Awareness and attitude towards HPV and its vaccines among market women in Bodija Market, Ibadan

Background: Cervical cancer, commonest among cancers of the female genital tract continued to pose major challenge to women of reproductive age in developing countries though infection by its causative agent,human papilloma virus (HPV) is preventable.This study aimed to assess awareness and attitude of market women concerning HPV and its vaccines in prevention of cervical cancer.Materials and methods: A cross sectional study involving 329 market women, using multistage sampling technique. Instrument was an Interviewer--administered questionnaire on socio-demographic characteristics,knowledge and awareness of HPV and its vaccine, sexual history and attitude towards HPV vaccines.Data analysis was done using SPSS version 20.0 with statistical significance level set at p<0.05.Results: Mean age of respondents was 29.49±3.65 years.All respondents were sexually active with majority (94.8%) having multiple sexual partners.Awareness of HPV vaccine and Pap smear test was among 1.2% and 9.4% respectively. Attitude towards HPV vaccination was good in 304 (92.4%) with 302 (91.8%) willing to take the HPV vaccines. There was significant association between attitude towards HPV vaccine and willingness to take HPV vaccine x2=111.8, p<0.01).Conclusions: Awareness of HPV and its vaccines is low among market women in our community.Policies and actions to step up information dissemination are urgently needed in order to stem the scourge of cervical cancer in our society.Keywords: Awareness,Market women,Ibadan,HPV vaccine

Anaemia in pregnancy maternal and perinatal outcome in Ibadan, south western Nigeria

Background: Anaemia during pregnancy is a global public health issue that may be associated with adverse pregnancy outcomes. Ante natal care should be concerned with early detection and management of all degrees of anaemia in pregnancy.Objectives: To determine the prevalence of anaemia and associated pregnancy outcomes among expectant mothers attending ante natal clinic at the University College Hospital, Ibadan.Subjects, Methods and Materials:A descriptive, longitudinal study of the maternal and perinatal outcomes of anaemia among an obstetric population at the University College Hospital, Ibadan.Results: Prevalence of anaemia in pregnancy was 6.5% with mild and moderate anaemia accounting for 4.6% and 2.2% respectively. Mild to moderate anaemia were not associated with adverse maternal and perinatal outcomes Conclusion: Prevalence of anaemia in our environment appears to be falling. Adverse maternal and perinatal outcome are unlikely with mild to moderate levels of anaemia.Keywords: Anaemia in pregnancy, prevalence, maternal outcome, perinatal outcome

Randomization of two dosing regimens of vaginal misoprostol for cervical ripening and labor induction in a low resource setting

Objectives: To compare the effectiveness of two dosing regimens of vaginal misoprostol for cervical ripening and induction of labour.Materials and Methods: Pregnant women with singleton low risk pregnancy at term scheduled for elective induction of labour were randomized to  receive either 25 µg or 50 µg of vaginal misoprostol for pre.labour  cervical ripening. All the patients received antenatal care and delivered at the University College Hospital (UCH) from January 1st to May 31st 2006. A total of 128 patients were randomized; 65 patients received 25 µg and 63 patients received 50 µg of vaginal misoprostol.Results: Significantly higher number of patients in the 50 µg group   progressed to active labour as compared with the 25 µg group (95.2% versus 84.6%, P < 0.05). The need for oxytocin augmentation of labour was higher among the 25 µg as compared with 50 µg (39.7% versus 16.4%, P = 0.007). There was higher proportion of patients in the 50 µg group delivering vaginally within 24 hours as compared with the 25 µg group (98.2% versus 90.0%, P = 0.063). However, the mean interval between the first dose of misoprostol and vaginal delivery was not  statistically different in the two groups (754 } 362 minutes and 885 } 582 minutes, P = 0.152). The incidence of caesarean section was similar in the two groups (7.7% versus 11%, P = 0.580). Labour complications, such as precipitate labour, tachysystole and abnormal fetal heart rate patterns were greater in the 50 µg group.Conclusion: Twenty.five microgram of misoprostol appears to be as  effective as 50 µg for pre.induction cervical ripening and labour induction. Though 50 µg of vaginal misoprostol resulted in relatively faster delivery and less need for oxytocin augmentation, it was associated with more  labour complications as compared with 25 µg of misoprostol.Key words: Cervical ripening, labour induction, misoprosto

Factors associated with quality of life of outpatients with breast cancer and gynecologic cancers and their family caregivers: a controlled study

<p>Abstract</p> <p>Background</p> <p>Quality of life (QOL) issues are of interest in cancer because effective methods of treatment and detection have led to an increase in the number of long-term survivors. The objectives of the study were: to assess the subjective QOL of stable Sudanese women cancer outpatients and their family caregivers, using the WHO 26-item QOL Instrument; compare with matched general population groups, as well as diabetic and psychiatric patient groups; examine patient-caregiver concordance in ratings; and assess the variables associated with their QOL, with a view to identifying factors that can enhance quality of care.</p> <p>Methods</p> <p>Responses of oncology outpatients with breast cancer (117), cervical cancer (46) and ovarian cancer (18) (aged 44.6, SD 11.5) were compared with those of their family caregivers and matched general population groups. Data were analyzed by univariate and multivariate statistics.</p> <p>Results</p> <p>The cancer groups had similar QOL domain scores, which were significantly lower than those of their caregivers, but higher than the control group as well as those of psychiatric and diabetic patients studied previously. Patients who were married, with higher education, better employment, and with longer duration of illness had higher QOL. Patients on radiotherapy and their caregivers had higher QOL scores. Correlations between patient's ratings and caregiver impression of patient's QOL were high. Caregiver impression was a significant predictor of patient's and caregiver's QOL. Other predictors for the patient were: currently feeling sick and duration of illness; for the caregiver: feeling sick, relationship to patient, and age.</p> <p>Conclusion</p> <p>Cancer patients in stable condition and with psychosocial support can hope to enjoy good QOL with treatment. The findings constitute an evidence base for the country's cancer care program, to boost national health education about prognosis in cancer. Families living with women cancer patients are vulnerable and need support if the patient is recently diagnosed, less educated, single, not formally employed; and the caregiver is female, parent, younger, less educated, unemployed and feels sick. Clinicians need to invest in the education and support of family caregivers. The patient-caregiver dyad should be regarded as a unit for treatment in cancer care.</p

An Audit of Vaginal Hysterectomies at thr University College Hospital, Ibadan

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Cervical spine cord injury in pregnancy. Conservative management of 3 consecutive cases in Ibadan, Nigeria

Study design A prospective study of 3 patients with incomplete cervical spinal cord injury in the 3rd trimester of pregnancy. Objectives To determine the effect of spinal cord injury and treatment with Gardner-Wells\' Tong traction on pregnancy, labour and parturition; and ascertain the effectiveness and safety of this conservative form of management in pregnancy. Setting The patients were admitted and managed between September 2002 and May 2004, in the University College Hospital Ibadan, Nigeria - the major referral Centre in neurological diseases for about a quarter to a third of Nigeria\'s population. Methods From the point of admission into our Emergency Unit, data on each patient was documented prospectively until discharge to the out-patient clinic where each of them was followed up at appointed intervals. These data were then analyzed and compared with reports in literature. Results All the patients had good outcome from the conservative management as measured by complete neurological recovery, uneventful pregnancy and normal parturition. They however, seem to be disposed to pre-term labour, without being aware of the labour pains. Conclusion Spinal cord injury in pregnancy could be successfully manage with Gardner-Wells\' Tong traction without deleterious effects on pregnancy and parturition, but appears to induce pre-term labour, associated with regional analgesia for labour pains. Etude prospecitve de 3 patientes présentant un traumatisme du rachis cervical au cours du 3ème trimestre de la grossesse. Déterminer les effets du traumatisme rachi-médullaire au cours d\'un traitement par traction cervicale de Gardner-Well dutant le travail et l\'accouchement. Les patientes ont été admises entre septembre 2002 et mai 2004 au centre hospitalier et universitaire d\'Ibadan, Nigeria, centre réferent neurochirurgical pour environ le tiers voire la moitié de la population du Nigéria. Les données cliniques et paracliniques ont été recueillies de l\'admission jusqu\'à la sortie et au cours des consultations de contrôle puis analysées par rapport aux observations de la littérature. Tous les patients ont eu une évolution favorable avec le traitement conservateur que nous avons adopté, avec une récupération neurologique complète, une absence d\'événement indésirable lors du travail, de l\'accouchent et des suites de couches. Keywords: Cervical spinal cord. Gardner-Wells\' Tongs traction. Third trimester gestationAfrican Journal of Neurological Sciences Vol. 25 (2) 2006: pp. 6-1

Conservative Management Of Third Trimester Cervical Spinal Cord Injury Using Gardner-Wells\' Tongs Traction

Spinal cord injury, though an important cause of morbidity appears to be uncommon in pregnant women or perhaps, has not been accurately documented among them. Superimposed on the many impairments resulting from spinal cord injury is the presence of the foetus in the womb, which in itself normally brings about intense physiological alterations in the patient. Despite the complexities, neither the pregnancy nor the spinal cord injury needs jeopardize the optimal care of the other as long as the standard protocols are followed. In the past 10 years, the University college Hospital, Ibadan, Nigeria treated approximately 900 spinal cord injury patients, and only 3 of these were pregnant-an incidence of 0.30 per 90 patients per year, or 0.33%. We report here, the conservative management of one of these pregnant patients using the Gardner-Wells\' tongs traction, resulting in normal parturition and full neurological recovery. Key Words: Spinal cord injury, Third trimester pregnancy, Gardner-Wells\' tongs traction Nigerian Journal of Clinical Practice Vol 8(1) 2005: 46-5

Relationship Between Oxidative Stress and Preeclampsia in Nigerian Women

Introduction: Oxidative stress contributes to the pathogenesis of many disease states including preeclampsia. However the degree of change and the precise timing of the tilt from balanced to oxidative stress is not well document in preeclamptic toxaemia of pregnancy in Nigerian women. Thisunderlined the basis of this studyMaterial and Method: 580 nulliparous attendees who consented to the study were enrolled from July 2006 to February 2009. A structured questionnaire was utilized for one aspect of the study while 5ml ofwhole blood sample was obtained at booking and from 29, 25, 21and 25 pregnant women who developed preeclampsia, pregnant women without hypertension, women sampled at post natal visit and non pregnant women of similar age respectively, for determination of total antioxidant status.Results: The incidence of hypertension in the study was 19% while the incidence of preeclampsia was 5%. The study showed progressive consumption total oxidative capacity with progression in pregnancyas evidenced by significant decrease in the mean TAS of the women that delivered with preeclampsia (35% decrease) and without hypertension(19% decrease) compared to TAS level at booking p=0.000, 0.035 respectively.Conclusion: Our study has buttressed the growing body of evidence supporting increased oxidative stress in the pathogenesis of preeclampsia.Key Words: Preeclampsia, oxidative stress, total antioxidant statu