Obstetrics. & Gynecology
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Item Comparative effectiveness of 50g glucose challenge test and risk factor based screening in detection of gestational diabetes mellitus in Ibadan, Nigeria.(2015) Bello, O. O.; Oluwasola, T. A. O.; Adeleye, J. O.; Adedapo, K. S.; Maxwell, O.; Odukogbe, A. A.Context: Gestational diabetes mellitus (GDM) complicates 3-5% of pregnancies. Prompt diagnosis helps to prevent its subsequent complications and one-step effective screening method is desirable for our environment. Objective: To compare the effectiveness of 50g glucose challenge test (GCT) with risk factors alone in screening for GDM. Study Design: Prospective study of booked, consenting pregnant women with no previous history of diabetes mellitus. Fasting sample of venous blood was obtained for plasma glucose, followed by administration of SOg oral glucose and collection of blood sample an hour later. The process was repeated after a week using 7Sg oral glucose; each patient serving as her own control. Threshold blood glucose of 140mg/dl was used for both post-ingestion tests. Statistical analysis was done using SPSS version 17. Results: All the seventy-nine study participants completed the 2 arms. Mean maternal and gestational ages at recruitment were 30.8+1.2 years and 24.2+1.6 weeks respectively. Among the respondent, 3S( 44.3%)were nulliparous while24(30.3%) had positive risk factors for GDM. The 50g GCT was abnormalin 10 patients (12.7%) while GDM was confirmed in 2 patients giving an incidence rate of2.5%. The 50g GCT was normal in 89.6% of women withnormat75g OGTT and it was more predictive of GDM (Positive Predictive Value, PPV -20%) compared to risk factors only (PPV-11.1 %). Conclusion: Using 50g GCT will enhance selection of patients for confirmatory test for GDM as compared to risk factors alone. It would therefore be of great benefit in this environment.Item Plasma C-reactive protein and selected nutritional indices in elective caesarean section(Journalgurus, 2009-04) Adedapo, K. S.; Nwobi, L. N.; Olayemi, O.; Aimakhu, C. O.; Ogunbode, O. O.; Akinboade, A. F.; Adeniyi, F. A. A.Context: Caesarean Section (CS) is a major surgical procedure, often performed when a vaginal delivery is considered unsafe. Objective: This study was carried out to understand the interaction between acute phase proteins and nutritional factors consequent to caesarean section. The knowledge of this interaction is important for successful management of these patients. Methods: Plasma samples from fifty (50) pregnant women booked for elective caesarean section in Ibadan, Nigeria were collected on the day preceding surgery, one day and four days post-surgery to determine the levels of CRP, vitamin C, PCV, Total protein, albumin and globulin (Glb) levels. Results: The mean age of the patients studied was 32.29 + 3.66 years, range; 24 39 years. Significant elevations were observed in the levels of TP, Glb and CRP one day post-surgery (1DPS) compared with baseline (BS) (7.36 + 1.46) vs 6.56±1.30, (4.68 + 1.33) vs 2.70±1.51, (111.43 + 68.89) vs 6.00 ± 13.27 respectively, while albumin reduced significantly (2.68 + 1.08) vs 3.87±0 .63. Similar changes were observed on day 4. There was no significant change in the levels of Vitamin C. Conclusion: One of the positive predictive indicators of good outcome after caesarean delivery is adequate nutrition.Item Prevalence of hepatitis B and C seropositivity in a Nigerian cohort of HIV-infected patients(2008) Otegbayo, J. A.; Taiwo, B. O.; Akingbola, T. S.; Odaibo, G. N.; Adedapo, K. S.; Penugonda, S.; Adewole, I. F.; Olaleye, D. O.; Murphy, R.; Kanki, P."INTRODUCTION:The clinical and public health implications of the convergence of the human immunodeficiency virus (HIV) epidemic and chronic viral hepatitis in sub-Saharan Africa are poorly understood. This study was designed to determine the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV), and the impact of co-infection on baseline serum alanine transaminase (ALT), CD4+ T lymphocyte (CD4) count, and plasma HIV-RNA (viral load) in a cohort of HIV-infected Nigerians. METHODS:A retrospective study was conducted, on eligible treatment-naive patients who presented between August 2004 and February 2007 to the University College Hospital (UCH), Ibadan, Nigeria. Demographic data and pre-treatment laboratory results (hepatitis B surface antigen (HBsAg), HCV antibodies (anti-HCV), ALT, CD4 count and viral load) were retrieved from the medical records. Fisher's exact, two sample t-tests, and the Wilcoxon rank sum tests were used to compare groups. A logistic regression model was fitted to explore characteristics associated with co-infection status. RESULTS:A total of 1779 HIV-infected patients (male: female ratio, 1:2) met inclusion criteria. HBsAg was present in 11.9%, anti-HCV in 4.8% and both markers in 1%. HBsAg was more common among males than females (15.4% vs 10.1%, respectively p = 0.001) while anti-HCV was detected in a similar proportion of males and females (5.3% versus 4.6%, respectively p = 0.559). HIV-infected patients with anti-HCV alone had a lower mean baseline CD4 count compared to those without anti-HCV or HBsAg (197 cells/mm3 vs 247 cells/mm3, respectively p = 0.008). Serum ALT was higher among patients with HBsAg compared to those without HBsAg or anti-HCV (43 International Units (IU) vs. 39 IU, respectively p = 0.015). Male gender was associated with HBV co-infection on logistic regression (OR1.786; 95% CI, 1.306-2.443; p < 0.005). CONCLUSION:More HIV-infected females than males presented for care in this cohort. We identified a relatively high prevalence of HBV and HCV co-infection in general, and a higher rate of HBV co-infection among males than females. Pre-treatment CD4 count was significantly lower among those with HCV co-infection, while ALT was slightly higher among those with HBV co-infection. Triple infection with HIV, HBV and HCV was present in a small but significant proportion of patients. These findings underscore the importance of testing for HBV and HCV in all HIV-infected persons in our setting."Item Utility of serum cystatin C as a predictive marker for preeclampsia in pregnant Nigerian women(Society of Gynaecology and Obstetrics of Nigeria (SOGON), 2019) Oluwasola, T. A. O.; Adedapo, K. S.; Odukogbe, A. A.; Olayemi, O. O.