacteriuria among women with pelvic organ prolapse, to know the organisms commonly implicated and the sensitivity pattern. METHODS: This study was conducted among 96 women with POP at the National Obstetric Fistula Centre Abakaliki. A cross sectional descriptive study was done. Standard microbial technique was used to analyze the urine. Data was analysed using the Statistical Package for Social Sciences version 17. RESULTS: Out of the 96 patients, 76 were found to have asymptomatic bacteriuria giving a prevalence of 79.2%. Nine different bacteria species isolated include E. Coli (34.2%), Streptococcus pneumonia (23.7%), Staphylococcus aureus (7.9%), Proteus Spp (7.9%) others (5.3%). The highest level of microbial sensitivity to the antimicrobials was with Ciprofloxacin. CONCLUSIONS: This study suggests that prevalence of asymptomatic bacteriuria is very high among women with POP. More than 50% of the bacterial isolates were mainly E.coli and Streptococcus pneumonia. The highest level of microbial sensitivity was with ciprofloxacin while the least was with cotrimoxazole.

The prevalence of osteoporosis among antenatal clinic attendees in a rural mission hospital in South-East Nigeria.

INTRODUCTION: Osteoporosis is a global public health problem characterized by reduction of bone mineral density (BMD). This study aimed to assess the prevalence of osteoporosis among antenatal clinic attendees in a rural Southeastern hospital. MATERIAL AND METHODS: This was a cross-sectional study of booking Antenatal Clinic Attendees at Mile 4 Catholic Hospital, Abakaliki, between October 2014 and February 2015. The study participants were selected through systematic random sampling. The BMD of the right calcaneal bone of the participants was measured using the OsteoPro, a Quantitative ultrasound scan. RESULTS: A total of 327 eligible women participated in the study. The average age of the participants was 29 ± 4.5 years. The average parity was 2 ± 1.6 childbirths. The mean T-score was -1.19 ± 4.9. Osteoporosis and osteopenia were recorded in 119 women (36.4%) and 56 women (17.1%), respectively, whereas 152 (46.5%) were within normal range. History of regular exercise by the respondents is statistically significant on the reduction of osteopenia and osteoporosis (P ≤ 0.05). The history of ever use of calcium supplementation by the study participants in the index pregnancy did not have any significant effect on the reduction of osteoporosis. CONCLUSION: There is a high prevalence of osteoporosis among pregnant women in Southeast Nigeria. This may be due to the predominant poor adherence and low dose of calcium supplementation among pregnant women in this environment. Therefore, there is an urgent need for sensitization on this public health problem.

Prevalence of Sexual Dysfunction among Females in a University Community in Enugu; Nigeria

Background: Female sexual dysfunction is a common; condition that significantly reduces the quality-of-life of the affected persons. Unfortunately; because of the veil of secrecy that shrouds discussions on human sexuality; there has been limited research on this topic in some sociocultural settings. Aim: The aim was to determine the prevalence and some sociodemographic factors associated with sexual dysfunction in females in a university community at the University of Nigeria; Enugu Campus; Enugu State; Nigeria. Subjects and Methods: This is a cross-sectional study involving 500 females recruited randomly in a tertiary institution in Nigeria. A self-administered structured pretested questionnaire on sexual activity was administered (the Female Sexual Function Index [FSFI]). Statistical analysis was performed using SPSS software package (Version 17.0; Chicago; IL; USA). Multiple logistic regression was used to determine the relationship between the sociodemographic factors; and the total FSFI scores dichotomized as normal and reduced sexual function. In addition; multiple linear regression was used to determine the relationship between the six different domains scores and the continuous values of the total score. For all; calculations; P 0.05 was considered as statistically significant at 95 confidence interval (CI). Results: The prevalence of female sexual dysfunction (FSFI score ? 26.50) was 53.3. The highest prevalence occurred in the 41-50 years age group (73.3; 66/90); married and living together 56.4 (123/218) and had postsecondary education (56.1 CI; 0.691-0.943). Marital status; religion; ethnic group; and educational qualification had no significant effect (P 0.05). The total FSFI significantly increase as desire increases (P

Prevalence of sexual dysfunction among females in a university community in Enugu, Nigeria.

BACKGROUND: Female sexual dysfunction is a common, condition that significantly reduces the quality-of-life of the affected persons. Unfortunately, because of the veil of secrecy that shrouds discussions on human sexuality, there has been limited research on this topic in some sociocultural settings. AIM: The aim was to determine the prevalence and some sociodemographic factors associated with sexual dysfunction in females in a university community at the University of Nigeria, Enugu Campus, Enugu State, Nigeria. SUBJECTS AND METHODS: This is a cross-sectional study involving 500 females recruited randomly in a tertiary institution in Nigeria. A self-administered structured pretested questionnaire on sexual activity was administered (the Female Sexual Function Index [FSFI]). Statistical analysis was performed using SPSS software package (Version 17.0, Chicago, IL, USA). Multiple logistic regression was used to determine the relationship between the sociodemographic factors, and the total FSFI scores dichotomized as normal and reduced sexual function. In addition, multiple linear regression was used to determine the relationship between the six different domains scores and the continuous values of the total score. For all, calculations, P < 0.05 was considered as statistically significant at 95% confidence interval (CI). RESULTS: The prevalence of female sexual dysfunction (FSFI score ≤ 26.50) was 53.3%. The highest prevalence occurred in the 41-50 years age group (73.3%; 66/90), married and living together 56.4% (123/218) and had postsecondary education (56.1%; 137/244). Only age significantly predicted female sexual function (P = 0.007; 95% CI; 0.691-0.943). Marital status, religion, ethnic group, and educational qualification had no significant effect (P < 0.05). The total FSFI significantly increase as desire increases (P = 0.002; 95% CI = 0.817-3.573). CONCLUSION: Female sexual dysfunction is common in the university environment, with the highest prevalence occurring in 41-50 years age group.

Investigating maternal mortality in a public teaching hospital, abakaliki, ebonyi state, Nigeria.

BACKGROUND: Maternal mortality in sub-Saharan Africa has remained high and this is a reflection of the poor quality of maternal services. AIM: To determine the causes, trends, and level of maternal mortality rate in Abakaliki, Ebonyi. MATERIALS AND METHODS: This was a review of the records of all maternal deaths related to pregnancy over a ten-year period, that is, January 1999 to December 2008. Relevant information on number of deaths, booking status, age, parity, educational level of women, mode of delivery, and causes of death were extracted and analyzed. RESULTS: During the study period, there were 12,587 deliveries and 171 maternal deaths. The maternal mortality ratio (MMR) was 1,359 per 100,000 live births. The trend over the period was lowest in 2008 and highest in 1999 with an MMR of 757 per 100,000 live births and 4,000 per 100,000 live births, respectively. There was a progressive decline in the MMR over the period of study except in the years 2003 and 2006, when the ratio spiked a little, giving an MMR of 1,510 per 100,000 live births and 1,290 per 100,000 live births, respectively. The progressive decline in maternal mortality corresponded with the time that free maternal services were introduced. Hemorrhage was the most important cause of maternal death, accounting for 23.0% (38/165), whereas diabetic ketoacidosis, congestive cardiac failure, and asthma in pregnancy were the least important causes of maternal deaths, each accounting for 0.6% (1/165). Majority of the maternal deaths occurred in unbooked patients (82.4% (136/165)), whereas 17.6% (29/165) of the deaths occurred in booked cases. Forty-seven (28.5% (47/165)) patients died following a cesarean section, 8.5% (14/165) died as a result of abortion complications, and 10.9% (18/165) died undelivered. Seventy-seven (46.7% (77/165)) of the maternal death patients had no formal education. Low socioeconomic status, poor educational level, and grand multiparity were some of the risk factors for maternal mortality. CONCLUSION: There was a decline in MMR during the period of study. The free maternal health services and adequate staff recruitment, which may have contributed to the observed decline in maternal mortality, should be sustained in developing countries.

Culture and biomedical care in Africa: the influence of culture on biomedical care in a traditional African society, Nigeria, West Africa.

BACKGROUND: Biomedical Care in Africa and the influence of culture on the health-seeking behaviour of Africans can not be underestimated; many African cultures have different understanding of the causes of disease which more often affect our public health system, policy, planning and implementations. The traditional African healer unlike a doctor trained in western biomedicine, looks for the cause of the patient's ailments as misfortune in relationship between the patient and the social, natural and spiritual environments. The complexity of African society with different cultural and religious practices also reflects on the people's attitude and understanding of their health matters. This paper is an overview of the cultural influence on biomedical care in a traditional African society, Nigeria, West Africa. METHODS: A research on the patients' health seeking behaviour and Primary Health Care service organization in 10 health centres in the five eastern states of the Federal Republic of Nigeria was carried out using a multistage cross-sectional study. A semi-structured questionnaire was administered to the health care providers and patients while an in-depth semi- structured interview was also conducted. RESULT: We observed there is underutilization of health care services at the primary level because most people do not accept the model of health care system provided for them. Most people believe diseases are caused by supernatural beings, the handiwork of neighbours or vengeance from an offended god as a result of transgressions committed in the past by an individual or parents. This group of people therefore prefers seeking traditional medicine to seeking orthodox medicine and often ends up in the hands of witch doctors who claim to have cure to almost all the diseases. CONCLUSION: Biomedical care in Africa is influence by culture because of different understanding of what ailment is and also due to limited knowledge of health matters, poverty and ignorance. There is a need therefore to focus on health out-reach programme, communication and enlightment campaign in Africa especially in the rural areas that are more vulnerable and are burdened with many of these diseases.

Pattern and determinants of antenatal booking at abakaliki southeast Nigeria.

BACKGROUND: Antenatal care is one of the pillars of SAFE Motherhood Initiative aimed at preventing adverse pregnancy outcome. Early antenatal booking is recommended for this benefit. AIM: The objective of this study was to determine the antenatal booking pattern of pregnant women and its determinants. SUBJECTS AND METHODS: A cross-sectional survey of pregnant women attending the antenatal booking clinic at Federal Medical Centre Abakaliki Ebonyi State between April 6, 2011 to August 5, 2011 was undertaken. Epi info 2008 version was used for analysis. RESULTS: The mean age of the respondents was 27.46 (5.81) years and the mean gestational age at booking was 24.33 (5.52) weeks. A total of 83.1% (286/344) of the pregnant women booked after the first trimester while the remaining 16.9% (56/344) booked early. Socio-biological variables and past obstetrics history did not contribute significantly to the gestational age at booking while sickness in index pregnancy, personal wishes, and financial constraint were statistically significant reasons given for seeking antenatal care. Majority of the pregnant women 37.2% (128/344) suggested that the second trimester was the ideal gestational age for booking while 18.3% (63/344) did not know the ideal gestational age for booking. Most pregnant women 81.1% (279/344) knew the benefits of early antenatal care even though they booked late 83.1% (286/344). CONCLUSION: Most pregnant women access antenatal care late at Abakaliki because of misconception and poverty. Health education and subsidization of cost of medical services will help in reversing the trend of late antenatal booking.

Low Levels of some Nutritional Parameters of Pregnant Women in a Rural Community of South East Nigeria: Implications for the Attainment of the Millennium Developmental Goal

In developing countries; under nutrition is common; and this plays a crucial role in the pathogenesis of malaria and anemia. Indeed it has been associated with adverse pregnancy outcomes. Unfortunately; published evidence concerning the situation is lacking. Objectives: To evaluate some nutritional function indices of pregnant women in a rural Nigerian community. Subjects and Methods: This is a cross sectional study involving of 171 pregnant women from a rural area in South-eastern Nigeria. They included 72 and 99 women in their second and third trimesters respectively. The control group was of 60 women; matched in age; parity and socioeconomic conditions; non-pregnant; non-menstruating and non lactating apparently healthy women. The parameters measured by standard methods included serum iron; total proteins; albumin; globulin; packed cell volume and hemoglobin. Results: The results obtained from control group; second and third trimesters; recorded as Mean (SEM) were 134.60(3.12) ?g/L; 101.20(4.48) ?g/L and 91.87(3.42) ?g/L respectively for iron; 69.12(0.80) g/L; 63.60(0.71) g/L and 57.74(0.75) g/L for total proteins; 42.95(0.92) g/L; 35.74(1.00) g/L and 35.26(0.64) g/L for albumin; 26.77(1.00) g/L; 27.78(1.07) g/L and 22.93(0.88) g/L for globulin; 32.80(0.36); 27.92(0.37) and 27.73(0.34) for packed cell volume; and 11.25(0.11) g/L; 9.59(0.13) g/L and 9.57(0.14) g/L for hemoglobin respectively. These results showed that all the parameters decreased significantly in pregnancy (P0.001) except globulin that did not show immediate; significant decrease. Conclusion: There is a general decrease in the nutrition parameters studied among the pregnant women from our study area; indicating under-nutrition. Urgent measures should be taken to improve the nutritional status of rural dwellers especially the antioxidant micronutrients

Pattern and Determinants of Antenatal Booking at Abakaliki Southeast Nigeria

Background: Antenatal care is one of the pillars of SAFE Motherhood Initiative aimed at preventing adverse pregnancy outcome. Early antenatal booking is recommended for this benefit. Aim: The objective of this study was to determine the antenatal booking pattern of pregnant women and its determinants. Subjects and Methods: A cross-sectional survey of pregnant women attending the antenatal booking clinic at Federal Medical Centre Abakaliki Ebonyi State between April 6; 2011 to August 5; 2011 was undertaken. Epi info 2008 version was used for analysis. Results: The mean age of the respondents was 27.46 (5.81) years and the mean gestational age at booking was 24.33 (5.52) weeks. A total of 83.1 (286/344) of the pregnant women booked after the first trimester while the remaining 16.9 (56/344) booked early. Socio-biological variables and past obstetrics history did not contribute significantly to the gestational age at booking while sickness in index pregnancy; personal wishes; and financial constraint were statistically significant reasons given for seeking antenatal care. Majority of the pregnant women 37.2 (128/344) suggested that the second trimester was the ideal gestational age for booking while 18.3 (63/344) did not know the ideal gestational age for booking. Most pregnant women 81.1 ( 279/344) knew the benefits of early antenatal care even though they booked late 83.1 (286/344). Conclusion: Most pregnant women access antenatal care late at Abakaliki because of misconception and poverty. Health education and subsidization of cost of medical services will help in reversing the trend of late antenatal booking

Pattern and Determinants of Antenatal Booking at Abakaliki Southeast Nigeria

Antenatal care is one of the pillars of SAFE Motherhood Initiative aimed at preventing adverse pregnancy outcome. Early antenatal booking is recommended for this benefit. Aim: The objective of this study was to determine the antenatal booking pattern of pregnant women and its determinants. Subjects and Methods: A cross-sectional survey of pregnant women attending the antenatal booking clinic at Federal Medical Centre Abakaliki Ebonyi State between April 6; 2011 to August 5; 2011 was undertaken. Epi info 2008 version was used for analysis. Results: The mean age of the respondents was 27.46 (5.81) years and the mean gestational age at booking was 24.33 (5.52) weeks. A total of 83.1 (286/344) of the pregnant women booked after the first trimester while the remaining 16.9 (56/344) booked early. Socio-biological variables and past obstetrics history did not contribute significantly to the gestational age at booking while sickness in index pregnancy; personal wishes; and financial constraint were statistically significant reasons given for seeking antenatal care. Majority of the pregnant women 37.2 (128/344) suggested that the second trimester was the ideal gestational age for booking while 18.3 (63/344) did not know the ideal gestational age for booking. Most pregnant women 81.1 ( 279/344) knew the benefits of early antenatal care even though they booked late 83.1 (286/344). Conclusion: Most pregnant women access antenatal care late at Abakaliki because of misconception and poverty. Health education and subsidization of cost of medical services will help in reversing the trend of late antenatal booking