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Papers by francis adebayo

West African journal of medicine, 2021

BACKGROUND Biomarkers of susceptibility to COVID-19 are being investigated by many scientists all... more BACKGROUND Biomarkers of susceptibility to COVID-19 are being investigated by many scientists all over the world. The ABO blood group antigens are the most frequently studied genetic markers. Reports from China and USA have shown that people with blood group A are more susceptible to COVID- 19 while those with blood group O are least susceptible. METHODS The ABO blood group of 51 patients with COVID-19 admitted at the University of Abuja Teaching Hospital, Nigeria was determined and compared with the ABO blood group distribution in the general population. RESULTS Out of the 51 patients, 39 (76.5%) were males and 12 (23.5%) were females, giving a male: female ratio of 3.25:1. Out of the 51 patients, 29 (56.9%) had blood group O, 12 (23.5%) had blood group A, 10 (19.6%) had blood group B and none (0%) had blood group AB. This blood group distribution was comparable to the blood group distribution in the general population. CONCLUSION Preliminary analysis of the blood group distributio...

The aims of this study were to determine the contraceptive method mix accepted by clients who wer... more The aims of this study were to determine the contraceptive method mix accepted by clients who were new to the methods and to study their socio-demographic characteristics. It was a 5-year (2013-2017) retrospective review of case records of clients who accepted different modern methods of contraception for the first time in the family planning clinic of the University of Abuja teaching hospital, Abuja, Nigeria. Their socio-demographic characteristics, the methods chosen and how they got information about family planning were studied. The discontinuation rate was also studied. There were 1620 acceptors new to different modern contraceptive methods within the 5-year period. The mean age was 31.8±6.0 years (range: 15-55 years). One thousand six hundred and six clients (99.1%) were married while 14 (0.9%) were single. The mean parity was 3.4±1.8 (range: 0-12). Implants were accepted by 588 clients (36.6%) and were the most accepted methods, followed by Cu T 380 (520, 32.1%). Bilateral tu...

Open Journal of Obstetrics and Gynecology, 2018

Background: Trial of labour after Caesarean section (TOLAC) refers to an attempt at vaginal deliv... more Background: Trial of labour after Caesarean section (TOLAC) refers to an attempt at vaginal delivery after a previous caesarean section. Outcome is influenced by a number of factors which are important in patient's selection. Objectives: The aim of this study was to find out the incidence and feto-maternal outcome of the practice of Trial of labour after Caesarean section. Methodology: This is a retrospective study of cases of vaginal birth after Caesarean section Data were retrieved from the case notes of patients who attempted vaginal birth after Caesarean section from January 1, 2013 to December 31, 2017, a period of five years. Result: There were 10,669 deliveries, 3179 of which were through Caesarean section. This gave a Caesarean section rate of 29.8%. A total of 217 patients attempted vaginal birth after Caesarean section and 83 ended up as repeat Caesarean section (38.2%) while 138 (61.8%) had successful vaginal birth after Caesarean section. Patients with previous vaginal delivery, age range 25-29 years and interdelivery interval of greater than or equal to 2 years were more successful at achieving vaginal birth after Caesarean section. The leading indications for the repeat Caesarean section include cephalopelvic disproportion (45.8%), poor progress of labour (19.3%) and hypertensive disorders of pregnancy (8.4%). Conclusion: Vaginal birth after Caesarean section was successful in most of the parturients that attempted it in this study especially in patients within the age range of 25-29 years, those that have had previous vaginal delivery and with interdelivery interval of greater than or equal to 2 years.

International Journal of Gynecology & Obstetrics

Journal of Radiation Medicine in the Tropics

The Pan African Medical Journal, 2022

Introduction globally, the ravaging effect of the coronavirus disease-2019 (COVID-19), pandemic i... more Introduction globally, the ravaging effect of the coronavirus disease-2019 (COVID-19), pandemic is evident on public health and the global economy. We aimed at describing the clinical characteristic and management outcome of COVID-19 patients in Abuja, Nigeria. Methods we conducted a retrospective study by reviewing the hospital charts of the first 200 COVID-19 patients admitted at the isolation center, University of Abuja Teaching Hospital (UATH), Gwagwalada. Extracted data includes; demographic data, clinical symptoms, underlying comorbidities, and clinical outcomes. The outcome of interest was either discharged or died. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Results the median age was 45 years (range 2-84 years). Majority of the patients were males (66.5%). The most affected age group was 50-59 years (21%). Children and adolescents were least affected; less than 10 years constituted 2.5% and 10-19 years constituted 4.5%. The commo...

African Journal of Reproductive Health, Nov 6, 2021

Sexual assault is assuming an alarming status and usually leaves a devatating effect on women and... more Sexual assault is assuming an alarming status and usually leaves a devatating effect on women and girls who fall victim. The aim of this study was to determine the trend and pattern of sexual assaults. This was a retrospective cohort study. Case notes were retrieved from gynaecological emergency unit from January 2016 to December 2018. A total of 45 Case folders were collected. The information from the case notes were entered into a structured proforma. A total 2250 gynaecological emergency cases were seen and out of these 45 were victims of sexual assault, giving the prevalence of sexual assault to be 2.0%. A large proportion 84.4% were noted in children less than 16 years of age. There was delay in presentation as only 40% did so within 24 hours of the incidence. In 84.4% of the cases, the victim had a relationship with the alleged assailant and the assault was said to have occured most times in the home of the assailant. In 95.5%, vaginal penetration was the commonest and threat of violence was the commonest method of overcoming the victims. About 42.2% victims did not have a human immunodeficiency virus screening test done for various reasons. In conclusion, gender-based violence and other practices that affect the health of women and children negatively, and sexual assault against children and adolescence are still prevalent in our clime as seen from this study.

International Journal of Research in Medical Sciences, 2021

Background: Anaemia in pregnancy and HIV infection are two common public health issues in sub-Sah... more Background: Anaemia in pregnancy and HIV infection are two common public health issues in sub-Saharan African with Nigeria bearing the greatest burden. The duo occurring together poses a higher risk of morbidity and mortality for both the foetus and the mother. We therefore conducted this study to determine the burden of anaemia and other haematological abnormalities among HIV positive pregnant mothers on antiretroviral therapy who attended antenatal clinical services in our health institution.Methods: A 10-year retrospective review from January 2010 to December 2019 of medical records of HIV positive mothers on highly anti-retroviral therapy in attendance for antenatal clinical services in our health institution was carried out for the above objectives. Information extracted were, age, HIV status, gestational age at delivery, type of antiretroviral drugs used, duration of use, haemoglobin level, platelet, and complete blood count at booking of the positive mothers.Results: Of a tot...

The Lancet, 2021

Summary Background Surgical site infection (SSI) is the most common postoperative complication wo... more Summary Background Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This study aimed to test both interventions in low-income and middle-income countries. Methods FALCON was a 2 × 2 factorial, randomised controlled trial stratified by whether surgery was clean-contaminated, or contaminated or dirty, including patients undergoing abdominal surgery with a skin incision of 5 cm or greater. This trial was undertaken in 54 hospitals in seven countries (Benin, Ghana, India, Mexico, Nigeria, Rwanda, and South Africa). Patients were computer randomised 1:1:1:1 to: (1) 2% alcoholic chlorhexidine and non-coated suture, (2) 2% alcoholic chlorhexidine and triclosan-coated suture, (3) 10% aqueous povidone–iodine and non-coated suture, or (4) 10% aqueous povidone–iodine and triclosan-coated suture. Patients and outcome assessors were masked to intervention allocation. The primary outcome was SSI, reported by trained outcome assessors, and presented using adjusted relative risks and 95% CIs. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, NCT03700749. Findings Between Dec 10, 2018, and Sept 7, 2020, 5788 patients (3091 in clean-contaminated stratum, 2697 in contaminated or dirty stratum) were randomised (1446 to alcoholic chlorhexidine and non-coated suture, 1446 to alcoholic chlorhexidine and triclosan-coated suture, 1447 to aqueous povidone–iodine and non-coated suture, and 1449 to aqueous povidone–iodine and triclosan-coated suture). 14·0% (810/5788) of patients were children and 66·9% (3873/5788) had emergency surgery. The overall SSI rate was 22·0% (1163/5284; clean-contaminated stratum 15·5% [454/2923], contaminated or dirty stratum 30·0% [709/2361]). For both strata, there was no evidence of a difference in the risk of SSI with alcoholic chlorhexidine versus povidone–iodine (clean-contaminated stratum 15·3% [223/1455] vs 15·7% [231/1468], relative risk 0·97 [95% CI 0·82–1·14]; contaminated or dirty stratum 28·3% [338/1194] vs 31·8% [371/1167], relative risk 0·91 [95% CI 0·81–1·02]), or with triclosan-coated sutures versus non-coated sutures (clean-contaminated stratum 14·7% [215/1459] vs 16·3% [239/1464], relative risk 0·90 [95% CI 0·77–1·06]; contaminated or dirty stratum 29·4% [347/1181] vs 30·7% [362/1180], relative risk 0·98 [95% CI 0·87–1·10]). With both strata combined, there were no differences using alcoholic chlorhexidine or triclosan-coated sutures. Interpretation This trial did not show benefit from 2% alcoholic chlorhexidine skin preparation compared with povidone–iodine, or with triclosan-coated sutures compared with non-coated sutures, in preventing SSI in clean-contaminated or contaminated or dirty surgical wounds. Both interventions are more expensive than alternatives, and these findings do not support recommendations for routine use. Funding National Institute for Health Research (NIHR) Global Health Research Unit Grant, BD.

Open Journal of Obstetrics and Gynecology, 2018

Background: Hyoscine butyl bromide (Buscopan) is being used as an agent for reducing the duration... more Background: Hyoscine butyl bromide (Buscopan) is being used as an agent for reducing the duration of labour. There are however conflicting results on the effect of this agent on cervical dilation. Materials and Methods: This was an open label clinical trial of one hundred and thirty two (132) pregnant women in labour. Women were grouped to receive either 20 mg of hyoscine butyl bromide intramuscularly at the onset of active phase labour or placebo "Normal saline". The main outcome measure was to compare the duration of first stage labour in the study and control groups as well as feto-maternal outcomes. Relevant data were collected using a proforma. The data were analysed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 132 were randomised and 123 yielded for analysis. Of these 59 received hyoscine butyl bromide and 64 received placebo. There was no significant difference in the mean duration of active labour to second stage between the drug and placebo arms (312.5 versus 305.3 minutes, respectively, P = 0.788). The feto-maternal outcomes were similar between both arms. Conclusion: Hyoscine butyl bromide does not shorten the duration of labour in spontaneous labour. It also does not change feto-maternal outcomes.

Journal of Fetal Medicine, 2019

The role of calcium supplementation in pregnancy to prevent preeclampsia is conflicting. The goal... more The role of calcium supplementation in pregnancy to prevent preeclampsia is conflicting. The goal was to determine if there was significant difference between plasma calcium levels in women with preeclampsia and normotensive pregnant women. This was a cross-sectional study of 90 consecutive preeclamptic and 90 normotensive pregnant. Blood samples were taken from them and the plasma isolated from each was analyzed using colorimetric method for calcium and albumin employing calcium kit, albumin kit and spectrum lab 7225 spectrophotometer set (Bran Scientific and Instrument Company, England). The data was analysed using SPSS version 16. Their mean ages were 28.67 ± 5.23 and 28.33 ± 5.06 years respectively (preeclamptic vs. normotensive women respectively; P = 0.688). Majority of them were nullipara (48, 53.3% and 46, 51.1% of preeclamptic and normotensive women respectively). The mean gestational age of the preeclamptic women was 36.38 ± 2.54 weeks while that of the normotensive women was 36.24 ± 2.34 years, (P = 0.715). The plasma calcium level in preeclamptic women was significantly lower than in normotensive pregnant women (2.07 ± 0.318 mmol/L vs. 2.41 ± 0.224 mmol/L, P \ 0.001). Preeclamptic women have significantly lower plasma calcium levels than normotensive pregnant women in our community. Routine calcium supplementation for pregnant women at risk of developing preeclampsia is therefore recommended.

Journal of Womens Health Care, 2017

Sonographic assessment of amniotic fluid has formed an integral and important component of pregna... more Sonographic assessment of amniotic fluid has formed an integral and important component of pregnancy assessment of fetal wellbeing. Changes in amniotic fluid volume are associated with variable outcome of the fetus. Amniotic fluid index which is an objective means of assessing adequacy of amniotic fluid volume does not only vary with gestational age but also differs from population to population. The study determined the reference values of amniotic fluid index and compared the values with the established ranges throughout gestation in uncomplicated singleton pregnancies among women attending our antenatal care facility. This was a longitudinal prospective assessment of amniotic fluid index in eighty six healthy pregnant women with singleton pregnancies recruited at 20 to 22 weeks of gestation and followed up to 41 weeks and 3 days. The patients recruited at 20 weeks had amniotic fluid measurements at recruitment and 4 weeks apart until 40 weeks gestation. Those recruited at 22 weeks had it also at recruitment and 4 weekly with the last estimation at 41 weeks +3 days. These measurements were plotted against their respective gestational ages. The graph was then analyzed using statistical and graphical packages of SPSS version 21. The study populations mean, 5 th and 95 th percentiles was documented and discussed appropriately. A total of 414 readings were obtained from 81 subjects who underwent more than 3 measurements. Analysis of the data obtained shows a rising AFI with a mean 28 weeks and, thereafter gradually fell till term. The mean age obtained in the study group compared with that of Caucasians showed statistically significant difference (P=0.014). Also, comparison with Chama et al. showed obvious statistical difference at the lower limit (5 th percentile; P=0.007, 50 th percentile; P=0.006) but no differences at the upper limit (95 th percentile; P=0.726). Amniotic fluid index values appear to be differing in different population. The reference range of AFI used in clinical practice should therefore be based on data obtained from local population.

Journal of Womens Health Care, 2017

Background: Misoprostol is increasingly being accepted as a standard agent for cervical ripening ... more Background: Misoprostol is increasingly being accepted as a standard agent for cervical ripening and induction of labor. The lowest effective dose is still not known. Materials and Methods: This was an open label clinical trial of one hundred and eighty four women with obstetrics or medical indications for induction of labor at University of Abuja Teaching Hospital, Abuja. Women were grouped to receive either 25 µg or 50 µg of intravaginal misoprostol. The main outcome measure was inductionvaginal delivery interval while the secondary outcome measures were requirements for oxytocin augmentation, mode of delivery, frequency of tachsystole/hyperstimulation, as well as feto-maternal outcomes. Data was analyzed using SPSS version 21.0. Chi-square test was used to compare categorical variables. Mann-Whitney test was used to analyze continuous variables of the two treatment groups. P-value of less than 0.05 was accepted as indicating statistical significance. Results: Mean induction delivery interval was 13.8 ± 5.9 and 14.0 ± 5.7 hours (P=0.842) with the 25 µg and 50 µg misoprostol respectively. The delivery rate within 24 hours of 66.3% (61/92,) in 25 µg group was lower than 67.4% (62/92) recorded in the 50 µg group but the difference was not statistically significant (P=0.156). The rates of caesarean section and operative vaginal delivery were similar in both groups. There were no significant difference in maternal side effects and neonatal outcomes among the women in the two groups. Conclusion: There were no statistically significant differences in the effectiveness and safety of either of the dose regimen over the other. The choice may therefore be guided by the physician's experience, availability and/or departmental protocol.

African Journal of Medical and Health Sciences, 2016

Vaginal birth after one caesarean section (CS) is considered safe in selected women. However, wom... more Vaginal birth after one caesarean section (CS) is considered safe in selected women. However, women with more than one CS in low-income settings are at higher risk of complications with vaginal birth. Thus, abdominal delivery is recommended for women with more than one CS in low-income countries unlike in high-income countries. This study was designed to raise awareness on the remote possibility of safe vaginal delivery after three CS in low-income countries. The records of two women who had vaginal deliveries after three previous CS were retrieved and reviewed. Both women presented in advanced labour and had unplanned but successful vaginal deliveries. There was no uterine rupture. The risks and consequences of uterine rupture may outweigh the benefits of unplanned vaginal birth after more than one CS. These unusual cases suggest the remote possibility of success and the need for further studies on defining safety guidelines for low-resource settings.

Journal of Infectious Diseases and Epidemiology, 2020

Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus now called severe acute resp... more Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The most serious complication of COVID-19 is a type of pneumonia that's been called 2019 novel coronavirus-infected pneumonia (NCIP). COVID-19 pneumonia presents as an atypical pneumonia, with diffuse bilateral lung involvement. Severe cases present with acute lung injury, and acute respiratory distress syndrome (ARDS). Potential risk factors for severe COVID-19 pneumonia include age above 65 years, diabetes, hypertension, chronic obstructive pulmonary disease, immunosuppression, pregnancy, overcrowding. In addition, some laboratory parameters such as elevated C-reactive protein and D-dimers and low lymphocyte count have also been associated with increase disease severity with a poor prognosis. This is a case of fulminant COVID-19 pneumonia in a 53-yrold know diabetic and hypertensive, who had markedly elevated C-reactive protein and D-dimers and low lymphocyte count during COVID-19 infection.

International Journal of Research in Medical Sciences, 2021

Background: Contraception is key to the reduction of maternal mortality. Tubal ligation is a good... more Background: Contraception is key to the reduction of maternal mortality. Tubal ligation is a good option for women seeking out a safe, effective, permanent and convenient form of contraceptive. However, due to variety of reasons, there is aversion to it especially in developing world. The objective of this study was to determine the trends, uptake, socio-demographic characteristics of acceptors, indications and complications of bilateral tubal ligation (BTL) in our environment. Methods: A retrospective study of BTL at UATH was conducted over a five year period, from 1 January 2015 to 31 December 2019. The records of women who had BTL were retrieved from the medical records department, family planning clinic, and the theatre. The data was analyzed using SPSS 21. Results: The mean age and parity were 36.0±4.0 and 5.0±2.0 respectively. The incidence of BTL was 1.3%. Majority of those that had BTL had at least secondary level of education 100 (83.4%) and 58 (48.3%) were grand multiparou...

Nigerian Medical Journal, 2016

inconsistent or incorrect use of effective contraceptive methods 2 although pregnancy unintendedn... more inconsistent or incorrect use of effective contraceptive methods 2 although pregnancy unintendedness is seen as a complex concept as pregnancy intentions are increasingly viewed as encompassing effective cognitive, cultural, and contextual dimensions. 1,4 The cost of unintended pregnancy is high because the woman has an option of either carrying the pregnancy to term and keep the baby, decide for an adoption, or have an induced abortion. 5,6 Nigeria has restrictive abortion laws and that can compound the problem of unintended pregnancies. Births that are unintended by the mother are INTRODUCTION Unintended pregnancies are pregnancies that are either unwanted (i.e., they occur when no children or no more children are desired) or mistimed (i.e., they occur earlier than desired). 1,2 Unplanned pregnancy is a concept related to unintended pregnancy. It is said to occur either when a woman used a contraceptive method or when she did not desire to become pregnant but did not use a method. 1 In contrast, pregnancies are described as intended if they are reported to have happened at the right time or later than desired (because of infertility or difficulties in conceiving). 1,3 Unintended pregnancy mainly results from lack of,

West African journal of medicine, 2021

BACKGROUND Biomarkers of susceptibility to COVID-19 are being investigated by many scientists all... more BACKGROUND Biomarkers of susceptibility to COVID-19 are being investigated by many scientists all over the world. The ABO blood group antigens are the most frequently studied genetic markers. Reports from China and USA have shown that people with blood group A are more susceptible to COVID- 19 while those with blood group O are least susceptible. METHODS The ABO blood group of 51 patients with COVID-19 admitted at the University of Abuja Teaching Hospital, Nigeria was determined and compared with the ABO blood group distribution in the general population. RESULTS Out of the 51 patients, 39 (76.5%) were males and 12 (23.5%) were females, giving a male: female ratio of 3.25:1. Out of the 51 patients, 29 (56.9%) had blood group O, 12 (23.5%) had blood group A, 10 (19.6%) had blood group B and none (0%) had blood group AB. This blood group distribution was comparable to the blood group distribution in the general population. CONCLUSION Preliminary analysis of the blood group distributio...

The aims of this study were to determine the contraceptive method mix accepted by clients who wer... more The aims of this study were to determine the contraceptive method mix accepted by clients who were new to the methods and to study their socio-demographic characteristics. It was a 5-year (2013-2017) retrospective review of case records of clients who accepted different modern methods of contraception for the first time in the family planning clinic of the University of Abuja teaching hospital, Abuja, Nigeria. Their socio-demographic characteristics, the methods chosen and how they got information about family planning were studied. The discontinuation rate was also studied. There were 1620 acceptors new to different modern contraceptive methods within the 5-year period. The mean age was 31.8±6.0 years (range: 15-55 years). One thousand six hundred and six clients (99.1%) were married while 14 (0.9%) were single. The mean parity was 3.4±1.8 (range: 0-12). Implants were accepted by 588 clients (36.6%) and were the most accepted methods, followed by Cu T 380 (520, 32.1%). Bilateral tu...

Open Journal of Obstetrics and Gynecology, 2018

Background: Trial of labour after Caesarean section (TOLAC) refers to an attempt at vaginal deliv... more Background: Trial of labour after Caesarean section (TOLAC) refers to an attempt at vaginal delivery after a previous caesarean section. Outcome is influenced by a number of factors which are important in patient's selection. Objectives: The aim of this study was to find out the incidence and feto-maternal outcome of the practice of Trial of labour after Caesarean section. Methodology: This is a retrospective study of cases of vaginal birth after Caesarean section Data were retrieved from the case notes of patients who attempted vaginal birth after Caesarean section from January 1, 2013 to December 31, 2017, a period of five years. Result: There were 10,669 deliveries, 3179 of which were through Caesarean section. This gave a Caesarean section rate of 29.8%. A total of 217 patients attempted vaginal birth after Caesarean section and 83 ended up as repeat Caesarean section (38.2%) while 138 (61.8%) had successful vaginal birth after Caesarean section. Patients with previous vaginal delivery, age range 25-29 years and interdelivery interval of greater than or equal to 2 years were more successful at achieving vaginal birth after Caesarean section. The leading indications for the repeat Caesarean section include cephalopelvic disproportion (45.8%), poor progress of labour (19.3%) and hypertensive disorders of pregnancy (8.4%). Conclusion: Vaginal birth after Caesarean section was successful in most of the parturients that attempted it in this study especially in patients within the age range of 25-29 years, those that have had previous vaginal delivery and with interdelivery interval of greater than or equal to 2 years.

International Journal of Gynecology & Obstetrics

Journal of Radiation Medicine in the Tropics

The Pan African Medical Journal, 2022

Introduction globally, the ravaging effect of the coronavirus disease-2019 (COVID-19), pandemic i... more Introduction globally, the ravaging effect of the coronavirus disease-2019 (COVID-19), pandemic is evident on public health and the global economy. We aimed at describing the clinical characteristic and management outcome of COVID-19 patients in Abuja, Nigeria. Methods we conducted a retrospective study by reviewing the hospital charts of the first 200 COVID-19 patients admitted at the isolation center, University of Abuja Teaching Hospital (UATH), Gwagwalada. Extracted data includes; demographic data, clinical symptoms, underlying comorbidities, and clinical outcomes. The outcome of interest was either discharged or died. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Results the median age was 45 years (range 2-84 years). Majority of the patients were males (66.5%). The most affected age group was 50-59 years (21%). Children and adolescents were least affected; less than 10 years constituted 2.5% and 10-19 years constituted 4.5%. The commo...

African Journal of Reproductive Health, Nov 6, 2021

Sexual assault is assuming an alarming status and usually leaves a devatating effect on women and... more Sexual assault is assuming an alarming status and usually leaves a devatating effect on women and girls who fall victim. The aim of this study was to determine the trend and pattern of sexual assaults. This was a retrospective cohort study. Case notes were retrieved from gynaecological emergency unit from January 2016 to December 2018. A total of 45 Case folders were collected. The information from the case notes were entered into a structured proforma. A total 2250 gynaecological emergency cases were seen and out of these 45 were victims of sexual assault, giving the prevalence of sexual assault to be 2.0%. A large proportion 84.4% were noted in children less than 16 years of age. There was delay in presentation as only 40% did so within 24 hours of the incidence. In 84.4% of the cases, the victim had a relationship with the alleged assailant and the assault was said to have occured most times in the home of the assailant. In 95.5%, vaginal penetration was the commonest and threat of violence was the commonest method of overcoming the victims. About 42.2% victims did not have a human immunodeficiency virus screening test done for various reasons. In conclusion, gender-based violence and other practices that affect the health of women and children negatively, and sexual assault against children and adolescence are still prevalent in our clime as seen from this study.

International Journal of Research in Medical Sciences, 2021

Background: Anaemia in pregnancy and HIV infection are two common public health issues in sub-Sah... more Background: Anaemia in pregnancy and HIV infection are two common public health issues in sub-Saharan African with Nigeria bearing the greatest burden. The duo occurring together poses a higher risk of morbidity and mortality for both the foetus and the mother. We therefore conducted this study to determine the burden of anaemia and other haematological abnormalities among HIV positive pregnant mothers on antiretroviral therapy who attended antenatal clinical services in our health institution.Methods: A 10-year retrospective review from January 2010 to December 2019 of medical records of HIV positive mothers on highly anti-retroviral therapy in attendance for antenatal clinical services in our health institution was carried out for the above objectives. Information extracted were, age, HIV status, gestational age at delivery, type of antiretroviral drugs used, duration of use, haemoglobin level, platelet, and complete blood count at booking of the positive mothers.Results: Of a tot...

The Lancet, 2021

Summary Background Surgical site infection (SSI) is the most common postoperative complication wo... more Summary Background Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This study aimed to test both interventions in low-income and middle-income countries. Methods FALCON was a 2 × 2 factorial, randomised controlled trial stratified by whether surgery was clean-contaminated, or contaminated or dirty, including patients undergoing abdominal surgery with a skin incision of 5 cm or greater. This trial was undertaken in 54 hospitals in seven countries (Benin, Ghana, India, Mexico, Nigeria, Rwanda, and South Africa). Patients were computer randomised 1:1:1:1 to: (1) 2% alcoholic chlorhexidine and non-coated suture, (2) 2% alcoholic chlorhexidine and triclosan-coated suture, (3) 10% aqueous povidone–iodine and non-coated suture, or (4) 10% aqueous povidone–iodine and triclosan-coated suture. Patients and outcome assessors were masked to intervention allocation. The primary outcome was SSI, reported by trained outcome assessors, and presented using adjusted relative risks and 95% CIs. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, NCT03700749. Findings Between Dec 10, 2018, and Sept 7, 2020, 5788 patients (3091 in clean-contaminated stratum, 2697 in contaminated or dirty stratum) were randomised (1446 to alcoholic chlorhexidine and non-coated suture, 1446 to alcoholic chlorhexidine and triclosan-coated suture, 1447 to aqueous povidone–iodine and non-coated suture, and 1449 to aqueous povidone–iodine and triclosan-coated suture). 14·0% (810/5788) of patients were children and 66·9% (3873/5788) had emergency surgery. The overall SSI rate was 22·0% (1163/5284; clean-contaminated stratum 15·5% [454/2923], contaminated or dirty stratum 30·0% [709/2361]). For both strata, there was no evidence of a difference in the risk of SSI with alcoholic chlorhexidine versus povidone–iodine (clean-contaminated stratum 15·3% [223/1455] vs 15·7% [231/1468], relative risk 0·97 [95% CI 0·82–1·14]; contaminated or dirty stratum 28·3% [338/1194] vs 31·8% [371/1167], relative risk 0·91 [95% CI 0·81–1·02]), or with triclosan-coated sutures versus non-coated sutures (clean-contaminated stratum 14·7% [215/1459] vs 16·3% [239/1464], relative risk 0·90 [95% CI 0·77–1·06]; contaminated or dirty stratum 29·4% [347/1181] vs 30·7% [362/1180], relative risk 0·98 [95% CI 0·87–1·10]). With both strata combined, there were no differences using alcoholic chlorhexidine or triclosan-coated sutures. Interpretation This trial did not show benefit from 2% alcoholic chlorhexidine skin preparation compared with povidone–iodine, or with triclosan-coated sutures compared with non-coated sutures, in preventing SSI in clean-contaminated or contaminated or dirty surgical wounds. Both interventions are more expensive than alternatives, and these findings do not support recommendations for routine use. Funding National Institute for Health Research (NIHR) Global Health Research Unit Grant, BD.

Open Journal of Obstetrics and Gynecology, 2018

Background: Hyoscine butyl bromide (Buscopan) is being used as an agent for reducing the duration... more Background: Hyoscine butyl bromide (Buscopan) is being used as an agent for reducing the duration of labour. There are however conflicting results on the effect of this agent on cervical dilation. Materials and Methods: This was an open label clinical trial of one hundred and thirty two (132) pregnant women in labour. Women were grouped to receive either 20 mg of hyoscine butyl bromide intramuscularly at the onset of active phase labour or placebo "Normal saline". The main outcome measure was to compare the duration of first stage labour in the study and control groups as well as feto-maternal outcomes. Relevant data were collected using a proforma. The data were analysed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 132 were randomised and 123 yielded for analysis. Of these 59 received hyoscine butyl bromide and 64 received placebo. There was no significant difference in the mean duration of active labour to second stage between the drug and placebo arms (312.5 versus 305.3 minutes, respectively, P = 0.788). The feto-maternal outcomes were similar between both arms. Conclusion: Hyoscine butyl bromide does not shorten the duration of labour in spontaneous labour. It also does not change feto-maternal outcomes.

Journal of Fetal Medicine, 2019

The role of calcium supplementation in pregnancy to prevent preeclampsia is conflicting. The goal... more The role of calcium supplementation in pregnancy to prevent preeclampsia is conflicting. The goal was to determine if there was significant difference between plasma calcium levels in women with preeclampsia and normotensive pregnant women. This was a cross-sectional study of 90 consecutive preeclamptic and 90 normotensive pregnant. Blood samples were taken from them and the plasma isolated from each was analyzed using colorimetric method for calcium and albumin employing calcium kit, albumin kit and spectrum lab 7225 spectrophotometer set (Bran Scientific and Instrument Company, England). The data was analysed using SPSS version 16. Their mean ages were 28.67 ± 5.23 and 28.33 ± 5.06 years respectively (preeclamptic vs. normotensive women respectively; P = 0.688). Majority of them were nullipara (48, 53.3% and 46, 51.1% of preeclamptic and normotensive women respectively). The mean gestational age of the preeclamptic women was 36.38 ± 2.54 weeks while that of the normotensive women was 36.24 ± 2.34 years, (P = 0.715). The plasma calcium level in preeclamptic women was significantly lower than in normotensive pregnant women (2.07 ± 0.318 mmol/L vs. 2.41 ± 0.224 mmol/L, P \ 0.001). Preeclamptic women have significantly lower plasma calcium levels than normotensive pregnant women in our community. Routine calcium supplementation for pregnant women at risk of developing preeclampsia is therefore recommended.

Journal of Womens Health Care, 2017

Sonographic assessment of amniotic fluid has formed an integral and important component of pregna... more Sonographic assessment of amniotic fluid has formed an integral and important component of pregnancy assessment of fetal wellbeing. Changes in amniotic fluid volume are associated with variable outcome of the fetus. Amniotic fluid index which is an objective means of assessing adequacy of amniotic fluid volume does not only vary with gestational age but also differs from population to population. The study determined the reference values of amniotic fluid index and compared the values with the established ranges throughout gestation in uncomplicated singleton pregnancies among women attending our antenatal care facility. This was a longitudinal prospective assessment of amniotic fluid index in eighty six healthy pregnant women with singleton pregnancies recruited at 20 to 22 weeks of gestation and followed up to 41 weeks and 3 days. The patients recruited at 20 weeks had amniotic fluid measurements at recruitment and 4 weeks apart until 40 weeks gestation. Those recruited at 22 weeks had it also at recruitment and 4 weekly with the last estimation at 41 weeks +3 days. These measurements were plotted against their respective gestational ages. The graph was then analyzed using statistical and graphical packages of SPSS version 21. The study populations mean, 5 th and 95 th percentiles was documented and discussed appropriately. A total of 414 readings were obtained from 81 subjects who underwent more than 3 measurements. Analysis of the data obtained shows a rising AFI with a mean 28 weeks and, thereafter gradually fell till term. The mean age obtained in the study group compared with that of Caucasians showed statistically significant difference (P=0.014). Also, comparison with Chama et al. showed obvious statistical difference at the lower limit (5 th percentile; P=0.007, 50 th percentile; P=0.006) but no differences at the upper limit (95 th percentile; P=0.726). Amniotic fluid index values appear to be differing in different population. The reference range of AFI used in clinical practice should therefore be based on data obtained from local population.

Journal of Womens Health Care, 2017

Background: Misoprostol is increasingly being accepted as a standard agent for cervical ripening ... more Background: Misoprostol is increasingly being accepted as a standard agent for cervical ripening and induction of labor. The lowest effective dose is still not known. Materials and Methods: This was an open label clinical trial of one hundred and eighty four women with obstetrics or medical indications for induction of labor at University of Abuja Teaching Hospital, Abuja. Women were grouped to receive either 25 µg or 50 µg of intravaginal misoprostol. The main outcome measure was inductionvaginal delivery interval while the secondary outcome measures were requirements for oxytocin augmentation, mode of delivery, frequency of tachsystole/hyperstimulation, as well as feto-maternal outcomes. Data was analyzed using SPSS version 21.0. Chi-square test was used to compare categorical variables. Mann-Whitney test was used to analyze continuous variables of the two treatment groups. P-value of less than 0.05 was accepted as indicating statistical significance. Results: Mean induction delivery interval was 13.8 ± 5.9 and 14.0 ± 5.7 hours (P=0.842) with the 25 µg and 50 µg misoprostol respectively. The delivery rate within 24 hours of 66.3% (61/92,) in 25 µg group was lower than 67.4% (62/92) recorded in the 50 µg group but the difference was not statistically significant (P=0.156). The rates of caesarean section and operative vaginal delivery were similar in both groups. There were no significant difference in maternal side effects and neonatal outcomes among the women in the two groups. Conclusion: There were no statistically significant differences in the effectiveness and safety of either of the dose regimen over the other. The choice may therefore be guided by the physician's experience, availability and/or departmental protocol.

African Journal of Medical and Health Sciences, 2016

Vaginal birth after one caesarean section (CS) is considered safe in selected women. However, wom... more Vaginal birth after one caesarean section (CS) is considered safe in selected women. However, women with more than one CS in low-income settings are at higher risk of complications with vaginal birth. Thus, abdominal delivery is recommended for women with more than one CS in low-income countries unlike in high-income countries. This study was designed to raise awareness on the remote possibility of safe vaginal delivery after three CS in low-income countries. The records of two women who had vaginal deliveries after three previous CS were retrieved and reviewed. Both women presented in advanced labour and had unplanned but successful vaginal deliveries. There was no uterine rupture. The risks and consequences of uterine rupture may outweigh the benefits of unplanned vaginal birth after more than one CS. These unusual cases suggest the remote possibility of success and the need for further studies on defining safety guidelines for low-resource settings.

Journal of Infectious Diseases and Epidemiology, 2020

Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus now called severe acute resp... more Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The most serious complication of COVID-19 is a type of pneumonia that's been called 2019 novel coronavirus-infected pneumonia (NCIP). COVID-19 pneumonia presents as an atypical pneumonia, with diffuse bilateral lung involvement. Severe cases present with acute lung injury, and acute respiratory distress syndrome (ARDS). Potential risk factors for severe COVID-19 pneumonia include age above 65 years, diabetes, hypertension, chronic obstructive pulmonary disease, immunosuppression, pregnancy, overcrowding. In addition, some laboratory parameters such as elevated C-reactive protein and D-dimers and low lymphocyte count have also been associated with increase disease severity with a poor prognosis. This is a case of fulminant COVID-19 pneumonia in a 53-yrold know diabetic and hypertensive, who had markedly elevated C-reactive protein and D-dimers and low lymphocyte count during COVID-19 infection.

International Journal of Research in Medical Sciences, 2021

Background: Contraception is key to the reduction of maternal mortality. Tubal ligation is a good... more Background: Contraception is key to the reduction of maternal mortality. Tubal ligation is a good option for women seeking out a safe, effective, permanent and convenient form of contraceptive. However, due to variety of reasons, there is aversion to it especially in developing world. The objective of this study was to determine the trends, uptake, socio-demographic characteristics of acceptors, indications and complications of bilateral tubal ligation (BTL) in our environment. Methods: A retrospective study of BTL at UATH was conducted over a five year period, from 1 January 2015 to 31 December 2019. The records of women who had BTL were retrieved from the medical records department, family planning clinic, and the theatre. The data was analyzed using SPSS 21. Results: The mean age and parity were 36.0±4.0 and 5.0±2.0 respectively. The incidence of BTL was 1.3%. Majority of those that had BTL had at least secondary level of education 100 (83.4%) and 58 (48.3%) were grand multiparou...

Nigerian Medical Journal, 2016

inconsistent or incorrect use of effective contraceptive methods 2 although pregnancy unintendedn... more inconsistent or incorrect use of effective contraceptive methods 2 although pregnancy unintendedness is seen as a complex concept as pregnancy intentions are increasingly viewed as encompassing effective cognitive, cultural, and contextual dimensions. 1,4 The cost of unintended pregnancy is high because the woman has an option of either carrying the pregnancy to term and keep the baby, decide for an adoption, or have an induced abortion. 5,6 Nigeria has restrictive abortion laws and that can compound the problem of unintended pregnancies. Births that are unintended by the mother are INTRODUCTION Unintended pregnancies are pregnancies that are either unwanted (i.e., they occur when no children or no more children are desired) or mistimed (i.e., they occur earlier than desired). 1,2 Unplanned pregnancy is a concept related to unintended pregnancy. It is said to occur either when a woman used a contraceptive method or when she did not desire to become pregnant but did not use a method. 1 In contrast, pregnancies are described as intended if they are reported to have happened at the right time or later than desired (because of infertility or difficulties in conceiving). 1,3 Unintended pregnancy mainly results from lack of,