Aberrant right coronary artery in an elderly Nigerian with recent dyspnoea detected on coronary CT angiogram

An anomalous origin of the right coronary artery has been documented in up to 0.92% of the general population, which is more common than an anomalous origin of the left coronary artery. We present a case of an elderly hypertensive man who developed mild dyspnoea on exertion for 3 months with associated retro-sternal pain as well as occasional palpitation which all tend to subside at rest. An electrocardiogram showed evidence of left atrial enlargement. A coronary computed tomographic angiogram was acquired with a 160-slice scanner which revealed the right coronary artery to originate from the left aortic sinus with a retro-aortic pattern of anatomical course. Vascular wall calcifications were noted with multilevel luminal narrowing on the left anterior descending however distal opacification was adequate. Our case further depicts the reason for keeping in mind anatomical variations while evaluating cardiac pathologies even among Black Africans.

Pregnancy-associated morbidity in Northern Nigeria

We sought to determine the magnitude and spatio-temporal pattern of maternal morbidity in Kano State, Nigeria. Analysis was on deliveries within the period 1990-1999. We counted 59772 maternal complications among 171621 deliveries, yielding an overall maternal morbidity ratio of 34.8%. We observed yearly variations and increment in the number of complications among mothers (p=0.04). A total of 4154 maternal deaths were registered within the period. The level of maternal deaths correlated significantly with burden of morbidity (r=0.44; p=0.0008). Case fatality rate was 6.9% with temporal fluctuations, and wide variations among the various health institutions. Our study revealed an extremely high morbidity ratio, which indicates that a high proportion of pregnant mothers are in need of essential obstetric care in this population.

Barriers to the use of antenatal and obstetric care services in rural Kano, Nigeria

The objective of this study was to identify the sociocultural and economic factors that act as barriers to women's use of antenatal care services and hospital delivery in a rural community in Kano State, Northern Nigeria. The study was based on an interview of 107 pregnant women conducted by a trained midwife in the native language of the area. Findings indicate that the majority of women (88%) (CI = 81.8-94.2%) in the study area did not attend for antenatal care, and 96.3% (CI = 93.0-99.8%) had delivered or plan to deliver at home without a skilled attendant. Major barriers identified were economic, cultural and those related to the women's perception of their condition. The study recommends that poverty reduction and economic empowerment of rural women are prerequisites for any tangible improvement in the utilisation of antenatal care and obstetric delivery services.