Upper gastrointestinal tract endoscopy indications in northern Nigeria.

Upper gastrointestinal tract endoscopy is one of the commonly performed endoscopic procedures, and has only recently become available in Nigeria. The indications for upper gastrointestinal tract endoscopy in three health facilities in Northern Nigeria were reviewed. Two hundred and sixty-nine patients were found to have undergone upper gastrointestinal tract endoscopy. Their ages ranged from 12-90 years with a mean of 48.1+16.2 years. There were 46.8% males and 53.2% females. The commonest indication for the procedure was dyspepsia (61.0%), followed by upper gastrointestinal bleeding, gastro-oesophageal reflux disease, gastric cancer, gastric outlet obstruction, acute exacerbation of peptic ulcer disease, dysphagia, epigastric mass, excessive salivation, abdominal pain, anaemia, chronic diarrhoea, haematochexia and persistent vomiting.

Full-term pregnancy in an incisional hernia--a case report.

We report a case of full-term pregnancy in a 40 year old woman who presented with her fifth pregnancy with the uterus in the incisional hernia sac hanging below the groin. She has had previous abdominal operation through a midline scar. Complication of the previous operation led to the incisional hernia into which she carried a full term pregnancy. Caesarian section and bilateral tubal ligation were done with repair of the incisional hernia with nonabsorbable suture with uneventful postoperative recovery. It is advised that surgeons carrying out abdominal operations for whatever reason, the operations should be done on fit patient as much as possible, proper incisions should be made and the fascia should be closed with non-absorbable sutures (mass closure) in order to avoid occurrence of incisional hernias. Emergency operations in the abdomen including caesarian section, surgical principles should always be observed.

Maternal mortality at federal medical centre yola, adamawa state: a five-year review.

BACKGROUND: The North Eastern region of Nigeria has one of the highest maternal mortality ratios (MMRs) in the world, and most of these deaths are preventable. Culture, religion and customs that prevent access to care contribute immensely to these deaths. AIM: To review and document the MMR. MATERIALS AND METHODS: This was a retrospective study of all maternal deaths recorded at the Federal Medical Centre Yola (FMCY). The case notes of all cases of maternal deaths from January 2007 to December 2011 were retrieved and relevant data obtained and analyzed. The age, parity, literacy level, booking status, causes of maternal deaths, were analysed. Data were presented in tables and percentages, using SPSS version 16(Chicago, USA 2006). RESULTS: There were 54 maternal deaths among the 8497 deliveries, giving an overall MMR of 636 per 100,000 deliveries. Thirty three folders (33) folders were retrieved and 28 had complete information for analysis. The mean (SD) age and parity were 28.2 (6.2) and 3.4 (2.0), respectively. Most deaths (9/28; 32.1%) were in the age group of 20-24 years. Multiparae (14/28; 50%) constituted the largest parity group. Majority (16/28; 57.1) were non-literates, 16/28 (57.1%) were of Hausa/Fulani extraction and 12/28 (42.9%) were unbooked. The leading causes of maternal mortality were preeclampsia/eclampsia (9/28; 32.1%), obstetric hemorrhage (8/28; 28.6%) and severe anemia (3/28; 10.7%). All those who died of preeclampsia/eclampsia were Hausa/Fulani. Most (14/28; 50%) deaths occurred within 24 h of admission. Majority of the deaths were Muslims (χ(2) = 15.108, P = <0.001). Ethnicity had no significant influence on maternal death (χ(2) = 15.550, P = 0.21). CONCLUSION: In conclusion, the MMR in FMCY is higher than the national average. The fact that most deaths occurred within 24 h of admission suggests that many of the patients delayed reaching the referring center for a variety of reasons. Preventive measures should focus on this delay, which is usually beyond the reach of the hospital. Measures to reduce preventable hospital deaths should also be put in place.