Objective: To document our experience on the use of Jadelle/Implanon contraceptives that was recently introduced into Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria. It is pertinent to generate data on the experiences in the use of this contraceptive in a cross sectional study within Zaria, Northern Nigeria. Method: Data on consecutive clients that accepted Jadelle/ Implanon from June 2009 to November 2013 at ABUTH were extracted from their cards and analyzed using SPSS version 17. Out of a total of 11,502 clients that were for contraception during the period under review, 798 accepted Jadelle/Implanon accounting for 7% of the total clients. All the clients were married. About 67.8% were Muslims while 27.2% were Christians and 5% belong to other sect. 4140 (36%) had tertiary education. Most of the client has been on one form of modern contraception; only 16% were first time users who accepted implant after counselling. 37% of the clients are full time housewives. The discontinuation rate was found to be 26% for Jadelle and 19% for Implanon. No pregnancy was recorded during this period. Conclusion: Jadelle/Implanon account for 7% of contractive uptake and a high discontinuation rate was found among the users.
Background:Method of testing clinical competence of medical students in this setting has been controversial. This report evaluates the perceptions and preferences of 5th and 6th year medical students about traditional clinical examination (TCE) and objective structured clinical examination (OSCE).Materials and Methods:A cross-sectional study using a structured questionnaire, administered to 156 students, who had been previously exposed to TCE and OSCE.Results:There were 110 (70.5%) males and 46 (29.5%) females, with median age group of 26–30 years. One hundred and thirty-one respondents (84%) felt TCE is more difficult and 20 (12.8%) felt OSCE was more difficult. One hundred and forty-two (91%) felt OSCE was easier to pass, 8 (5.1%) felt TCE was easier to pass and 6 (3.8%) were undecided. Majority of the 5th and 6th year students (95.5% and 100%, respectively) preferred OSCE for assessment. In relation to validity and reliability of OSCE, 124 (79.5%) of all the students felt it provides a true measure of essential clinical skills, 130 (83.3%) felt its scores are standardised, 143 (91.7%) felt it is a practical and useful experience and 135 (86.5%) felt students’ personality, ethnicity and gender will not affect OSCE scores. Overall, there were no significant differences in preference and perceptions between 5th and 6th year students and between males and females.Conclusion:Students preferred OSCE as method of assessing clinical competence and considered it a more valid and reliable method of examination.
The effectiveness of low-dose regimen of magnesium sulphate appeared comparable to the 'standard dose regimen'. Low-dose regimen may guarantee more safety and in an environment (such as ours) where cost is an important determinant of accessibility to qualitative health services, it is certainly attractive. More studies are needed to establish the place of low-dose regimen of magnesium sulphate in the management of eclampsia.
Background:In spite of knowledge of the causes and prevention of cervical cancer, screening programs for cervical cancer have not yet been fully implemented in most developing countries including Nigeria. Documented data on the prevalence of preinvasive cervical lesion in pregnancy are scarce in our environment.Objectives:To determine the prevalence, risk factors, and course of preinvasive cervical lesion in pregnant women attending an antenatal clinic in Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Northern NigeriaStudy Design:This was a cross-sectional longitudinal study.Setting:The study was conducted in an antenatal clinic of ABUTH Zaria.Materials and Methods:A prospective cross-sectional longitudinal analysis was carried out at an Antenatal Clinic of ABUTH Zaria, Nigeria. A total of 250 consecutive pregnant women who fulfilled the inclusion criteria and have given their consent were recruited into the study at the time of their first prenatal (booking clinic) visit for antenatal care. Data from the pregnant women were obtained using a pro forma to evaluate sociodemographic characteristics and risk factors for preinvasive disease. Conventional Papanicolaou smear was taken using the standard procedure. The cytopathologic findings of initial and postpartum Pap smear were documented in the pro forma. Prevalence, persistence, progression, and regression rates of preinvasive diseases were determined.Results:Out of the 250 pregnant women who had cervical cytology by Pap smear during the study, 15 had preinvasive cervical lesion, giving a prevalence rate of 6%; 13 (87%) were low-grade squamous intraepithelial lesion (LGSIL) while 2 (13%) were high-grade squamous intraepithelial lesion (HGSIL). Negative smears were seen in 158 women (63.2%). Inflammatory and other conditions of the cervix which are technically negative smears made up the remaining 30.8%. At postpartum follow-up of the 13 women with LGSIL, 2 (15.4%) became negative while persistence of the disease was observed in 9 (69.2%) of the cases. Two women with LGSIL were lost to follow-up. Of the two women with HGSIL, persistence of the disease was seen in one woman (50%) and regression of the disease was seen in the other woman. Risk factors that were found to be associated with preinvasive cervical lesion were age at coitarche <16 years, number of sexual partners since coitarche, and previous history of sexually transmitted infection and human immunodeficiency virus. Parity, smoking, and use of contraception were found not to be significant risk factors.Conclusion:Preinvasive lesion of the cervix is relatively common among antenatal clients in our center. Antenatal clients with HGSIL should have a repeat smear at the end of the puerperium before treatment. Routine Pap smear should be offered to all antenatal clients in our setting.
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