Federal Teaching Hospital Gombe Research Articles

The prevalence, risk factors and the management outcome of placenta praevia at Federal Teaching Hospital Gombe: A 5-year retrospective study

Background: Placenta praevia is one of the main causes of antepartum haemorrhage, which may be associated with severe maternal and perinatal morbidity and mortality, especially in developing countries. This study aimed to evaluate the prevalence, risk factors and the feto-maternal outcome of placenta praevia among patients managed in Federal Teaching Hospital Gombe, Northern Nigeria. Methodology: This was a retrospective study where all cases of placenta praevia managed in Federal Teaching Hospital Gombe, over 5 years, from January 1st 2017 to December 31st 2021 were analyzed using SPSS V 20. Results: There was a total of 11,937 deliveries during the study period and 63 cases of placenta praevia were managed, giving an incidence of 1.9%. Also, a total of 2,907 Caesarean deliveries were done during this period, and placenta praevia cases contributed 2.2% of the CS. About half of the cases also (47.4%) were asymptomatic and diagnosed incidentally with routine ultrasound scan while painless vaginal bleeding (32.2%) and warning bleeds (20.4%) were the other noted symptoms. The commonest risk factors noted in this study were previous dilatation and curettage (28.6%), previous CS and multiparity (22.6%) each. The fetal complications noted in this study were low birth weight (13.2%), birth asphyxia (10.3%) and 2.9% had intrauterine fetal death. Maternal complications were postoperative anaemia 55.4%, shock 7.7%, and 1.5% had peripartum hysterectomy. There was no maternal mortality noted in this study. Conclusion: Placentae previa is fairly common at our Centre and associated maternal and perinatal morbidities. Therefore, routine late obstetric ultrasound scan should be performed to diagnose it in women with risk factors so that they can receive optimal care.

Duffy Red Cell Antigen Phenotype among Indigenous Pregnant Women attending Antenatal Clinic at Federal Teaching Hospital Gombe, Nigeria.

Background and Objectives: Duffy (FY) blood group system is implicated in transfusion incompatibilities and haemolytic disease of the foetus and newborn. The primary objective was to determine the Duffy phenotype among the indigenous pregnant women in Gombe, Gombe State, Nigeria. Materials and Methods: This was a cross sectional study where simple random sampling was employed on consented participants. Two hundred and fifty nine pregnant women attending antenatal clinic at Federal Teaching Hospital Gombe were randomly recruited into the study. Three milliliters (3mls) of blood was taken, and Duffy antigens typed by standard tube technique (LORNE LABORATORY UK). Results: Among the Indigenous tribe, the percentage of Fy(a+b+) was seen in 2.2% of Fulani and 3.4% of Tangale, Fy(a+b-) phenotype was seen in 4.3% of Tangale, 6.8% of Fulani,9.5% of Tera, 10.3% of Hausa and 10.5% of Waja. Fy(a-b+) phenotype was seen in 5.3% of Waja, 7.6% of Fulani,8.7% of Tangale, 9.5% of Tera and 12.5% of Bolawa. Fy(a-b-) phenotype was seen in 2.4% of Tula,6.4% of Bolawa,7.3% of Waja, 7.8% of Tera, 17.8% of Tangale, 11.8% of Hausa and 46.5% of Fulani. 84.6% of the study population had the null Duffy phenotype. Conclusion: The research showed the phenotypic distribution of Duffy blood group among the study participants with relatively high percentage of null Duffy phenotype hence possible risk of alloimmunisation.

Utility of rapid antigen detection test in group A ß-haemolytic streptococcal pharyngitis at a tertiary hospital, Gombe, North-East, Nigeria

Background: Throat swab cultures still remain the gold standard for the confirmation of Group A Streptococcal (GAS) pharyngitis but Rapid Antigen detection Test (RADT) are increasingly becoming popular. Recent studies show RADT can be as sensitive and specific as the throat swab culture. This study aimed to determine the utility of RADT in the diagnosis of GAS pharyngitis in children at the Federal Teaching Hospital Gombe. Methods: A cross-sectional study that included 324 children aged 3- 18 years presenting with sore throat at the out-patient department, consecutively recruited between April and September 2018. Socio-demographic and clinical findings were document. Throat swab samples were taken for RADT using Encode strep A Rapid antigen test and culture on 5% sheep blood agar. The sensitivity, specificity and positive and negative predictive values of the RADT was determined against throat swab cultures, which is the gold standard. CC –BY 4.0 Results: There were 190 (58.6%) females and Male to Female ratio of 1:1.4. The mean age was 8.3± 3.9 years. Only 125 (38.6%) of the participants were from low social class and 162 (62.3%) are from overcrowded households. Sociodemographic factors have no effect on the performance of the RADT, however, the use of antibiotics within 2 weeks prior to presentation significantly affected the performance of the RADT 1.4% (1/64) compared to 28.1% (73/260) for those without prior antibiotics use p<0.001. GAS was isolated in 73 (28.1%) of the children with pharyngitis. The RADT had sensitivity and specificity of 84.6% and 96.2% respectively and a PPV and NPV of 90.4% and 93.6% respectively. Conclusion: The RADT is reasonably sensitive and specific and can be used in the diagnosis of GAS pharyngitis in clinics as a substitute for throat swab cultures.

Diagnostic value of rapid test for malaria among febrile neonates in a tertiary hospital in North-East Nigeria: a prospective cross-sectional study

ObjectiveThe WHO recommends testing using microscopy or rapid diagnostic test (RDT) before treatment for malaria. However, the use of RDT to diagnose neonatal malaria has not been widely validated with...

Maternal and Newborn Morbidity in Federal Teaching Hospital Gombe, North-East, Nigeria

Background: Efforts are being made to promote mother and child survival by reducing the high rate of maternal and newborn morbidities in developing nations, particularly in sub-Sahara Africa. The study was designed to find the pattern and associated factors of maternal and newborn morbidities in Gombe, northeast Nigeria test. Materials and Methods: Patients were prospectively interviewed with the use of a structured questionnaire and medical case records were also reviewed. Data obtained was entered into SPSS version 21 for analysis. Results: A total of 250 women were studied. Most (53.6%) were aged 26–35 years. The majority (97.2%) were married. Most (40.0%) were unemployed and of the Fulani ethnicity (36.4%). Urban dwellers were in the majority (55.2%). Approx. 78% had at least a secondary level of education. Most (64.4%) were multiparous, had 2 or more living children (72%), and 76% with less than 8 ANC visits. Distribution of MOD showed C/S (52.4%), SVD (36%), and Instrumental delivery (1.6%). Maternal morbidity was recorded in 22% with PPH (47.3%), Genital injury (30.5%), and Genital sepsis (16.4%) most common. Newborn morbidity was recorded in 23.6% with neonatal asphyxia (25.4%), neonatal jaundice (25.4%), and LBW (22%) most common. Women who had less than 8 ANC visits (p = 0.05) and underwent instrumental delivery (p = 0.002) were more likely to suffer morbidity. Those who had Caesarean Section were less likely to have a maternal morbidity (p = 0.002). Whereas, neonates born to primiparous women were more likely to suffer a morbidity (p = 0.042). There was no significant relationship between number of ANC visits (p = 0.512) and MOD (p = 0.680). Conclusion: PPH, genital injuries, and genital sepsis were the commonest maternal morbidities while Neonatal asphyxia, jaundice, and LBW were commonest in the newborn. Less than eight ANC visits and instrumental delivery increased the likelihood of maternal morbidity, while delivery to primiparous mothers increased the likelihood of newborn morbidity. Campaign for adequate antenatal care clinic visits should be sustained and when indicated cesarean delivery should not be denied to women. Accouchers must be trained in the usage of instrumental deliveries to reduce morbidities associated with it.

Evaluation of outdoor background ionizing radiation level around radiological sections in Federal Teaching Hospital Gombe, Gombe State Nigeria

This study presents the results of ambient radioactive radiation, radiation health hazard indices and excess lifetime cancer risk estimation around radiological sections in Federal Teaching Hospital Gombe, Gombe State, Nigeria using a well calibrated Rados-200 meters and a Global Positioning System (Garmin 765). The mean annual outdoor equivalent dose of 0.078 mSv/y. was measured. Mean annual outdoor effective doses of 0.1358 mSv/y. and 0.0950 mSv/y. were computed respectively, that were less than 1 mSv/y. maximum recommended limit for general public. The mean outdoor ELCR values of 0.3330 x10-3 was also estimated. The results though below the world’s average, are comparable with those of some other locations similar to the study area.

Provider-identified barriers to performance at seven Nigerian accident & emergency units: A cross-sectional study.

Nigeria hosts much of Africa's morbidity and mortality from emergency medical conditions. We surveyed providers at seven Nigerian Accident & Emergency (A&E) units about (i) their unit's ability to manage six major types of emergency medical condition (sentinel conditions) and (ii) barriers to performing key functions (signal functions) to manage sentinel conditions. Here, we present our analysis of provider-reported barriers to signal function performance. 503 Health Providers at 7 A&E units, across 7 states, were surveyed using a modified African Federation of Emergency Medicine (AFEM) Emergency Care Assessment Tool (ECAT). Providers indicating suboptimal performance ascribed this performance to any of eight multiple-choice barriers [infrastructural issues, absent and broken equipment, inadequate training, inadequate personnel, requirement of out-of-pocket payment, non-indication of that signal function for the sentinel condition, and hospital-specific policies barring signal function performance] or an open-ended "other" response. The average number of endorsements for each barrier was obtained for each sentinel condition. Differences in barrier endorsement were compared across site, barrier type and sentinel condition using a three-way ANOVA test. Open-ended responses were evaluated using inductive thematic analysis. Sentinel conditions were Shock, Respiratory Failure, Altered Mental Status, Pain, Trauma, and Maternal & Child Health. Study sites were the University of Calabar Teaching Hospital, the Lagos University Teaching Hospital, the Federal Medical Center, Katsina, the National Hospital Abuja, the Federal Teaching Hospital Gombe, the University of Ilorin Teaching Hospital (Kwara), and the Federal Medical Center Owerri (Imo). Barrier distribution varied widely by study site. Just three study sites shared any one barrier to signal function performance as their most common. The two barriers most commonly endorsed were (i) non-indication of, and (ii) insufficient infrastructure to perform signal functions. A three-way ANOVA test found significant differences in barrier endorsement by barrier type, study site and sentinel condition (p<0.05). Thematic analysis of open-ended responses highlighted (i) considerations disfavoring signal function performance and (ii) lack of experience with signal functions as barriers to signal function performance. Interrater reliability, calculated using Fleiss' Kappa, was found to be 0.5 across 11 initial codes and 0.51 for our two final themes. Provider perspective varied with regards to barriers to care. Despite these differences, the trends seen for infrastructure reflect the importance of sustained investment in Nigerian health infrastructure. The high level of endorsement seen for the non-indication barrier may signal need for better ECAT adaptation for local practice & education, and for improved Nigerian emergency medical education and training. A low endorsement was seen for patient-facing costs, despite the high burden of Nigerian private expenditure on healthcare, indicating limited representation of patient-facing barriers. Analysis of open-ended responses was limited by the brevity and ambiguity of these responses on the ECAT. Further investigation is needed towards better representation of patient-facing barriers and qualitative approaches to evaluating Nigerian emergency care provision.

Correlation of Entrance Skin Dose with Body Mass Index of Patients Undergoing Routing X-Ray Examination at Federal Teaching Hospital Gombe, North-Eastern Nigeria

This study was conducted to assess the amount of dose received by patients undergoing routine x-ray examinations at Federal Teaching Hospital, Gombe in Gombe State, Nigeria. Entrance skin doses (ESDs) for different kinds of x-ray procedures, include Posterior Anterior (PA) and Lateral (Lat) chest, Anterior Posterior (AP) Abdomen, AP pelvis, AP and Lat lumber spine and PA and Lat skull were assessed using standard exposure parameters. Data were obtained from eighty (80) patients who were exposed to diagnostic X-ray during their regular X-ray examinations. The patients’ age ranged from 1 to 80 years, while the weight was between 20kg and 100kg and height of these patients was between 95.0cm and 171cm. The skin dose of each patient was evaluated using a formula, based on the radiographic exposure parameters of kVp, mAS, SSD, the X-ray tube and the total filtration of the beams. The mean entrance skin dose ranged from 0.016 mGy to 3.168 mGy. Eventually, the ESDs measured for these x-ray procedures were found to be below the maximum permissible limits set by Nigeria Basic Ionizing Radiation Regulation and all the examinations conducted showed that there is a good correlation between the entrance skin doses and body mass index for the studied subjects. This implies that patients with higher body mass index will received more dose than the patients with low body mass index.

Mother’s Satisfaction with Delivery Services and Intended Future Utilization at Federal Teaching Hospital, Gombe, North-Eastern, Nigeria

Background: Maternal death reduction could be achieved through the utilization of hospital delivery services. In Nigeria, unfortunately delivery in health facilities where skill birth attendants exist is reported to be only 39%. Maternal satisfaction with hospital services will encourage utilization. Aim of the study: The study was designed to assess the satisfaction of mothers’ and their intention to utilize delivery services in subsequent pregnancies at the Federal Teaching Hospital Gombe, North-East, Nigeria. Methods: This was a descriptive, cross-sectional study conducted at the postnatal ward of the hospital amongst 250 women within 48 hours after childbirth. Data was collected with the use of a pretested, semi structured questionnaire and analysis done with SPSS statistical software version 25. Results: Overall satisfaction with delivery services was 84.4% with only 15.6% dissatisfied. Total satisfaction with the cleanliness of the facility was 92.8%, interpersonal relationship 84.8%, information provided 74.4% and technical aspects of care 82.8%. As many as 78.4% of women will utilize the facility in future for delivery services. The major reason amongst this category being satisfaction with services (76.5%). Those who do not intend to utilize facility in the future were 21.6% amongst which 27.8% gave reasons as completed family size and only 22.2% would not because of dissatisfaction. Satisfaction was only statistically related to ethnicity (P value=0.02) and none amongst obstetric variables tested. Conclusion: Majority of the women were satisfied with delivery services rendered and would utilize the facility in the future. There is need to sustain and further improve upon the quality of services.

The Outcomes of Trabeculectomy Surgery among Patients at Makkah Specialist Eye Hospital Bauchi Nigeria

Trabeculectomy remains the world’s gold standard and the main therapeutic intervention for controlling moderate to advanced glaucoma in Nigeria due to the expensive anti-glaucoma drugs as well as the unavailability of facilities to carry out minimal invasive glaucoma surgery (MIGS). There is still limited knowledge of the outcome of trabeculectomy surgery in northeastern, Nigeria. To determine the outcomes of trabeculectomy surgery regarding lowering post-operative Intra Ocular Pressure (IOP), preserved visual acuity (VA) as well as a preserved functional vision among glaucoma patients attending Makkah Specialist Eye Hospital Bauchi (MSEHB). A retrospective trabeculectomy surgery data search of operating theatre records was done to collect the outcomes from January 2021 to January 2023. Patients who have undergone trabeculectomy with a minimum follow-up of 6 months were included in the study. The criteria for a good outcome were post-operative IOP of less than 22mmHG or at least 30% reduction from pre-operative levels, and a preserved aided VA. A visiting consultant from the Ophthalmology Department of Federal Teaching Hospital Gombe performed the trabeculectomy surgeries. A total of fifty-two eyes of 50 patients having a postoperative follow-up of six months were included in the study. The mean age at presentation was 54.10(± 13.02) years. On the last day before surgery, the mean Snellen VA was 0.37(± 0.36) but became 0.40(± 0.36) post-operatively, p = 0.01, mean cup-to-disc ratio (CDR) was 0.86(± 0.12) but changed to 0.87(± 0.12) p = 0.79 at six months after surgery. Complete success, qualified success (with postoperative anti-glaucoma eyedrops), and failure of trabeculectomy (even with postoperative anti-glaucoma eyedrops) were 47(90.40%), 4(7.70%), and 1(1.90%), respectively. Based on the IOP, the complete success rate of trabeculectomy was 90.40%. The mean preoperative Snellen VA was improved by about half a line, six months after surgery and there was a significant reduction of IOP from its baseline. These outcomes will revolutionize our approach to the referral of suitable candidates for this surgical procedure as well as assure post-operative reserved vision.

L- Arginine and Nitric Oxide Levels Among Children with Sickle Cell Disease Presented With Vaso-Occlusive Crisis in Federal Teaching Hospital Gombe, North Eastern Nigeria.

Aim: The Aim of This Study Is To Evaluate The Level Of L- Arginine And Nitric Oxide Levels Among Children With Sickle Cell Disease presented with vaso-occlusive crisis in pediatric department, Federal Teaching Hospital Gombe, North Eastern Nigeria. Methology: The area selected for this study was Federal Teaching Hospital (FTH), Gombe, Nigeria. Gombe State is located in the North- estern part of Nigeria. This study included 60 children aged 1-14 years with a confirmed HbSS electrophoretic pattern presented to the sickle cell clinic unit of Federal Teaching Hospital Gombe, Gombe State. About 5 millilitres of blood sample was collected from each subject aseptically using the venepuncture technique. The blood was collected into tubes containing dipotassium ethylenediamine tetra-acetic acid (K2EDTA) anticoagulant and the remaining samples was left undisturbed at room temperature and later centrifuged at 3000rpm for 5minutes to obtain clear non- haemolysed plasma. The plasma was transferred into sterile labelled test tubes and assayed (in batches) for l-arginine and Nitric Oxide. Results: This study included children with a confirmed HbSS electrophoretic pattern aged 1-14 years with mean age 7.4500 ±0.50613 years, Presented to the sickle cell clinic unit of Federal Teaching Hospital Gombe, Gombe State. There was a statistically significant difference between the baseline and post L-arginine supplementation. The L-arginine and nitric oxide were significantly higher post supplementation compared to baseline levels among sickle cell disease subjects with vaso-occlusive crisis (p= 0.001and 0.01 respectively).

Evaluation of Serum Cytokines Biomakers in HIV-Infected Subjects Before and After Commencement of Haart in Federal Teaching Hospital Gombe

The Human Immunodeficiency Virus (HIV) infection causes the acquired immunodeficiency syndrome (AIDS), which is a systemic disorder characterized by severe impairment and progressive damage of both cellular and humoral immune responses. The aim of this study is to evaluate the effect of long administration of HAART on haematological indices, immunological biomarkers, Biochemical and some cytokines in HIV infected subjects &nbsp;&nbsp;at federal teaching hospital Gombe. &nbsp;This is a cross sectional study carried out from May to December 2021 on 132 HIV infected adults. The design entails collecting pre and post blood sample after treatment with highly anti-retroviral treatment (HAART) for more than six months. Out of the 132 subjects studied, 66 were HIV sero-positive and these were the test group, while the remaining 66 were HIV Sero-negative drawn from client visiting blood bank of FTH Gombe to make voluntary donation and HIV Testing Unit (HTS) for Marital and Medical Certificate of Fitness Screening and served as control group. All the subjects were between the ages of 15 - 65 years and are aged matched with the control group. Demographic data was collected using structured questionnaire.&nbsp; The protocol entails collecting 9mls of venous blood from those who were seropositive for HIV 1 &amp;2 before commencement of HAART. This sample is designed pre- treatment sample and these individuals were followed up for 6 months and a second sample collection was done some were lost to follow up and so the attrition was compensated by also collecting blood samples from other HIV individual who had been on HAART for several years. 4ml was dispensed into EDTA bottle for Full blood count using ELIZA analyzer. P&lt;0.05 was considered as significant.The result of the analysis indicated that the mean±se of Interleukines-2 (IL-2) (pg/ml) and Interleukines -6 (IL-6) (pg/ml) parameters for the control group are 65.43 ± 3.37and 34.74 ± 1.20 respectively. The mean±se of the treatment naïve for IL-2 and IL-6 are 101.61 ± 16.47 and 14.63 ± 1.65 respectively. Also, the mean±se of the treatment/HAART for Interleukines-2 (IL-2) (pg/ml) and Interleukines -6 (IL-6) (pg/ml) are 67.43 ± 1.40 and 10.80 ± 0.45 respectively. The IL-2 significantly higher among treatment Naïve HIV infected participants when compared with treatment and control group with (p-value &lt; 0.05). The result is also shown in table 2.0 Above.From this work it is clear that all the cases in this regard, confirm the fact that Long-term HAART remarkably drops the viral load and inflammation in HIV positive&nbsp; subjects and shows&nbsp; that&nbsp; a&nbsp; low-level&nbsp; inflammation&nbsp; continues&nbsp; which probably leads to&nbsp; chronic inflammatory&nbsp; state, morbidity&nbsp; and mortality in this group of subjects among HIV positive patients in this part of Northern Nigeria despite the reported side effects

PREVALENCE OF MALARIA USING TWO RAPID DIAGNOSTIC TEST KIT IN THE DIAGNOSIS OF MALARIA IN GOMBE STATE, NIGERIA.

This study aims at evaluating the comparative diagnostic efficiencies of two commercially available kits in relation to microscopy in detecting Plasmodium falciparum HRP-2, a polyhistidine antigen in urine and blood of febrile patients for malaria diagnosis along with blood based RDTs. This was an observational study in which matched blood and urine from symptomatic patients were tested for malaria using two rapid tests, with microscopy as gold standard in the outpatient clinic of Federal Teaching Hospital Gombe, Gombe state North Eastern Nigeria were enrolled who presented with fever (≥37.5°C). Thick films were prepared, stained and examined for malaria parasite under the microscope using the oil immersion objective while urine samples as well as blood were taken and immediately tested using RDTs. &#x0D; With the blood smear microscopy as standard, the disease prevalence was 68.4% and sensitivity for the UMT and SD Bio line (Blood RDT) was 70.1% respectively. The RDT had a specificity of 96.3% as well as the positive and negative predictive values were 97.6% and 59.7% respectively. The rapid diagnostic kits showed moderate level of sensitivity compared with blood smear microscopy as they show considerable acceptable levels in the diagnosis of malaria.

Unsure Last Normal Menstrual Period among Pregnant Women in Low Resource Setting: The Experience from Federal Teaching Hospital Gombe, North-Eastern Nigeria

Background: The proper management of any pregnancy depends on the accurate determination of the gestational age. In resource constrained environment where imaging techniques may not be readily available, accessible and affordable, the knowledge of menstrual period is key. Unfortunately, some of the pregnant women at antenatal clinics do not know their last normal menstrual period (LNMP). Aim/Objectives: This research was designed to ascertain the proportion of women who do not know their LNMP and associated factors. Materials and Methods: This was a descriptive, cross-sectional study involving antenatal attendees at the booking clinic of the Federal Teaching Hospital Gombe. Data such as socio-demographics, knowledge of dates/associated factors and willingness to remember the menstrual period subsequently was collected through a structured questionnaire from 1st March to 31st August 2022 and analysis done with IBM® SPSS® statistical Inc., Armonk, New York, USA software version 25 for analysis. Qui-square used as a test of statistics and the results presented in charts, graphs and tables. Results: Out of the 350 respondents 181(51.7%) knew their LNMP, while 169(48.3%) did not know. However, as much as 70.6% of the respondents knew that LNMP is used to date pregnancy. Reasons for not knowing dates included; not just keeping records of dates (25.4%), ignorance of Gregorian calendar (13.0%), on contraceptives when pregnancy was identified (10.7%), no reason (8.3%), was breastfeeding (6.5%), among several others. Surprisingly, 32% did not know the problems that may arise due to ignorance of LNMP. Majority (90.0%) of the respondents are willing to remember their LNMP in the next pregnancy. Women ≤ 19years and ≥ 40 years (p=0.004), lower level of education (p=0.004), Grand-multiparity (p=0.035), more than 4 living children (p=0.02) and rural dwellers (p=0.001) were more likely not to know their LNMP. Conclusion: The study showed 48.3% of the women were ignorant of their LNMP. The associated factors were extreme of ages, low level of education, grand multi-parity, having more than 4 living children and rural place of residence. Going forward, majority of the women accepted to remember their LNMP.

Prevalence And Outcomes Of Eclampsia At Federal Teaching Hospital Gombe, Nigeria

Background: Eclampsia is a major contributor to maternal and perinatal morbidity and mortality. A periodic review of the prevalence and outcome of eclampsia in Federal Teaching Hospital, Gombe (FTHG) is needed to serve as a regular clinical audit with a view to improving patient care. Objective: The objective of the study was to determine the prevalence, maternal and perinatal outcomes of eclampsia at Federal Teaching Hospital Gombe (FTHG). Materials and Methods: This was a retrospective review of women managed with Eclampsia between 1st January 2012 to 31st December 2014. The case notes of the patients were obtained, and the information obtained was analyzed using SPSS (Statistical Package for Social Sciences) version 20. Information extracted included sociodemographic data and fetal and maternal outcomes. Results were represented as frequencies and percentages. Result: There were 5662 deliveries within the study period and 89 cases of Eclampsia giving a prevalence of 1.57%. The disease was most prevalent in teenagers (47.0%). Emergency caesarean section was used to deliver 31.3% of the women while 67.5% had vaginal delivery. Majority of the patients (85.5%) had an uneventful recovery and 14.5% (12) had one or more complications. There were two (2) maternal deaths, giving a case fatality of 2.4% and both occurred in patients with aspiration pneumonitis. Other maternal complications were 3.6% each had HELLP syndrome and PPH, 2.4% had renal failure and 1.2% each had Pulmonary edema and temporary loss of vision. Twenty-five (30.1%) had perinatal complications. Among them, 16.9% 14.5%, 13.3% and 9.6% suffered IUFD, low birth weight, prematurity and birth asphyxia, respectively. Seventeen (20.5%) babies had perinatal mortality. Conclusion: The prevalence of eclampsia is still high in Gombe and contributes significantly to maternal morbidity and mortality. The disease is common among teenagers with case fatality of 2.4%.

Complications Of Unsafe Abortion At The Federal Teaching Hospital Gombe, North-east Nigera: A 10 Year Review

Background: Complicated abortion is a major cause of maternal morbidity and mortality world-wide, the majority of which are due to unsafe induced abortions. This is particularly so in developing nations due to restrictive abortion laws and scarcity of post-abortion care services. Objectives: The objective of the study was to describe the nature of complications from unsafe abortions, associated factors, and its contribution to maternal mortality in the hospital. Materials and methods: This was a 10 year retrospective study of all complicated abortions admitted at the federal teaching hospital from 1st January 2010 to 31st December 2019. Data was extracted from the patients folders and analyzed. A proforma was used to obtain information on the nature and type of complication, factors associated with unsafe abortion and its contribution to maternal mortality during the period of the study. Chi-square was used to compare association with p value of less than 0.05 set for statistical significance. Results: Sixty-two cases of complicated abortions were admitted during the study period and 38.7% (24) were from unsafe induced abortions. The most common complication was hemorrhage (43.5%). Younger age was more associated with induced abortions-65.2% vs. 12.5% for ages 20-24 years and 30-34years respectively, 90.9% of those with induced abortions did not desire the pregnancy and 95% of the induced abortions were among singles ladies (p-value &lt;0.001). There were six (9.7 %) mortalities all of which were due to unsafe induced abortions (p-value 0.002). Conclusion: Complications of abortions continue to be a major contributor to maternal morbidity and mortality in Gombe, Nigeria. Most of the morbidities and mortalities occur in young and single women that had unsafe abortion.

Clinical Audit of Low Dose Prophylaxis Programme for Nigerian Children with Haemophilia

Introduction: The evidence of benefits for prophylaxis especially low dose prophylaxis is incontestable yet most children in developing countries as Nigeria do not have access to this treatment protocol.&#x0D; Aim: The aim was to audit the low dose prophylaxis treatment in Nigerian children with haemophilia.&#x0D; Methodology: A multicentre clinical audit of five haemophilia treatment centres; University of Nigeria Teaching Hospital Enugu, Lagos University Teaching Hospital, National Hospital Abuja, University of Port Harcourt Teaching Hospital Port Harcourt, and Federal Teaching Hospital Gombe. Eighteen children with mild-severe haemophilia were enrolled into low-dose prophylaxis treatment programme. The reduction of joint bleeding, improvement of joint function and Quality of Life (QoL) during prophylaxis were analysed.&#x0D; Results: In total 18 children - 17males and 1 female (median age 8 years) were enrolled. The median duration of observation was 7 months (range 3-15months). Seven of the children were on primary prophylaxis (41%) while 10 of the children (59%) were on secondary prophylaxis. The number of joint bleeds decreased from a total of 162 (individual range 5-20, mean 10.3) to 42 (range 0-7, mean 3.0) during the observation period with an overall reduction of 74%. Joint function improved in 94.1% of disease joints, while only 5.6% reported no improvement (due to poor compliance). School attendance improved in all subjects, sports participation and daily activity improved moderately.&#x0D; Conclusion: Low dose prophylaxis was beneficial in reduction of joint bleeds, improvement of joint function and improvement of QoL of Children with haemophilia in Nigeria.&#x0D; &#x0D; Authors&#x0D; T U Nwagha 1, H C Okoye 1, C E Udo 2, S Yuguda 3, K I Korubo 4, T A Adeyemo 5&#x0D; &#x0D;

Assessment Of Job Satisfaction Among Doctors And Nurses Of Federal Teaching Hospital Gombe, Northeast Nigeria

Background:Job satisfaction refers to how people feel about their jobs and the different aspects of their jobs. Job satisfaction has been associated with benefits that range from giving an employee the motivation to work, improving the performance of employees, efficiency, commitment, and reduction of burnout level. Job satisfaction is an important determinant of productivity and effective service delivery in the workplace. Objective:To assess the level of job satisfaction, factors associated with it and the difference in job satisfaction between doctors and nurses in Federal Teaching Hospital, Gombe, Nigeria Methodology: A cross-sectional descriptive study was carried out among doctors and nurses of the federal teaching hospital Gombe. A Cluster sampling technique was implored to select the study participants. Data was collected using a semi-structured, self-administered questionnaire. The questionnaire was divided into two sections; socio-demographic data and evaluation of job satisfaction which has five domains (general satisfaction, opportunity to develop and responsibility, patient care, time pressure, and staff relation). Results were presented in the form of tables, and charts and described using mean and standard deviation. The analysis was carried out using the statistical package for social sciences (SPSS) program. The level of job satisfaction was measured on a five-point Likert scale. The association between the independent variable with overall job satisfaction was then determined using the chi-square test, taking p-value &lt;0.05 to be statistically significant. Results: The mean age, length of service, and working hours were found to be 35.6±8.7 years, 8.2±5.9 years, and 8.5±1.9 hours respectively. Only 37.1% of the respondents were nurses, and 62.9% of the respondents were doctors. The study showed that the overall job satisfaction of respondents was 90.0%, of which 82.7% of respondents were satisfied with the general aspect of their job. The study also found that job satisfaction amongst nurses and doctors was associated with younger age and shorter working hours per day with p values of &lt;0.001 and 0.002 respectively. Conclusion: Job satisfaction among the doctors and nurses in this study is high. The younger staff and those working shorter hours daily are more satisfied with their jobs. We recommend that the daily working hours should also be reviewed and those working longer hours be compensated for the additional hours done daily

Sero-Prevalence of Human T-Cell Lymphotropic Virus (HTLV) Among Blood Donors Attending Federal Teaching Hospital Gombe State, Nigeria

Sero-Prevalence of Human T-Cell Lymphotropic Virus (HTLV) Among Blood Donors Attending Federal Teaching Hospital Gombe State, Nigeria

Bacterial Blood Isolates in Children: Conventional vs. Bactec Automated Blood Culture System in a Tertiary Health Centre in Gombe, North East Nigeria

Background/Aim: Blood culture is critical in the diagnosis and treatment of blood stream infections (BSIs) especially in children. BSIs are among the most common cause of morbidity/mortality and blood culture has remained the gold standard for diagnosis. We sought to compare Blood Culture Isolates (BCI) from conventional and Bactec automated blood culture system (ABCS) among paediatric patients at the Federal Teaching Hospital Gombe (FTHG) Nigeria. Methods: BCI in children (0 - 18 years) by conventional method from 2008-2012 and Bactec Automated culture system from 2015-2020 were retrieved from the clinical microbiology laboratory register. Information analyzed included, age, sex, month, and year and blood culture isolates. Results: There were 5276 (56.9% males, 43.1% females) and 1169 (54% males, 46% females) Blood Culture Isolates by CM and ABCS respectively. Overall positive culture isolates were 9.7% (515/5276) in CM and 45.9% (536/1169) in ABCS (p = 0.01). Positivity rate in newborn was 13.3% (282/2114) by CM and 40.9% (219/263) by ABCS p = 0.01; under-5 was 10.5% (448/4253) vs. 37% (359/873) (p = 0.01); Gram positive 32.6% (172) vs. 65% (759) (p = 0.01; Gram negative 55% (2910) vs. 34% (397) (p = 0.01). Staph aureus 22% (114/515) by CM vs. 61.9% (332/536)) by ABCS (p = 0.01); Klebsiella 24.9% (128/515) by CM vs. 7.5% (40/536) p = 0.01) in ABCS, E. coli 8.9% (46/515) vs. 2.1% (11/536) p = 0.01; Proteus vs. 1.1% (6/515) by ABCS, Pseudomonas 3.3% (17/515) vs. 5.6% (30/536) p = 0.05, Alkaligenes 1% (5/515) vs. 8.2% (44/536) p = 0.01 and Citrobacter 1% (5/515) vs. 8.4% (45/536) p = 0.01. Conclusion: Blood culture yield was five times higher with Bactec compared with Conventional method.