International Research Journal of Medicine and Medical Sciences

Number 4, 2014

73-78
Factors associated with miscarriage and perinatal mortality in women with HIV infection

Authors: Henrique Meirelles Boldori, Wendel Mombaque dos Santos, Izabel Cristina Hoffmann, Caroline Mombaque dos Santos, Francisco Maximiliano Pancich Gallarreta, Stela Maris de Mello Padoin and Sonia Maria Oliveira de Barros

Abstract

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Number of views: 426

The purpose of this study was to evaluate risk factors associated with miscarriage (defined as the interruption of pregnancy before the 20th week of gestation) and perinatal mortality (defined as fetal death from the 21st week of pregnancy until neonatal stage, occurring until the first week of life) in HIV-infected pregnant women. This retrospective, cross-sectional study included HIV-infected pregnant women from Brazil aged between 18 and 47 years, who had miscarriage, vaginal delivery, or delivery by cesarean section. Data on miscarriage or perinatal mortality, sociodemographic characteristics, clinical conditions, and treatment were obtained. Statistical analyses included the use of binary logistic regression. In this cohort, the prevalence of miscarriage was 6.1% and the perinatal mortality rate was 4.0%. Risk factors for miscarriage included drug use (OR = 6.23; CI = 0.5 to 73.1), multiple gestation (OR = 3.06; CI = 0.9 to 10.9), and lack of prenatal care (OR = 18.42; IC = 3.9 to 87.6). Moreover, risk factors for perinatal mortality included drug use (OR = 1.03; IC = 0.9 to 1.1), vaginal delivery (OR = 5.56; CI = 1.2 to 26.1), and the absence of antiretroviral use during labor (OR = 17.77; CI = 3.9 to 81.8). In order to reduce the rates of miscarriage and perinatal mortality in HIV-infected pregnant women, actions aimed at eliminating drug use during pregnancy, ensuring adequate prenatal care, performing elective cesarean section delivery, and using antiretroviral medications during labor should be prioritized. Keywords: Pregnant women, abortion, miscarriage, perinatal mortality, risk factors.

79-83
Evaluation of youths’ knowledge of voluntary counseling and testing in Anambra State, Nigeria

Authors: Christiana Okafor, Elkenah Ndie, Chinyere Okafor and C. H. Odira

Abstract

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Number of views: 405

This study aimed at determining youths’ knowledge of voluntary counseling in Anambra State of Nigeria. Questionnaire was used to collect data from 400 youths (15 to 29 years) that were selected using multi-stage, simple random and proportionate sampling. Data generated were analyzed using SPSS version 17. Findings from the study revealed that youths in Anambra state were aware (85.5%) of voluntary counseling and testing (VCT). The results also show that mass media (Radio/TV, Newspapers) provide highest information to the youths. 71.4% of the youths know the location of a VCT centers. It was concluded that the current method used in creating awareness about VCT services seems to be working. It was recommended that present method should be upheld and improved while health educators should carry the awareness campaign into primary schools to create more awareness about VCT services. Keywords: Youths, voluntary counseling and testing, knowledge of VCT.

84-90
Association of cytokine genes polymorphisms and the response to corticosteroid therapy in children with idiopathic nephrotic syndrome: A pilot study in Egypt

Authors: Hanan A. Madani, Hafez M. Bazaraa and Hanaa Rady

Abstract

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Number of views: 470

The pathogenesis of idiopathic nephrotic syndrome (INS) is associated with Th1 and Th2 cytokines imbalance. Cytokines act as mediators of inflammation in childhood NS. The objectives are to investigate the role of cytokine genes polymorphisms (IL6-G174C, IL4-C590T, and TNFα-G308A and the response to corticosteroid therapy in children with INS in Egypt. 90 children were included in this study, they divided into 3 groups: 30 children with steroid sensitive nephrotic syndrome (SSNS), 30 children with steroid resistant nephrotic syndrome (SRNS) and 30 age and sex matched healthy control children. Polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) were used to assess IL6-G174C, IL4-C590T, and TNFα-G308A polymorphisms. A significant association was found between the CC genotype and the C allele in IL6-G174C and INS group when compared to the control group (P = 0.003 and 0.009, OR = 4.3 and 2.67 respectively), also, they were significantly associated with SRNS compared to SSNS groups (P = 0.008 and 0.000, OR = 4.93 and 5.82 respectively). Also, TNF-α G308A AA genotype A allele were significantly associated with INS group compared to the control group (P = 0.045 and 0.014, OR = 3.5 and 3.51 respectively) and on comparing SRNS to SSNS groups TNF-α G308A A allele was only significantly associated with SSNS group (p = 0.032, OR = 2.83). IL4-C590T showed no significant difference in the genotypes or the allele distribution between the studied groups. In conclusion, IL6-G174C and TNFα-G308A polymorphisms may affect response to steroid therapy in childhood INS. Keywords: Idiopathic nephrotic syndromes, IL-4, IL-6, TNF-α gene polymorphism, steroid response.

91-97
Myths and facts on malaria: A pilot study of community oriented resource persons in rural communities in Anambra, South-east Nigeria

Authors: Arinze-Onyia SU, Ugwoke U, Aguwa EN, Modebe I, Nwobodo ED and Ilika A

Abstract

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Number of views: 441

Early access to diagnosis and effective treatment is one of the major strategies for reducing the burden of malaria. This is however negatively affected by myths and misconception about malaria. The present study aims at determining the prevailing myths and facts about malaria in a developing country. A cross sectional descriptive study was done in 2014 among 284 Community-Oriented Resource Persons in 3 rural communities in Anambra, southeast Nigeria using pre-tested semi-structured questionnaires and FGD (Focus Group Discussion) Guide. Of 284 participants, 204 (71.8%) were females. Majority (38%) fell within the age range of 31 to 40 years and most respondents (83.1%) were married with Christians accounting for 94.4% while those who had secondary education were 58.5%. Trading was the predominant occupation (52.5%). Almost 60% knew the actual cause of malaria. On the other hand, 57 (20.1%) believed malaria was caused by consumption of oil while 9 (3.2%) respectively identified excessive heat and physical stress as causes of malaria. Most identified the symptoms and route of transmission of malaria. Almost 86% believed malaria could be treated by use of orthodox drugs while the use of local herbs such as dogonyaro (4.9%) and removal of pins before hospital treatment (7.4%) were identified as ways of treating malaria. Respondents with primary education were significantly more likely (P < 0.05) to believe the myths than facts of malaria. In conclusion, knowledge of the facts and myths of malaria were high. However, knowledge in facts was significantly higher than belief in myths (2 = 135.46; P value = < 0.01). Respondents with higher educational status had better knowledge of the facts than myths of malaria. Keywords: Myths, facts, malaria, community resource persons, Nigeria.