Haemostatic Disorders in Sickle Cell Disease Subjects in Nigeria: A Review of Literature | Chapter 02 | Emerging Research in Medical Sciences Vol. 2

Background: Sickle cell disease (SCD) is an autosomal recessive disorder that is characterised with chronic anaemia and painful crisis. SCD is associated with hypercoagulability or prothrombotic state that can predispose to thromboembolic complications with increasing morbidity and mortality.

Aim: This study aimed to show the various documented haemostatic disorders and possible thromboembolic complications among SCD subjects in Nigeria.

Methods: A comprehensive literature search was performed using the internet search engines linked to academic databases including Pubmed, Google Scholar, Ebsco, Hinari, Scopus, etc. Studies involving hemostatic disorders in Nigeria were thoroughly searched, and the references of such articles were also searched for any probable relevant information.

Findings and Conclusion: There is a paucity of information on this subject in Nigeria, and there are inconsistencies in the available studies.

Haemostatic disorders in sickle cell disease are conditions that are associated with increased mortality and morbidity. Further research on the level of natural anticoagulant is required to verify the correlation between haemostatic disorders and thromboembolic complications in SCD subjects in Nigeria

Author(s) Details

Dr. Kingsley Akaba (MBBch, FMCPath)
Department of Haematology and Blood Transfusion, University of Calabar Teaching Hospital, Calabar, Nigeria.

Dr. Marcus Inyama
Department of Haematology and Blood Transfusion, University of Calabar Teaching Hospital, Calabar, Nigeria.

Dr. Timothy Ekwere
Department of Haematology and Blood Transfusion, University of Uyo Teaching Hospital, Uyo, Nigeria.

Dr. Obinna Iheanacho
Department of Haematology and Blood Transfusion, University of Calabar Teaching Hospital, Calabar, Nigeria.

Dr. Ekpeyong Bassey
Department of Haematology and Blood Transfusion, University of Calabar Teaching Hospital, Calabar, Nigeria.

Ushie Godwin
Department of Haematology and Blood Transfusion, University of Calabar Teaching Hospital, Calabar, Nigeria.

Dr. Hogan Archibong
Department of Haematology and Blood Transfusion, University of Calabar Teaching Hospital, Calabar, Nigeria.

Efiok Efiok
Department of Haematology and Blood Transfusion, University of Calabar Teaching Hospital, Calabar, Nigeria.

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Indications for Gynaecological Consultation by Women at a Rural Outreach Centre in North-Central Nigeria | Chapter 11 | Current Trends in Disease and Health Vol. 2

Aims: To identify the reasons for consultations, the common clinical diagnosis and disease pattern at a rural gynaecologic outreach clinic.

Study Design: Descriptive Retrospective Study.

Place and Duration of Study: NKST Hospital Mkar-Gboko, Benue state, North-central Nigeria, in seven years (1st April 2005 to 31st July 2012).

Methodology: Information from the case notes of patients who attended the outreach clinic over the study period were retrieved and analysed. Majority of the patients came by self-referral.

Results: Of the 1,733 women that attended the clinic during the study period, 1,605 (92.6%) women made the inclusion criteria and formed the study population. The age range was 15 to 78 years; mean value of 33.6 +/- 9.5 year; 78% of the women were ages 21 – 40 years.  The mean parity was 2.1 +/- 2.7and ranged between 0 to 13 children.  68% of the women were para 0 – 2 whilst 18% had parity of 5 and above.  The women had 73 reasons and 2,390 presenting complaints, 49.6% of them had multiple presenting complaints (average 1.5 complaints per woman). Most common complaints were inability to conceive, lower abdominal pain and leaking of urine and /or faeces amongst 38%, 11% and 10% of the women respectively. There were 63 disease conditions with 1,793 clinical diagnoses. About 12% of the women had multiple clinical diagnoses.  The three leading clinical diagnoses were infertility, genital fistulae and uterine myoma, in 46%, 12% and 10% of the women respectively; followed by sundry other gynaecological disorders (9%) and medical disease conditions (5%) in which hypertension, diabetes mellitus and retroviral diseases were more frequent in that order.  Some women (n = 21; 1%) came for second opinion.

Conclusion: Gynaecological diseases are diverse and common among women in rural central Nigeria. Inability to conceive, lower abdominal pain and incontinence of urine and or faeces were the three main reasons women sought consultation with the gynaecologist at Mkar. Infertility, genital fistulae, uterine myoma, non-communicable medical disorders and retroviral diseases were leading clinical diagnoses. Extending the services of Gynaecologist to the rural areas in the region may reduce the access gap to women’s health and enhance national development.

Author(s) Details

Jonathan Abina Karshima
Department of Obstetrics and Gynaecology, Jos University Teaching Hospital, Jos, Nigeria.

Victor Chuwang Pam
Department of Obstetrics and Gynaecology, Jos University Teaching Hospital, Jos, Nigeria.

Terkaa Atim
Department of Surgery, University of Abuja Teaching Hospital, Gwalgwalada, Federal Capital Territory, Nigeria.

Philip Pine Abata
Department of Obstetrics and Gynaecology, Federal Medical Centre, Makurdi, Benue State, Nigeria.

Michael Ira Reich
Department of Obstetrics and Gynaecology, North Shore Medical Centre, Salem, MA, USA.

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