Annals of Clinical Sciences

IMPACT OF BOOKING STATUS ON MATERNAL MORBIDITY AND MORTALITY IN A NIGERIAN TERTIARY HOSPITAL

2025-10-04T22:44:01+00:00

Background: Booking status strongly predicts maternal health outcomes, particularly in developing countries. Women who are not registered for antenatal care (unbooked) frequently present late with complications and are a major contributor to adverse maternal outcomes. In this study, the impact of booking status on maternal complications and deaths at Delta State University Teaching Hospital (DELSUTH), Oghara, was assessed.

Methodology: We conducted a retrospective analytical study of case records of women who delivered at the Obstetric unit of the Delta State University Teaching Hospital and data were extracted on socio-demographic factors, obstetric history, complications and outcomes. Associations were examined using Chi-square test and predictors of adverse outcomes were determined using logistic regression

Results: Of the 508 women included in our study, 331 were booked and 177 were unbooked. Unbooked women had a higher rate of complication ((70.1% vs 32.9%, p < 0.001) and a significantly higher rate of maternal deaths (16.4% vs 0.6%) than the booked women. Compared to no formal education, participants with primary (AOR = 0.45, 95% CI: 0.23–0.91, p = 0.026) and secondary (AOR = 0.49, 95% CI: 0.31–0.80, p = 0.004) education had a lower odd of adverse maternal outcomes. In addition, postpartum haemorrhage (AOR = 3.031; 95% CI: 1.857–4.961; p < 0.001), hypertensive disorders (AOR = 3.04; 95% CI: 1.96–4.71, p < 0.001), and unbooked status (AOR = 5.18; 95% CI: 2.96–9.08, p < 0.001) correlated with maternal morbidity and mortality.

Conclusion: Unbooked pregnancies are a major cause of maternal morbidity and avoidable mortality and are highly correlated with poor maternal outcomes. Maternal morbidity and mortality can be significantly reduced by improving health education, lowering the costs of healthcare, expanding access to services, and promoting community involvement.

MORINGA OLEIFERA MITIGATES JEJUNAL MUSCARINIC, HISTAMINERGIC, AND ION CHANNEL DYSFUNCTION INDUCED BY CRUDE OIL-CONTAMINATED WATER

2025-10-22T19:05:54+00:00

Background: Crude oil ingestion has been reported to induce oxidative stress and impair gastrointestinal function. Moringa oleifera (MO), rich in vitamin C, polyphenols, and other antioxidant phytochemicals, may provide protective effects. This study evaluated the impact of crude oil-contaminated water (CCW) ingestion and MO supplementation on jejunal smooth muscle contractility in male Wistar rats.

Methodology: Adult rats (200–250 g) were randomised into four treatment groups: control, CCW-only (2.5 mL crude water), CCW+MO (2.5 mL crude water+250 mg/kg MO), and MO-only (250 mg/kg MO). Jejunal tissues were excised for isometric tension studies, with contractile responses assessed using calcium chloride (CaCl₂), potassium chloride (KCl), histamine, and acetylcholine (ACh). To identify underlying pathways, jejunal tissues were preincubated with atropine, nifedipine, glibenclamide, barium chloride, indomethacin, and L-NAME. Oxidative stress indices, including malondialdehyde (MDA), superoxide dismutase (SOD), catalase, and glutathione (GSH), were quantified.

Results: CCW ingestion significantly (p<0.05) elevated MDA while reducing SOD, catalase, and GSH activities. Functionally, CCW suppressed CaCl₂- and histamine-induced contractions but exaggerated KCl- and ACh-evoked responses, suggesting dysregulation of ion channels and muscarinic receptor signalling. Atropine and nifedipine markedly attenuated ACh responses in CCW tissues, implicating M2/M3 muscarinic receptors and L-type calcium channels in CCW-mediated dysfunction. In contrast, MO supplementation restored antioxidant enzyme activity, reduced MDA, and normalised jejunal responses to most agonists and reversed the effects of key blockers.

Conclusion: CCW impairs jejunal contractility through oxidative stress–mediated disruption of muscarinic, histaminergic, L-type calcium, and ATP-sensitive K⁺ channel pathways. MO supplementation provides antioxidant and smooth-muscle-protective effects, underscoring its therapeutic potential in mitigating crude oil–induced gastrointestinal toxicity.

PATTERNS AND INDICATIONS OF INTENSIVE CARE UNIT ADMISSIONS IN PATIENTS WITH NEUROLOGICAL AND NEUROSURGICAL CONDITIONS: A 5-YEAR RETROSPECTIVE ANALYSIS

2025-11-03T15:41:54+00:00

Background: Neurological and neurosurgical patients frequently require intensive care due to the risk of rapid deterioration. Understanding intensive care unit (ICU) admission patterns in this population is critical for planning and optimizing resource utilization. Our objective is to analyse demographic patterns, indications, and outcomes of ICU admissions among neurological and neurosurgical patients over a five-year period.

Methodology: A retrospective review of ICU admissions at the Lagos State University Teaching Hospital (LASUTH) between October 2019 and October 2024 was conducted. Data included demographics, primary diagnosis, indication for admission, length of stay, need for mechanical ventilation or vasopressors, and outcomes.

Results: Of the 1,118 ICU admissions over the study period, 263 (23.5%) were neurological/neurosurgical. Mean age was predominantly in the working-age group (18–60 years). Haemorrhagic cerebrovascular accident (CVA) (n=75, 28.524%) was the leading diagnosis, followed by traumatic brain injury (TBI) (n=64, 24.3%) and ischaemic CVA (n=51, 19.39%). The major indication for ICU admission was reduced consciousness requiring airway protection (76.4%). Mechanical ventilation was required in 88% and vasopressor support in 70%. Mortality was 38.40% (101 deaths), while 61.6% were discharged alive, with survival favouring younger patients.

Conclusion: CVA is the predominant reason for neuro-ICU admission. Mortality remains high, especially in older patients. Improved early referral systems, stroke awareness, and enhanced neurocritical care capacity are urgently needed in resource-limited settings.

ISELIN DISEASE: A RARE CAUSE OF LATERAL FOOT PAIN IN CHILDREN

2025-11-22T22:38:43+00:00

Iselin disease is a traction apophysitis at the base of 5^th metatarsal bone. It is due repetitive injury to the apophysis. It is an uncommon condition that affects children who are very active. Its’ being uncommon could stem from its benign nature and spontaneous healing and/or under-diagnosis. It is rarely reported and may remain undiagnosed or under-diagnosed without high index of suspicion by the attending physician. This is a case of a 9 year old girl, who presented with persistent pain in the lateral part of the left foot of 3 weeks’ duration. The pain disturbed her ambulation as well as her daily activities. Diagnosis was made from the plain radiograph, which revealed a longitudinally lying small bony fragment lateral to the base of the 5^th metatarsal bone. This is pathognomonic of Iselin disease. Conservative management was sufficient in the treatment of this condition

This case was presented to highlight this condition in our environment. Attending physicians should be aware of this condition. High index of suspicion should be entertained in children presenting with lateral foot pain.

CHRONIC PAIN IN OLDER ADULTS: A NARRATIVE REVIEW OF MECHANISMS, CHALLENGES, AND MANAGEMENT

2025-12-23T06:09:56+00:00

Background: Chronic pain affects many older adults, often leading to functional disability and mental health issues. Pain is commonly caused by neurodegenerative and musculoskeletal conditions, among others, impacting quality of life and daily activities. Older adults may experience changes in pain processing mechanisms, leading to altered pain perception. Chronic pain in the elderly is associated with an increased risk of dementia. This review aims to explore current research on chronic pain in older adults, including mechanisms, challenges, and potential treatments.

Methodology: A narrative review was conducted to explore the available evidence. The databases were searched using the keywords “persistent chronic pain”, “older adults”, “older adults population”, “incidence” “correlates perceived effect”, “pain management”, and “perceived effects.

Results: Chronic pain is a persistent discomfort that endures for three months or longer. Pain that persists for this duration signifies a transition from acute pain, which functions as a warning or protective mechanism, to a condition that may possess multifaceted underlying causes. In older adults, chronic pain is often associated with various medical conditions that can profoundly impact their quality of life.

Conclusions: Chronic pain becomes increasingly complex with age, influenced by factors such as institutionalization, altered pain thresholds, and varying impacts on pain coping, particularly among females. It may exacerbate neurodegenerative diseases and cognitive decline, diminishing the autonomy and quality of life in seniors, which healthcare professionals must consider. Chronic pain treatment in older adults includes pharmacological and non-pharmacological approaches.