Active management of third stage of labour: a survey of providers’ knowledge in southwest Nigeria

Background  

The disparity between current evidence and practice on active management of third stage of labour (AMTSL) demands assessment of providers’ knowledge on the subject.     

In vivo antimalarial activity of Vernonia amygdalina

Extracts from the leaves and root bark of Vernonia amygdalina are assessed for antimalarial activity against drug-sensitive Plasmodium berghei in mice. A standard inoculum of 1 x 10(7) infected erythrocytes is used, and leaf and root-bark extracts of 500 mg/kg, 250 mg/kg or 125 mg/kg are used in a four-day suppression test and a Rane test of established infection. Leaf extract produced 67% suppression of parasitaemia in the four-day test, while root-bark extract produced 53.5% suppression. These results are significant when compared to a placebo (P<0.001).     

Pregnancy, obstetric and neonatal outcome after assisted reproduction in Nigerians.

PURPOSE: To evaluate the pregnancy, obstetric and neonatal outcome after assisted reproduction in Nigerians. METHODS: Case control study of all confirmed pregnancies following assisted reproduction managed at the Havana Specialist Hospital (HSH), Lagos over a 7 year period. RESULTS: Adverse obstetric and neonatal outcome occurred in 30.8% of pregnancy following assisted reproduction compared to 12.6% in spontaneously conceived pregnancy (p = 0.0003). Multiple pregnancy (<0.001), preterm delivery (p < 0.000), placenta praevia (0.00002), antenatal admission (0.02), early pregnancy bleeding (0.04), miscarriage (0.001) and caesarean delivery (<0.001) were significantly commoner in the assisted reproduction group. After adjustment for confounding variables, preterm delivery (OR: 5.95), miscarriage (OR: 5.84), multiple pregnancy (OR: 4.58), placenta praevia (OR: 4.13), caesarean delivery (OR: 3.57), early pregnancy bleeding (OR: 2.18) and antenatal admission (OR: 2.01) retained their significance. CONCLUSION: This study has provided the first evidence from our part of the world showing that assisted pregnancy is associated with poorer obstetric outcome when compared with spontaneously conceived pregnancy.     

Comparison of two immunoassays in the determination of IGF-I levels and its correlation with oral glucose tolerance test (OGTT) and with clinical symptoms in acromegalic patients

The aim of our study was to evaluate two different methodologies in IGF-I levels determination, its correlation with GH nadir in OGTT <1 and <0.4?ng/ml and with clinical symptoms in acromegalic patients. We analyzed 37 patients. Sixteen patients had not undergone any kind of treatment (Group 1). Twenty-one patients underwent surgery as primary treatment, and after that, some of them another kind of treatment (except pegvisomant) (Group 2). Serum IGF-I levels were measured by Immulite-1000 (IMM) and by an immunoradiometric assay (DSL) and, GH by immunochemiluminometric assay. IGF-I levels by IMM and by DSL showed a significant difference. When we analyzed in both groups the concordance by crosstabs-Kappa coefficients, between different parameters, GH nadir <1 and <0.4?ng/ml with IGF-I by DSL and IMM showed concordance in group 1, but in group 2 only GH nadir <1 and <0.4?ng/ml had a weak concordance with IGF-I by IMM. When we analyzed clinical symptoms in the patients and, GH nadir <1 and <0.4?ng/ml and IGF-I levels by both methodologies, more than 90% of clinically active patients had abnormal GH response or/and elevated IGF-I levels in group 1, but less than 70% in group 2. In the 8 patients under medical treatment, GH nadir was higher than 0.4?ng/ml in all patients, and IGF-I levels were elevated in 8/8 by DSL and in 6/8 by IMM. In conclusion, discrepant GH and IGF-I levels in the diagnosis and follow-up of patients with acromegaly requires consideration of many factors that influence these parameters.