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Table of Contents
October-December 2014
Volume 9 | Issue 4
Page Nos. 135-164
Online since Thursday, May 14, 2015
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EDITORIAL
Fertility following myomectomy
p. 135
Onwere Nwankwo Stephen
DOI
:10.4103/9783-1230.157041
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ORIGINAL ARTICLES
Fertility following myomectomy at Aba, Southeastern Nigeria
p. 136
B Chigbu, S Onwere, C Aluka, C Kamanu, P Feyi-Waboso, O Okoro, E Ezirim, P Ndukwe, E Akwuruoha, M Ejikem, C Aharauka, U Ojike
DOI
:10.4103/9783-1230.157045
Background:
While hysterectomy remains the gold standard treatment for fibroids, it is an unacceptable treatment option for women who wish to conserve their fertility. The actual effects of myomectomy on fertility remain uncertain though.
Objective:
The objective was to ascertain pregnancy and live birth rates among a small group of women undergoing abdominal myomectomy.
Methods:
The study population consisted of women of reproductive age intending to conceive soon after undergoing abdominal myomectomy. A total of 40 women who met the inclusion criteria were recruited for the study and followed-up for 4 years. Women who achieved pregnancy within the study period were analyzed in terms of their demographics and intra-operative findings.
Results:
The mean age of the women was 28 years (range 24-35) married for about 3 years. Majority of the women (50%) had more than 11 fibroid nodules, and the largest nodule was bigger than 5 cm in 35 women (87.5%). Cumulative pregnancy rate was 60% (24/40) while live birth rate was 22/40 (55%) following myomectomy and majority 19/22 achieved this within 2 years of myomectomy.
Conclusion:
Myomectomy for fibroid-associated infertility increase pregnancy rates such that approximately 60% of women undergoing the procedure subsequently conceive.
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Breastfeeding and weaning practices among Nigerian women
p. 140
I Aliyu, C Duru, TO Lawal, A Mohammed
DOI
:10.4103/9783-1230.157054
Background:
Infant feeding is an important determinant of child well-being. The practice of exclusive breastfeeding over the years is declining despite efforts at all levels to improve it; and with globalization there is concern of possible drift in the traditional weaning practices among Nigerian women. This study, therefore, seeks to determine the breastfeeding and weaning patterns among mothers attending two health facilities in the northern and southern parts of Nigerian.
Materials and Methods:
This was prospective cross-sectional study involving mothers seen in Paediatrics Outpatient and Child Immunization Clinics. This study involved two hospitals in northern and southern Nigeria respectively.
Results:
Two hundred breastfeeding mothers were recruited into this study. 75% of the mothers were in 25-40 years group and the majority of them (40.0%) commenced breastfeeding after 60 min of delivery. 83% of the mothers were aware of exclusive breastfeeding, but only 40.5% practiced it; their main reasons were that: Breastfeeding was not enough for the growth and development of the child (26.1%) and that breast-milk did not contain enough water; however most mothers' breasts fed for >12 months. About 44.5% of the mothers introduced complementary feeds between 4 and 6 months, and most complimentary meals (53.5%) were maize-based. 61½% of the mothers abruptly stopped breastfeeding, and the practice of separating the child from the home during weaning was reported in only 16% of the mothers.
Conclusion:
Exclusive breastfeeding is still unacceptably low among Nigerian women despite an increased level of awareness.
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Knowledge, attitude, and perception of teething myths among medical doctors in Nigerian hospitals
p. 144
I Aliyu, C Duru, TO Lawal
DOI
:10.4103/9783-1230.157056
Background:
Teething commences in children from the age of 6 to 8 months, however, it has been wrongly associated with systemic symptoms such as fever, diarrhea, vomiting by parents and health workers; this study hopes to determine the perception of doctors toward teething in Nigeria.
Materials and Methods:
This was cross-sectional descriptive study. Convince sampling technique was used to select 139 doctors who consented to participate in the study.
Results:
There were 116 males and 23 females with male to female ratio of 5:1. Fifty-nine (42.4%) of the subjects believed teething was associated with at least one symptom while 80 (57.6%) of them disagreed. Twenty-two (15.8%) of them got information on teething from their parents, 3 (2.2%) from their grand-parents, 61 (43.9%) was from school, 5 (3.6%) was from friends while 18 (12.9%), and 30 (21.6%) were from patients and their personal experiences, respectively. Seventy-nine (56.8%) did not believe in seeking for medical care for teething; while 60 (43.2%) believe in seeking for medical care for teething complaints. Ninety-six (69.1%) of the subjects will not prescribe any medication for teething; 18 (12.9%) prescribed paracetamol for teething, 10 (7.2%) prescribed antibiotics for teething, 8 (5.8%) prescribe teething powder, 3 (2.2%) prescribed teething ring; and 2 (1.4%) prescribe clean cloth usage and teething syrup, respectively. Thirty-eight (27.4%) believed teething remedies works, 99 (71.2%) of the subjects did not believed it works while 2 (1.4%) were not sure of its efficacy.
Conclusion:
Doctors still believe that teething is associated with systemic illnesses; therefore continuous medical education is of importance in ensuring the eradication of these myths.
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Histopathological pattern of cervical cancer in Benin City, Nigeria
p. 147
Chukwuemeka Asouzu Okoye
DOI
:10.4103/9783-1230.157057
Background:
Cervical cancer is the second most frequent malignancy and a preventable cause of mortality and morbidity in females.
Objective:
The objective was to describe the relative frequency, pattern, and histological types of cervical cancer in a teaching hospital in South-South Nigeria.
Materials
and Methods:
All histologically diagnosed cases of cervical cancer seen over a 10-year period in the Department of Pathology, University of Benin Teaching Hospital, Benin City, Nigeria were reviewed to determine their histopathological patterns.
Results:
Four hundred and six cases of cervical cancer accounting for 30.3% of cancers in females and 62.9% of female genital tract malignancies respectively were seen during the 10-year study period. The ages of patients with cervical cancer which ranged between 18 and 99 years with a mean of 51.5 years (standard deviation = 12.8), with most frequent occurrence in 50-59 years age group. Squamous cell carcinoma was the most predominant subtype comprising 84.2% of cases while adenocarcinoma constituted 11.8%. Adenoid cystic carcinoma, adenosquamous carcinoma and metastatic carcinoma accounted for 2.0%, 0.8%, and 1.2% of cases respectively.
Conclusion:
The relative frequency of cancer of the cervix is high in Benin City, and this should necessitate attention to effective cervical cancer screening to increase detection of preinvasive lesions which in turn will decrease the frequency of cervical cancer.
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Microbiological studies of waste dumpsite in Abia State University Teaching Hospital, Aba
p. 151
Eugene Chimezie Ndimele, Uzochukwu Godswill Ekeleme, Alloysius Chibuike Ogodo, Nkechi Chinyere Nwachukwu, Chidiebere James Nnadi, Elijah Akachukwu Otutu
DOI
:10.4103/9783-1230.157058
Background:
Hospital is a vital place for our life, health and well-being. However, the waste generated from hospital can be hazardous, toxic and even lethal because of their high potential for disease transmission.
Objective:
The work is aimed at doing microbiological studies of hospital waste dumpsite in Abia State University Teaching Hospital (ABSUTH), Aba.
Materials and Methods:
The study area was ABSUTH, Aba. Passive air sampling was performed using settle plates, wastewater samples from the drippings, soil sediment underlying solid waste and soil adjacent to the dumpsite were collected from a depth of 0.9-30 cm and was evaluated using the standard microbiological and molecular techniques.
Result:
The result of the total microbial count of air samples within the waste dumpsite and reception unit of ABSUTH, Aba revealed that the total viable count (TVC) was 182 ± 0.5 air within waste dumpsite (AW) and 70 ± 2.0 air within reception unit (AR), the total coliform count (TCC) was 17 ± 0.2 (AW) and 5 ± 1.0* (AR), the total staphylococcal count (TSC) was 8 ± 0.1 (AW) and 3 ± 0.5* (AR) while the total fungal count was 60 ± 0.4 (AW) and 42 ± 0.7 (AR), the variations in the results differ significantly at
P
< 0.05. The total microbial count of soil samples within the waste dumpsite showed that the TVC was 3.0 ± 1.7 × 10
8
cfu/g which was significantly different (
P
< 0.05) when compared with the control, 3.2 ± 0.8 × 10
6
cfu/g. The TCC was 1.6 ± 0.4 × 10
4
cfu/g and do not differ significantly (
P
> 0.05) with the control (1.0 ± 1.0 × 10
4
cfu/g), the TSC was 2.6 ± 0.7 × 10
2
cfu/g and do not differ significantly (
P
> 0.05) with the control (2.1 ± 0.1 × 10
2
cfu/g) while the total fungal counts (6.8 ± 0.3 × 10
7
cfu/g) showed a significant difference when compared with the control (5.3 ± 0.6 × 10
6
cfu/g). The total microbial count of dripping samples from the waste dumpsite of ABSUTH showed that the TVC, TCC, staphylococcal count and the fungal count were 6.9 ± 1.7 × 10
7
, 3.5 ± 1.0 × 10
3
, 1.8 ± 0.6 × 10
2
, and 7.4 ± 0.1 × 10
5
, respectively. The variations in microbial counts of the dripping hospital waste dumpsite samples differed significantly (
P
< 0.05) when compared with the controls which showed no growth. The most occurring microorganisms were
Bacillus
species,
Staphylococcus
aureus
,
Streptococcus
sp. and
Aspergillus
fumigatus
. The susceptibility profile of bacterial isolates revealed that ciprofloxacin and augmentin produced the highest percentage inhibition of 33 to 100% against all the bacterial isolates except
Actinomycetes
isreali
which was resistant. Most of the isolates had no plasmid except for
Escherichia coli
which produced equal size of 23 kb of plasmid.
Conclusion/Recommendation:
The high microbial load densities suggests that the hospital wastes in the environment pose a major health and environmental threat. This study therefore calls for a proper regulatory system on disposal of hospital waste.
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CASE REPORT
Successful pregnancy outcome after
in vitro
fertilization at a public health facility in Nigeria
p. 157
Omokanye Lukman Omotayo, AWO Olatinwo, SA Biliaminu, KA Durowade
DOI
:10.4103/9783-1230.157059
We present a case of 31-year-old P0+1, who presented with 2 years history of infertility on account of bilateral tubal blockage. She achieved pregnancy and successful delivery following
in vitro
fertilization at the Assisted Reproductive Technology unit of the Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, Kwara State, Nigeria.
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Malaria in non-immune travelers: A case report and reminder for increased awareness of the problem
p. 160
Shadrach Awa Ukonye Offiah, Onyesom Ekperi, Franklin E Igwe, Simeon O Nwosu
DOI
:10.4103/9783-1230.157061
Malaria presents a serious hazard to travelers to endemic areas. With the current increase of international travel to tropical endemic countries, the fatality and incidence of malaria being imported into nonendemic countries has significantly increased. The risk of malaria infection varies depending on the destination and exposure to infected mosquitoes. A good knowledge of malarious areas and the frequency of infection acquired by nonimmune travelers are necessary when advice for prophylaxis is given by a physician to a prospective traveler. We discuss the case of a nonimmune, indigenous African from a malaria-free zone in Africa, who was not on prophylactics against malaria but visited a malaria-holoendemic region of Nigeria. Malaria remains a killer, especially to the nonimmune traveler; therefore, the need to carry a potent antimalarial drug for emergency treatment when traveling to a malarious country need not be overemphasized.
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