Niger J Clin Pract
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Randomized Controlled Trial
A Comparison of the Efficacy and Safety of Mifepristone and Misoprostol Versus Misoprostol alone for Induction of Labour in Nigerian Women with Intrauterine Fetal Death: A Triple Blind Randomized Controlled Trial.
Intrauterine foetal death (IUFD) is an unpleasant pregnancy outcome and prompt delivery of the dead foetus is usually desired by mothers. Unfortunately, spontaneous labour and delivery may not occur early and prolonged retention of the dead foetus in utero is life-threatening. Many of the agents currently used for the induction of labour may result in a prolonged delivery process. ⋯ The combination of mifepristone and misoprostol has greater efficacy and better safety profile than the use of misoprostol alone for induction of labour. This combination should be considered when induction of labour is indicated for IUFD.
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Observational Study
Treatment of Helicobacter Pylori İnfection and the Colonization of the Gastrointestinal System by Resistant Bacteria.
Helicobacter pylori (H. pylori) infections are widely treated with antibiotic regimens such as "Amoxicillin 1 gr 2 × 1 tablet, Clarithromycin 500 mg 2 × 1 tablet, and Lansoprazole 30 mg 2 × 1 tablet" for 14 days. We conducted a prospective observational study to explore whether this treatment protocol serves as a predisposing factor for the colonization of resistant gastrointestinal microflora, namely vancomycin-resistant enterococci (VRE), extended-spectrum beta-lactamase Enterobacterales (ESBL-E), and carbapenem-resistant Enterobacterales (CRE). ⋯ As the inaugural report from Turkey on this issue, our study suggests that antibiotic regimens for H. pylori eradication contribute to the increased risk of ESBL-positive bacterial colonization in the gastrointestinal tract.
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Vaginal bleeding is the most common cause of presentation at the emergency department in the first trimester. Clinical presentation helps determine the likely cause of first-trimester vaginal bleeding. However, ultrasound imaging is required to reach a definitive diagnosis. ⋯ Clinical assessment is insufficient in the identification of the cause of vaginal bleeding due to the overall low concordance rate. A combination of clinical assessment and ultrasonography is required for decision-making in every case.
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Every citizen of a nation has the basic constitutional right to quality health care. However, there is a dearth of literature on the validity and reliability of the Donabedian conceptual model of health service quality in Nigeria. ⋯ The study underscored the need for the adoption of the Donabedian model in the three other geopolitical zones in Nigeria for a generalized conclusion on the validity and reliability of the Donabedian conceptual model of health service quality. We recommended that research studies on health service quality should be anchored on Donabedian conceptual model as a way to increase awareness of the relevance of the model in improving clinical care in Nigeria.
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Treatment of cervical pre-cancers involves ablative and excisional therapies, and these have the potential to affect future pregnancy outcomes of women. Understanding the impact of the various treatment modalities on the outcome of pregnancies can motivate the development of interventions to improve pregnancy outcomes in women who had cervical pre-cancer treatment. ⋯ There is an increased odds of second-trimester miscarriage and preterm birth in women treated with LLETZ. A treatment-to-pregnancy interval of ≥ 12 months reduces this odd. Ablative therapies do not increase the odds of miscarriages and preterm births. This information could guide decisions on the choice of method of treatment for cervical pre-cancer in women of childbearing age.