N. Daniel - Academia.edu (original) (raw)

Papers by N. Daniel

Background: Cesarean section (CS) is employed when vaginal delivery is not feasible or hazardous ... more Background: Cesarean section (CS) is employed when vaginal delivery is not feasible or hazardous to the mother and/or her baby.
The procedure, however, is not without risk. We determined the maternal and early neonatal outcomes of CS in a Tertiary Hospital in
Nigeria. Materials and Methods: This is a 2‑year cross‑sectional study of all CS deliveries performed at the Usmanu Danfodiyo University
Teaching Hospital, Sokoto, North‑Western Nigeria, from July 01, 2009, to June 30, 2011. All patients who had CS at any time within the
24 h period were noted and followed up until discharge. The sociodemographic data, types of CS, anesthesia, indications, cadre of a
surgeon, and feto‑maternal outcomes were documented in a proforma. Statistical analysis was carried out using the EPI INFO 3.5.1 (CDC
Atlanta Georgia, USA). Results: There were 4462 deliveries out of which 504 (11.3%) were by CS. The age range of the subjects was
between 15 and 50 years, and the mean age was 28.7 (3.05) years. Most of the subjects 75.2% (379/504) were multigravida while the
primigravida constituted 3.1% (16/504). CS was performed for emergency reasons in 57.1% (288/504) while elective CS constituted
42.9% (216/504) of cases. The most frequent indication for emergency CS was obstructed labor 25.7% (30/288) and previous CS
39.8% (86/216) for elective CS. There were 514 babies delivered during the study of which 98.1% (504/514) were singletons while
1.9% (10/514) was multiple gestations. The maternal complication rate was 13.3% (67/504), and the main complication was hemorrhage
59.7% (40/67). Complications were more frequent with emergency CS compared to elective surgery (Chi‑square test [χ2] =6.633,
df = 1, P < 0.01) and with junior compared to senior residents (χ2 = 15.9, df = 1, P < 0.001). There was also a significant relationship
between the fetal Apgar scores and the type of CS. The low 1st and 5th min Apgar scores were more frequent with emergency cases
compared to elective CS (χ2 = 30.60, df = 1, P < 0.001; χ2 = 4.62.df = 1, P < 0.003). There were 10 maternal and 60 perinatal deaths.
Conclusion: The CS rate in this study was 11.3%. Obstructed labor and previous CS among multigravida were the most frequent
indications. Maternal and perinatal complications were more frequent with emergency CS and in the referred cases.

Background: The pattern of gynecological malignancies varies among nations and even within health... more Background: The pattern of gynecological malignancies varies among nations and even within health institution in the same country. Understanding the histo‑pathological pattern of these malignancies will help in the management of the patient.
Aim: The aim of the following study is to establish the frequency, histo‑pathological features, and distribution of genital tract malignancies as seen in a tertiary health institution in North ‑ western Nigeria.
Materials and Methods: A retrospective analysis of data from ward admissions and discharge records, surgical biopsy materials from the theater and the histopathology laboratory results of slides. The study was carried out at the Usmanu Dan‑Fodiyo University Teaching Hospital Sokoto, Nigeria. Data were entered
into a study proforma and analysis was through SPSS version 15 (Chicago IL) for windows. The results were expressed in simple percentages, tables and charts. Results: During the study period (2000‑2009), there were 404 cases of gynecological malignancies recorded in the hospital. Cervical cancer was the most common gynecological malignancy 274/404 (69%), followed by choriocarcinoma 52/404 (13.1%), ovarian cancer 46/404 (11.4%) while the least common was
vaginal cancer 1/404 (0.3%). The mean age of the cancers was 54 years (28.3). The mean age of incidence of all ovarian cancers was 52.5 years (SD ± 16.2). Epithelial ovarian tumors had a mean age incidence of 67 (12) years, while that of ovarian germ cell tumors was 18.5 (8) years. The incidence of cervical cancer showed a rising trend. Moderately differentiated squamous cell carcinoma was the most common histological variant of cervical carcinoma 170/252 (67.5%). Among the ovarian tumors, epithelial cancers were the most common 38/46 (82.6%), and
were followed by the germ cell tumors 5/46 (10.9%). Dysgerminoma was the predominant ovarian germ cell tumour 4/5 (80%). There were 50 deaths from these cancers in our hospital.
Conclusion: Cervical cancer is the most common gynecological malignancy in our center and it was followed by Choriocarcinoma. Efforts to reduce the cancer burden should focus on heath education of the masses, national organized screening especially for cervical cancer and establishing regional centers for monitoring and evaluation of these programs.