Nigerian Postgraduate Medical Journal最新文献

{"title":"Malaria in pregnancy","authors":"E. Okpere, E. Enabudoso, A. Osemwenkha","doi":"10.4314/NMJ.V51I3.59879","DOIUrl":"https://doi.org/10.4314/NMJ.V51I3.59879","url":null,"abstract":"Malaria remains one of the highest contributors to the precarious maternal mortality figures in sub-Saharan Africa. At least 6 million women worldwide are at risk of malaria infection in pregnancy. Malaria contributes to at least 10, 000 maternal deaths and to at least 200, 000 newborn deaths annually. Malaria is a contributor or aetiologic factor in pregnancy complications including anaemia, spontaneous abortion, prematurity and stillbirths. Pregnancy results in increased incidence and severity of malaria. Cerebral malaria, acute renal failure and severe anaemia, rare complications in adults living in malaria endemic areas, may complicate malaria in pregnancy. Research implicate reduced maternal immunity from increased steroid levels in pregnancy, increased attractiveness of pregnant women to mosquito bites and increased adherence of parasitized erythrocytes to Chondroitin sulphate A expressed in the placentae. This is worse in the first and second pregnancies. With infection with the Human Immunodeficiency Virus [HIV], the effects of malaria in pregnancy are even worse. Over the decades, there have been concerted worldwide collaborative efforts, spearheaded by the World Health Organization [WHO] and including governments and allied agencies to tackle the scourge of malaria in pregnancy. The main thrusts of such efforts have been: to increase the use of insecticide treated mosquito bed nets [ITN]; intermittent preventive treatment of malaria [IPT]; and adequate case treatment of acute malaria attacks in pregnancy. While for IPT, Sulfadoxine-Pyrimethamine [SP] combination has been proven to be of benefit in preventing acute and latent malaria in pregnancy and its associated complications, the WHO has introduced the use of Artemisinin-Combination Therapy [ACT] for the first-line treatment of uncomplicated malaria in pregnancy, the need to confirm malaria before treatment and the enforcement of completion of therapy once started. The Roll Back Malaria [RBM] campaign was launched as a strategy to curtail the incidence and scourge of malaria especially in the vulnerable groups including pregnant women. The Millennium Development Goals [MDGs] offer a new hope if adequately pursued to achieving eradication of malaria and its complications in pregnancy. There is need to support research into effectiveness and utilization of established and newer control measures.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"37 1","pages":"109"},"PeriodicalIF":1.1,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80829915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV/TB Co-infection in Nigerian children","authors":"E. Ugochukwu","doi":"10.4314/NMJ.V51I3.59899","DOIUrl":"https://doi.org/10.4314/NMJ.V51I3.59899","url":null,"abstract":"Tuberculosis (TB) is an important cause of childhood morbidity and mortality. The burden of childhood disease is not as well documented as that of adult disease, partly because of the difficulty of confirming the diagnosis. In Africa children have been estimated to account for 20-40% of TB case load. Children infected with M. tuberculosis have a high risk of progression to disease, the younger children being at highest risk. Infected children represent a reservoir of future adult disease. The incidence of childhood TB has increased in developing countries. This resurgence is partly attributed to the coexisting burden of human immunodeficiency virus (HIV) disease, which is most pronounced in Sub-Saharan Africa, Nigeria ranking third highest prevalence. The pattern of childhood HIV and TB infection mirror these epidemics in the adult population. The number of children co-infected with HIV and TB is rising, and so is the incidence of congenital and neonatal TB. In addition the emergence of multi-drug resistance TB and extensively drug-resistant TB has occurred within the context of a high prevalence of HIV and TB. The diagnosis of TB has always been difficult in children and is compounded by HIV co-infection. The clinical symptoms in both diseases are similar, and the radiological changes may be non-specific. Treatment of both conditions in children is a challenge due to drug interactions and problems with adherence. There are few stable syrup formulations of antituberculous and antiretroviral drugs in children, and hence division of tablets gives rise to unpredictable dosing and emergence of resistance. To reduce the morbidity and mortality of TB and HIV, existing childhood TB programs must be strengthened, and antiretroviral drug therapy and prevention of mother-to-child transmission programs scaled up. HIV prevalence in the adult population must also be reduced. An increased emphasis on childhood TB, with early diagnosis and treatment, must be a priority.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"28 1","pages":"120"},"PeriodicalIF":1.1,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86534337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community based healthcare financing: An untapped option to a more effective healthcare funding in Nigeria","authors":"E. Adinma, Brian-D J. I. Adinma","doi":"10.4314/NMJ.V51I3.59876","DOIUrl":"https://doi.org/10.4314/NMJ.V51I3.59876","url":null,"abstract":"Context:The Nigerian health system is characterized by chronic under funding. This has resulted in poor performance of the health sector evident from Nigerian's poor reproductive health indices. Objective: This review evaluates healthcare funding in Nigeria with respect to health budget and health expenditure, appraises the national health insurance scheme, and examines community health care financing as a plausible option to a more effective funding of healthcare in Nigeria. Pattern of health funding in Nigeria: Federal Government budget on health ranged from N 4, 835 million-N 17, 581. 9 million from 1996 to 2000. This amount represented only 2. 7%- 5. 0% of the total Federal Government budget. Nigerian's Total Health Expenditure (THE) as a percentage of Gross Domestic Product (GDP) is low ranging between 4. 3 %- 5. 5 % from 1996- 2005. General Government Health Expenditure (GGHE) as percentage of THE is also low ranging from 21. 8 %- 33. 5 %. Private sector expenditure on health as percentage of THE is high ranging between 66. 5 %- 78. 2 % from 19962005, with private households' out of pocket accounting for 90. 4 %- 95. 0 % over the period. Social security fund had no contribution to the general government expenditure over the 10-year period. The National Health Insurance Scheme (NHIS) currently covers only the formal sector of 4. 5 million people ( 3. 2 %) of the population. Community-based healthcare financing (CBHF): Community-based healthcare financing has been recognized as a community-friendly and community-driven initiative that has a wider reach and coverage of the informal sector especially if well designed. Experience with the Anambra State CBHF scheme, and a few other similar schemes in Nigeria indicate high acceptability of the people to CBHF scheme. Conclusion and Recommendations: Government and non-governmental organizations should collective develop various forms of CBHF to reach out widely to Nigerians.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"52 1","pages":"95"},"PeriodicalIF":1.1,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82686448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical education: Should undergraduate medicine be post-baccalaureate?","authors":"S. Nwosu","doi":"10.4314/NMJ.V51I2.59873","DOIUrl":"https://doi.org/10.4314/NMJ.V51I2.59873","url":null,"abstract":"In 1960 the first 13 medical students fully trained in Nigeria to internationally accepted standard graduated from the then University College Ibadan, earning the Bachelor of Medicine, Bachelor of Surgery (MBBS) London degree. Since then thousands of doctors trained to international standard have been produced from different medical schools in Nigeria. The Medical & Dental Council of Nigeria has now registered about 50, 000 doctors most of whom trained locally in Nigerian universities. The doctors were admitted into the universities with SSCE or its equivalent as the minimum entry requirement. These doctors have acquitted themselves by admirably working hard to in various capacities, including research, teaching and clinical services, to address and solve the health needs of Nigerians and beyond. Recently the National Universities Commission (NUC) proposed and may soon implement a policy that would make the university first degree the minimum qualification for entry into medical schools in Nigeria. The new policy advocates a 4 year medical undergraduate curriculum. However this would in effect translate to a minimum of 9 years post-secondary school to produce a medical doctor. Given the perennial instability in the health and educational sectors in Nigeria as well as the difficulties in obtaining placement for internship, it may practically take up to 15 years post-secondary school to fully register a doctor. Therefore the new NUC policy will have the effect of producing aging young doctors which will in turn put the lives of Nigerians at increased risk. Whatever be the flaw with the current 5 or 6 year straight MBBS programme is not due to the fact that SSCE or its equivalent is the minimum entry qualification. A minimum medical school entry qualification that has served Nigeria well for more than 50 years should not be jettisoned without convincing scientific evidence that it is detrimental to Nigeria's health policy and medical education process.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"245 1-4 1","pages":"89"},"PeriodicalIF":1.1,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72697522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolution of Health Care Systems in Nigeria: Which Way Forward in the Twenty-First Century","authors":"Ajovi Scott-Emuakpor","doi":"10.4314/NMJ.V51I2.59866","DOIUrl":"https://doi.org/10.4314/NMJ.V51I2.59866","url":null,"abstract":"Correspondence: Prof. A. Scott-Emuakpor Evolution is “change” and one of the most consistent phenomena of life is “change”. Change is to alter, to vary, to substitute, and to mutate. The complexity of life itself is brought about by change. Our individuality is fashioned by change. In the process of gamete formation, the genes within the germ cell undergo a complex rearrangement referred to as “meiosis”. During this event, the chromatids of homologous chromosomes participate in an almost ritualistic exchange of genetic materials called “crossing-over” or “recombination”. At the end of this process, paternal and maternal genes are recombined uniquely to produce an arrangement of genes never before encountered. This ultimate change produces a unique individual generation after generation. Whether you are an “evolutionist” or a “creationist”, change constitutes the main element of the process in which you believe. The entire theory of evolution glorifies “change”. Evolution derives its substance from the theory of “survival of the fittest”. The fittest are fittest because they have undergone change called “mutation”, which confers on them reproductive superiority in a constantly changing environment. Therefore, the “fittest” have a “selective advantage” to deal with a changed environment. The creationist should remember the story of creation very well. It consisted of a series of changes. As the narrative goes, “And the earth was without form, and void; and darkness was upon the face of the deep. And the spirit of God moved upon the face of the waters. And God said, “Let there be light: and there was light” (see Genesis 1:2-3). Light was the very first change God brought to bear in the process of His creation. The story of God's creation becomes even more fascinating as you read the rest of the book of Genesis. It shows how God changed the world and the beauty therein painstakingly. It also shows the changes that were introduced into our very existence when the first Humans disobeyed the instructions of God.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"7 1","pages":"53"},"PeriodicalIF":1.1,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76163823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universities and medical education in Nigeria","authors":"A. Malu","doi":"10.4314/NMJ.V51I2.59872","DOIUrl":"https://doi.org/10.4314/NMJ.V51I2.59872","url":null,"abstract":"Formal attempts at Medical Education in Nigeria began in 1927 with the establishment of an institution in Lagos for training medical manpower to diploma level. They were trained to practice only in Nigeria. The program was not popular and was discontinued. Following the report of the Elliot Commissions on higher education in West Africa it was decided to establish the University of London College at Ibadan, with a Faculty of Medicine as one of the initial faculties. This was realized in 1948. The debate on what type of doctor to produce for Nigeria ended with the decision to produce high caliber doctors of the same standing as British trained doctors. In 1960 the Ashby Commission on Higher Education in Nigeria recommended the establishment of more training institutions, including those for medicine. This led to the establishment of the University of Lagos with the College of Medicine. The three initial regional governments all established their universities with medical faculties. Medical education has expanded rapidly with the expansion of universities, and we now have Federal and State governments as well as other organizations or private individuals owning universities with medical schools. Regulation of undergraduate medical education has continued to be under the dual oversight of the National Universities Commission and the Medical and Dental Council of Nigeria. The main problems of the medical schools have been the shortage of properly trained staff and poor facilities, curriculum stagnation and lack of modern teaching and assessment instruments. To tackle these problems training in educational methods should be mandatory for academic staff; there should be greater synergy between the NUC and MDCN, and curriculums should be reviewed to reflect modern trends.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"4 1","pages":"84"},"PeriodicalIF":1.1,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78231265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Assurance in Medical Education: the Nigerian Context","authors":"A. Omigbodun","doi":"10.4314/NMJ.V51I2.59869","DOIUrl":"https://doi.org/10.4314/NMJ.V51I2.59869","url":null,"abstract":"Background: The ultimate goal of medical education is to improve the health of the community. To ensure that medical training achieves this objective, its quality must be assured. Objective: The aim of this presentation is to attempt a definition of quality assurance in the context of medical education, explore its linkage to improved services and outline a framework for its application in Nigeria. Methods: A review of published articles and policy documents on quality assurance in higher education and medical training from different parts of the world, identified through an internet search, was done to distil the current ideas on the subject. Findings: There is a consensus that graduates from training institutions must attain an agreed minimum standard in the quantum of skills and knowledge, as well as the attitudinal disposition that they are expected to acquire in the course of their medical education. This applies to both undergraduate and postgraduate professional training. There is no guarantee that the quality assurance that is implied in enforcing such minimum standards necessarily leads to an improvement in the quality of care that the community receives. Nonetheless, quality assurance should be seen as a first step towards quality improvement. Sustained improvement requires that stakeholders demand quality in service delivery and a credible process of clinical audit, with widespread dissemination of evaluation results, to ensure accountability and maintenance of quality. However, this can only happen if the medical professionals are properly trained in all accredited institutions, a situation that can best be attained by agreement on a common core curriculum and the systematic use of improvement tools, especially the continuing professional development (CPD) of trainers. The National Universities Commission (NUC) and the Medical and Dental Council of Nigeria (MDCN) are the two bodies that have the legal mandate for the accreditation of medical and dental schools in Nigeria. Both have published separate policy documents on minimum standards of training. There is however no system of audit or formalized CPD in place yet. Conclusions: For proper quality assurance and service improvement in Nigeria, the NUC and the MDCN need to achieve a consensus on the implementation of minimum standards for trainees and trainers, with the former leading the way on curricular issues while the latter sets the pace on quality of training facilities, the credentialing of trainers and their continuing medical education and self development.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"44 1","pages":"70"},"PeriodicalIF":1.1,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74350608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of Medical Graduates Within and Outside Nigeria","authors":"F. Nwariaku","doi":"10.4314/NMJ.V51I2.59874","DOIUrl":"https://doi.org/10.4314/NMJ.V51I2.59874","url":null,"abstract":"The objective of this report is to provide a summary of the outcome of Nigerian Medical Graduates globally. Since the establishment of the first medical school at the University College Hospital, Ibadan, at least four generations of medical schools have been created. With approximately 306 health training institutions and ~ 26 medical schools, www.who.int/hrh/wdms/ media/Nigeria.pdf, Nigeria graduates approximately 2300 medical doctors each year. Nigeria has one of the largest stocks of human resources for health in Africa comparable only to Egypt and South Africa. In 2005, there were about 39, 210 doctors and 124, 629 nurses registered in the country, which translates into about 39 doctors and 124 nurses per 100, 000 populations as compared to the Sub-Sahara African average of 15 doctors and 72 nurses per 100, 000 populations[2]. Between 2005 and 2007 requests for certificate of good standing (a surrogate for migration), were 2, 341, 2, 989 and 3, 567 respectively. While many graduates remain in-country, migration occurs in a significant percentage. Based on one study, the most common country of migration is the U.S.A ( 20%), United Kingdom ( 9%) and Ireland ( 5%). In the U.S. most Nigerian physicians in clinical practice, are in a private practice, whereas a small minority is engaged in academic medicine. Curriculum reform in medical schools will be important to adequately prepare medical graduates for practice within and outside Nigeria.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"51 1","pages":"92"},"PeriodicalIF":1.1,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89467415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malaria parasitaemia and household use of insecticide treated bed nets: A cross-sectional survey of under-fives in Jos, Nigeria","authors":"J. Daboer, M. Chingle, C. Ogbonna","doi":"10.4314/NMJ.V51I1.59848","DOIUrl":"https://doi.org/10.4314/NMJ.V51I1.59848","url":null,"abstract":"Background: In spite of enormous investments in Malaria control programme, malaria is still a major cause of morbidity and mortality among under-fives. Objective: The objective of this study was to determine malaria parasitaemia in under-fives and to relate it to household use of Insecticide Treated Bed Nets (ITBNs) in Jos - a malaria endemic setting. Methodology: A cross-sectional study was carried out in a selected settlement in Jos North Local Government Area (LGA) in September 2007 towards the end of the rainy season. All households with children less than 5 years of age in the selected settlement were listed and then 150 of the households were selected using systematic sampling technique. In each selected household one under five was selected and where there were more than one under five only one was selected by balloting. The selected 150 under-fives were then studied using thumb prick blood smear to determine the presence of malaria parasite in their peripheral blood and a semi structured interviewer administered questionnaire to obtain information on household use of ITBNs in the community. Result: Malaria parasitaemia was found in 57 (38.0%) of the children and the highest age specific prevalence of 46.4% was among the 36-47 months age group. The females were more (46.6%) infected than their male counterparts (29.9%) p=0.035. Eighty three (55.3%) mothers owned ITBNs but only 61(40.7%) used them for their children. Children who slept under ITBNs were less likely to have malaria parasites in their blood compared with those who did not (p=0.000..). Mothers’ age and education were among other factors that positively influenced the use of ITBNs. Conclusion: Malaria parasitaemia is high in this community and sleeping under ITBN has been found to significantly reduce the prevalence of parasitaemia in the children studied. It is therefore recommended that the ITBNs campaign should be intensified so that the ITBN use can cover all the under-fives. Key words : Malaria; Insecticide; bed nets; under-fives,","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"16 1","pages":"5"},"PeriodicalIF":1.1,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74727000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gestational trophoblastic disease in a tertiary hospital in Nnewi, southeast Nigeria","authors":"S. Mbamara, N. Obiechina, G. Eleje, C. Akabuike, O. Umeononihu","doi":"10.4314/NMJ.V50I4.54447","DOIUrl":"https://doi.org/10.4314/NMJ.V50I4.54447","url":null,"abstract":"Objective: This study was conducted to evaluate the prevalence of GTD and describe its clinical features and management in a tertiary level hospital in Nnewi Southeast Nigeria. Methods: We studied retrospectively the cases of GTD that were proved histologically and managed in the department of Obstetrics and Gynaecology of Nnamdi Azikiwe University Teaching Hospital Nnewi over a 5years period (200 - 2008).                                                        Results: The frequency of GTD in Nnewi is 4.6 per 100 deliveries. Ten (66.7%) of the cases were choriocarcinoma while 5 (33.3%) were hydatidiform mole. There was no case of invasive mole or placental site trophoblastic tumour (PSTT). The age range of the patients was 15 - 46 years with a mean of 31+ 8.6 years. There was no significant association between age and GTD (X2 = 4.5; p = 0.609) and between Parity and GTD (x2 = 1.87; p = 0.171 ). Most of the patients (73.3%) presented in late second trimester and the commonest mode of presentation was abnormal vaginal bleeding. The symphysio - fundal height was more than the estimated gestational age in 9 (60%) of cases. All the patients made an earlier presentation in different peripheral hospitals and were managed as incomplete miscarriage prior to presentation in our hospital. The average duration of follow - up in these patients was 2.4 =3.2 weeks. Contraception use was documented in 3 (20%) of the patients. Conclusion: There was a high prevalence of GTD and notably choriocarcinoma. The associated mortality was high. There was lack of suspicion of the pathology among the primary healthcare providers. This study suggests that all cases of evacuation products should be subjected to histopathological examination. There is the need to emphasize the role of adequate and appropriate counselling in the management of the patients with GTD. Call and recall system should be introduced in the management of patients with GTD to improve their compliance to recommended management standard. This will improve the prognosis of the condition in our women.                                                             Niger Med J. Vol. 50, No. 4, Oct. - Dec., 2009: 87–89 Key words: gestational trophoblastic disease, tertiary hospital Southeast Nigeria.","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"68 1","pages":"87"},"PeriodicalIF":1.1,"publicationDate":"2009-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80185057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}