Nigerian Medical Journal : Journal of the Nigeria Medical Association最新文献

{"title":"Demographics, Cost, and Sustainability of Haemodialysis among End-Stage Kidney Disease Patients in Southern Nigeria: A Single-Center Study.","authors":"Effiong E Akpan,&nbsp;Udeme E Ekrikpo,&nbsp;Emmanuel Edet Effa,&nbsp;Aniema I A Udo,&nbsp;Victor A Umoh","doi":"10.4103/nmj.NMJ_106_20","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_106_20","url":null,"abstract":"<p><strong>Context: </strong>Access to chronic hemodialysis for patients with end-stage kidney disease has improved over the years. However, it is unclear if this has resulted in lower cost and improved dialysis vintage.</p><p><strong>Aim: </strong>We aimed to assess the demographics, cost implication, and sustainability of maintenance hemodialysis in our cohort of end-stage kidney disease (ESKD) patients.</p><p><strong>Methods: </strong>Retrospective descriptive study of ESKD patients on maintenance HD from 2014 to 2018 using hemodialysis records. Time-to-HD discontinuation and reasons for discontinuation were recorded. Using Kaplan-Meier graphs, the time-to-dialysis discontinuation experience of the cohort was shown. Log-rank test was used to compare the experience between both genders. Univariable and multivariable Cox proportional hazard models were built to identify independent associations with time-to-dialysis discontinuation.</p><p><strong>Results: </strong>Over the 5-year period, 702 individuals initiated HD, males were older than females, the complete cohort contributed 65,714 person-days to the study and the median time-to-HD discontinuation was 10 days (interquartile range, 2-42). Females had a shorter time to HD discontinuation (8 days [1-32 days]) compared to males (11 days [2-48 days]). Only 28.5%, 15.3% and 8.3% of the patients had HD beyond 30, 90, and 180 days, respectively. About 128 (18.2%) had thrice-weekly HD. Most sustained the treatment for the 1^st week. Majority (98.4%) of the patients were presumed dead, while 4 (0.65%) were still alive and 6 (0.98%) had renal transplantation. All patients who discontinued dialysis did so for financial reasons. Multivariable Cox proportional hazards model showed that individuals who could afford dialysis more than once a week had reduced hazard of dialysis discontinuation.</p><p><strong>Conclusion: </strong>Most patients cannot sustain HD beyond a few weeks for financial reasons. Several cost containment strategies need to be deployed to bring down the cost of care.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":" ","pages":"307-311"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/21/ac/NMJ-61-307.PMC8040937.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38900170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Postcesarean Wound Infection in a Tertiary Hospital in Lagos, Nigeria.","authors":"Kabiru Afolarin Rabiu,&nbsp;Fatimat Motunrayo Akinlusi,&nbsp;Adeniyi Abiodun Adewunmi,&nbsp;Taiwo Ganiyat Alausa,&nbsp;Idayat Adejumoke Durojaiye","doi":"10.4103/nmj.NMJ_1_20","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_1_20","url":null,"abstract":"<p><strong>Background: </strong>There has been a global increase in cesarean section rates. While this has improved perinatal outcome, it is associated with complications such as wound infection. We determined risk factors for cesarean section wound infection in a tertiary hospital in Lagos, Nigeria.</p><p><strong>Materials and methods: </strong>We prospectively studied a cohort of 906 women who had cesarean section at the Obstetrics Unit of the Lagos State University Teaching Hospital between January 1, 2011, and December 31, 2011. A comparison was made between 176 women who had wound infection and 730 women who did not using logistic regression.</p><p><strong>Results: </strong>Of the 2134 deliveries during the study, 906 (42.5%) had cesarean section and of which 176 (19.4%) had wound infection. Independent risk factors for wound infection were: preoperative anemia (adjusted odds ratio [aOR] = 1.88; 95% confidence intervals [CI] = 1.03-3.41; <i>P</i> = 0.0396), presence of diabetes mellitus (aOR = 7.94; 95% CI = 1.60-39.27; <i>P</i> = 0.0111), HIV infection (aOR = 6.34; 95% CI = 1.74-23.06; <i>P</i> = 0.0051), prolonged operation time (aOR = 2.30; 95% CI = 1.19-4.42; <i>P</i> = 0.0127), excessive blood loss at surgery (aOR = 5.05; 95% CI = 2.18-11.66; <i>P</i> = 0.0002), and chorioamnionitis (aOR = 9.00; 95% CI = 1.37-59.32; <i>P</i> = 0.0224).</p><p><strong>Conclusions: </strong>Patients with HIV infection, diabetes mellitus, preoperative anemia and chorioamnionitis have an increased risk of postcesarean wound infection as is when surgical time exceeds 1 h or when associated with blood loss >11.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":" ","pages":"262-268"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/f8/NMJ-61-262.PMC7808289.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38854470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sideswipe Injury of the Knee: The New Face of an Old Foe?","authors":"Olugboyega Abimbola Oyewole,&nbsp;Ajibola B Oladiran,&nbsp;Tolulope O Ogunrewo,&nbsp;Richard Adelana Omoyeni","doi":"10.4103/nmj.NMJ_156_19","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_156_19","url":null,"abstract":"<p><p>The term \"sideswipe injury\" has become synonymous and used interchangeably with the term \"traffic elbow.\" However, with the continuous rise in the use of the tricycle as a means of public transportation in some developing countries, a rise in sideswipe injuries of various severities is being experienced. We report a case of sideswipe injury to the left knee region of a 45-year-old female who was a passenger in the backseat of a tricycle. She sustained a severe injury to the soft tissues and bones around the knee and the popliteal region, with disruption of the neurovascular bundles in the popliteal fossa necessitating an above-knee amputation.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":" ","pages":"288-290"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/6b/NMJ-61-288.PMC7808287.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38853408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed Tomographic Imaging Appraisal of Traumatic Brain Injury in a Tertiary Hospital in South-South Nigeria: A 6-Year Review.","authors":"Felix U Uduma,&nbsp;Philip Chinedu N Okere,&nbsp;Ubong U Ekpene,&nbsp;Timothy E Nottidge","doi":"10.4103/nmj.NMJ_10_20","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_10_20","url":null,"abstract":"<p><strong>Background: </strong>Computed tomography (CT) remains the gold standard in imaging evaluations of traumatic brain injury (TBI). TBI on its own has become a major concern in developing countries with its untoward effects.</p><p><strong>Objectives: </strong>The objective was to appraise the craniocerebral computed tomograms of patients who had TBIs.</p><p><strong>Materials and methods: </strong>A retrospective study of patients who underwent craniocerebral CT on account of head injury in the University of Uyo Teaching Hospital, Uyo, Nigeria, from November 13, 2013 to May 31, 2019 was done. The duration was regardless of the disjointed periods of service interruption. Patients' demographic and CT features were evaluated with application of simple analysis of data.</p><p><strong>Results: </strong>Two hundred and thirty-two patients were evaluated with minimum and maximum ages of 6 months and 78 years, respectively. Males were predominant with a ratio of 2.74: 1. Most affected age ranges were 30-39 years (23.27%) and 20-29 (22.84%). Normal brain CT was seen in 44 patients (18.97%). The most frequent lesion in patients with abnormal CT was intracranial hemorrhages (<i>n</i> = 188, 81.03%). Here, extra-axial hemorrhages (<i>n</i> = 100, 53.19%) supersede intracerebral hemorrhages (<i>n</i> = 88, 46.81%). Half of the intracerebral hemorrhages were multiple. Calvarial fractures were seen in 34.48% (<i>n</i> = 80) of patients. The most common localization was the facial bones (<i>n</i> = 24, 30.00%), whereas the least site was the occipital bone (<i>n</i> = 4, 5.00%). Fifteen percent of the patients had multiple fractures which also included base of the skull.</p><p><strong>Conclusion: </strong>TBIs commonly occur among young active males. The most frequent lesion is intracranial hemorrhages with extra-axial bias.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":" ","pages":"252-256"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ec/c4/NMJ-61-252.PMC7808284.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38854468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Juvenile Dermatomyositis in an 11 Year Old Nigerian-Boy: A Case Report and Review of Literature.","authors":"Olusola Adetunji Oyedeji,&nbsp;Saheed B A Oseni,&nbsp;Olamide Valentine Kayode,&nbsp;Oladapo Adedayo Kolawole,&nbsp;Musa Tawakalit Lily","doi":"10.4103/nmj.NMJ_128_18","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_128_18","url":null,"abstract":"<p><p>We report the case of an 11-year-old boy with proximal myopathy, heliotrope, and Gottron papule-like rashes. Serum chemistry revealed muscle enzyme elevations, whereas muscle biopsy histology showed necrosis and inflammation, which were in keeping with juvenile dermatomyositis. Plain radiographic examination of the thigh 3 weeks after commencing treatment with prednisolone was normal. The aim of this presentation is to highlight the diagnostic challenges posed by this rare condition in a resource-limited setting and to underscore the need for prompt diagnosis and appropriate management. We hope that this report will assist physicians practicing in similar settings to make a prompt and accurate diagnosis when confronted with the same disease.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":" ","pages":"284-287"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/c5/NMJ-61-284.PMC7808286.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38853409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons Learned from Strategies for Promotion of Evidence-to-Policy Process in Health Interventions in the ECOWAS Region: A Rapid Review.","authors":"Chigozie Jesse Uneke,&nbsp;Issiaka Sombie,&nbsp;Ermel Johnson,&nbsp;Bilikis Iyabo Uneke","doi":"10.4103/nmj.NMJ_188_20","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_188_20","url":null,"abstract":"<p><strong>Context: </strong>The West African Health Organization (WAHO) is vigorously supporting evidence-informed policymaking (EIPM) in the countries of West Africa. EIPM is increasingly recognized as one of the key strategies that can contribute to health systems strengthening and the improvement of health outcomes. The purpose of this rapid review is to examine two key examples of evidence-based strategies used to successfully implement health interventions in each of the West African countries and to highlight the lessons learned.</p><p><strong>Methods: </strong>A rapid review technique, defined as a type of knowledge synthesis in which systematic review processes are accelerated and methods are streamlined to complete the review more quickly, was used. A PubMed search was conducted using the combination of the following keywords: Health, policy making, evidence, plus name of each of the 15 countries to identify studies that described the process of use of evidence in policymaking in health interventions. Two examples of the publications that fulfilled the study inclusion criteria were selected.</p><p><strong>Results: </strong>Among the key processes used by the countries to promote EIPM in health interventions include policy cycle mechanism and political prioritization, rapid response services, technical advisory group and steering committees (SCs), policy dialog, capacity-strengthening mechanisms, local context evidence and operational guidelines, multisectoral action and consultative process.</p><p><strong>Conclusion: </strong>Various degrees of success have been achieved in by West African countries in the promotion of EIPM. As the science of EIPM continues to evolve and better understanding of the process is gained among policymakers, more studies on effective strategies to improve the evidence-to-policy process are advocated.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":" ","pages":"227-236"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b9/0c/NMJ-61-227.PMC7808283.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38858427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penetrating Arrow Injuries of the Head-and-Neck Region: Case Series and Review of Literature.","authors":"Hamisu Abdullahi, Auwal Adamu, Muhammad Ghazali Hasheem","doi":"10.4103/nmj.NMJ_17_20","DOIUrl":"10.4103/nmj.NMJ_17_20","url":null,"abstract":"<p><p>Penetrating arrow injuries of the head-and-neck region are rare in the developed countries, but they are common in the rural communities of our country. Arrow shot to the head-and-neck region can be life-threatening due to the presence of major vessels and vital organs. Management of arrow injury to the head-and-neck region is seriously challenging, extraction of the arrows are usually difficult due to the proximity to vital structures, unskilled removal may worsen the existing injury or result in inadvertent damage to the vital structures. We presented the four cases of arrow shot to the head-and-neck region, three were managed successfully, and one was brought in dead probably due to attempt at the removal at home or poisonous nature of the arrow. Therefore, the aim of this report is to highlight our experience and challenges in the management of penetrating arrow injuries to head-and-neck region and to review some literature reports.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":" ","pages":"276-280"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/b6/NMJ-61-276.PMC7808282.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38853405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Burden of Visual Impairment and Blindness from Vitreoretinal Diseases: A Nigerian Tertiary Hospital Retina Unit Experience.","authors":"Oluwatoyin Helen Onakpoya,&nbsp;Patrick Udonwa,&nbsp;Oluwaseun Olaniyi Awe","doi":"10.4103/nmj.NMJ_210_16","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_210_16","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to determine the burden of visual impairment and blindness from vitreoretinal diseases in the retina unit of a Nigerian tertiary hospital.</p><p><strong>Methodology: </strong>A prospective, cross-sectional study on all consecutive new patients presenting with vitreoretinal diseases (VRD) at the vitreoretinal (VR) clinic at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife from May 2011 to April 2014. Patient's bio-data, presenting complains, Snellen's or tumbling E-chart visual acuity unaided, slit-lamp examination of the vitreous and fundus with +90/+78D, binocular indirect ophthalmoscopy as well as slit-lamp examination of anterior segment, and applanation tonometry findings were recorded in predesigned pro forma. Visual acuity was categorized using WHO/ICD. The data were analyzed using the SPSS software version 16 for simple frequencies and presented.</p><p><strong>Results: </strong>Of 2025 eyes reviewed, 112 (49.8%) eyes were visually impaired and 67 (29.8%) were blind. Eight (5.2%) patients were bilaterally blind. Diabetic retinopathy was the most common cause of bilateral blindness (25%), and concurrently, the most common VRD (29.8%). All categories of visual loss were more prevalent among the aged ≥65 years. More males (62.2%) were blind from VRD. Cataract was the most common ocular comorbidity seen (43.6%).</p><p><strong>Conclusion: </strong>The burden of visual impairment and blindness from VRD is large; eye health education for early presentation for eye care as well as the development of VR care with infrastructure upscale to include optical coherence tomography, laser, and surgical care for prompt diagnosis and treatment will be of benefit in reducing the burden.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":" ","pages":"257-261"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/d6/NMJ-61-257.PMC7808290.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38854469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parathyroid Adenoma with Unusual Presentations of Rib Bone and Thoracic Vertebrae Fractures in a Premenopausal Female in Ibadan, Nigeria.","authors":"Omolade O Adegoke,&nbsp;Mustapha A Ajani,&nbsp;Babatope L Awosusi,&nbsp;Francis A Onakpoma,&nbsp;O Saiki,&nbsp;A Daniel","doi":"10.4103/nmj.NMJ_29_20","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_29_20","url":null,"abstract":"<p><p>Parathyroid adenoma is the most common cause of primary hyperthyroidism which leads to abnormal calcium homeostasis, hypercalcemia, and reduction in bone density. A 37-year-old female referred from a private health facility with a 1-year history of upper back swelling and pain. The pain was worse when sitting down for long periods and with movement and relieved by rest. There was no antecedent history of trauma, but the patient had noticed poor appetite and weight loss. There were no constipation, no abdominal discomfort, and no symptom suggestive of hyperthyroidism or hypothyroidism. General physical examination revealed kyphoscoliosis, and vital signs were within normal limits. Spine X-ray showed features of cervical spondylosis. Computed tomography (CT) scan and magnetic resonance imaging showed pathologic fractures of the right 9 ^thrib, anterior wedge compression, and reduction of T4 vertebrae with other abnormalities at T4-T5, T5-T6, T7-T8, T10-T11, and L4-L5 vertebrae. Bone marrow aspiration and serum electrophoresis were within normal limits. Serum calcium showed hypercalcemia. A CT scan of the neck was done which showed features of a right superior parathyroid adenoma. Blood count, other serum electrolytes, and thyroid function tests were all normal. A parathyroidectomy with right thyroid lobectomy was done. Histopathological examination of the resected parathyroid gland showed a diagnosis of parathyroid adenoma. A high index of suspicion is needed to diagnose this unusual presentation of parathyroid adenoma. Radiological imaging is an important tool for early diagnosis.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":" ","pages":"273-275"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/85/NMJ-61-273.PMC7808288.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38854472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Ovarian Hyperstimulation Syndrome: A Report of Two Cases from Different Pathogenesis.","authors":"Nkem Nnenna Nwafor,&nbsp;Nsikak Paul Nyoyoko","doi":"10.4103/nmj.NMJ_183_20","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_183_20","url":null,"abstract":"<p><p>Spontaneous ovarian hyperstimulation syndrome (s-OHSS) is a rare finding that occurs in early pregnancy. There is a rapidly increasing ovarian size secreting vasoactive substances that lead to fluid shift into third spaces. This occurs in the absence of exogenous hormonal therapy. We present two cases of s-OHSS. A 35-year-old gravida 4 para 3 presented with complaints of progressive abdominal pain, distension, nausea, vomiting, and difficulty in breathing at 10 weeks gestation. On imaging, a singleton intrauterine gestation, enlarged ovaries containing multiple cysts, and moderate ascites were seen. Second, a 17-year-old primigravida presented with abdominal distension and pain and bleeding per vaginam following 4 months amenorrhea. A bulky uterus containing a large hyperechoic structure with multiple cystic spaces in keeping complete molar gestation and enlarged ovaries containing multiple cysts were seen on ultrasound imaging. The singleton gestation was managed successfully to term with conservative therapy tailored to clinical symptoms.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":" ","pages":"269-272"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/f9/NMJ-61-269.PMC7808280.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38854471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}