Knowledge and perception regarding surgical antibiotic prophylaxis among physicians in the department of obstetrics and gynecology

Background: Evidence shows that compliance with surgical antibiotic prophylaxis (SAP) among obstetricians and gynecologists is poor. This study evaluates the knowledge and perceptions regarding SAP among doctors in Obstetrics and Gynecology units. Methods: This was a cross‑sectional study conducted among physicians in the Department of Obstetrics and Gynecology in two public tertiary hospitals in Nigeria. Data was collected using a 30‑item validated and pre tested self‑administered questionnaire, and analyzed using SPSS. Results: A total of 41 respondents (response rate: 68.3%) returned the survey with a male preponderance (61%). Medical officers (Senior Registrars and Registrars) constituted almost two‑third (63.4%) of the respondents. Only 26.8% had attended a workshop, seminar, conference or clinical meeting regarding SAP. Most respondents were not aware of the most common organism that causes surgical site infection and the appropriate time and duration of SAP. However, majority (90%) knew that the inappropriate use of SAP could lead to antibiotic resistance. More than two‑third agreed that SAP malpractices were due to the lack of knowledge about SAP and poor awareness regarding antibiotic resistance. More than 90% agreed that education, audit and feedback, and guidelines would improve compliance with SAP. Respondents with 6–10 years working experience had significantly higher knowledge score than those with 1 –5 years experience. Respondents who had not attended any workshop or course pertaining to SAP had more positive perception. Conclusion: Respondents demonstrated inadequate knowledge of SAP and most of them were aware that inappropriate use of SAP could lead to antibiotic resistance

Hysterectomies pattern at a tertiary healthcare center, northern Nigeria

Background: The uterus is an important female genital organ for menstrual and reproductive functions. However, there are various gynecologic and obstetric indications for carrying out hysterectomy.Objectives: To determine the indications and the patterns of hysterectomies done at Ahmadu Bello University Teaching Hospital, Zaria Nigeria.Materials and Methods: 5‑year retrospective descriptive study on patients who had hysterectomy done from 2011 to 2015.Results: The age range of the patients was 2–70 years with a mean of 48.6 ± 8.8 years. Hysterectomies constituted 19.3% of total gynecology surgeries done during the same period. Of these total abdominal hysterectomy 144 (87.8%) was the most common, next was vaginal hysterectomy with pelvic floor repair 13 (7.9%), and then subtotal hysterectomy was 7 (4.3%). The most common indication for total abdominal hysterectomy was multiple uterine fibroids, a benign uterine tumor.Conclusion: Hysterectomy is a common gynecological surgery which may be used to treat benign uterine pathologies, especially when there is no more desire for conception. It could also be lifesaving in uncontrollable postpartum hemorrhage as well as malignant pelvic organ pathologies, especially in early stages.Keywords: Gynecological surgery; hysterectomy, pattern; uterine fibroid

Knowledge and perception regarding surgical antibiotic prophylaxis among physicians in the department of obstetrics and gynecology

Background: Evidence shows that compliance with surgical antibiotic prophylaxis (SAP) among obstetricians and gynecologists is poor. This study evaluates the knowledge and perceptions regarding SAP among doctors in Obstetrics and Gynecology units.Methods: This was a cross‑sectional study conducted among physicians in the Department of Obstetrics and Gynecology in two public tertiary hospitals in Nigeria. Data was collected using a 30‑item validated and pre tested self‑administered questionnaire, and analyzed using SPSS.Results: A total of 41 respondents (response rate: 68.3%) returned the survey with a male preponderance (61%). Medical officers (Senior Registrars and Registrars) constituted almost two‑third (63.4%) of the respondents. Only 26.8% had attended a workshop, seminar, conference or clinical meeting regarding SAP. Most respondents were not aware of the most common organism that causes surgical site infection and the appropriate time and duration of SAP. However, majority (90%) knew that the inappropriate use of SAP could lead to antibiotic resistance. More than two‑third agreed that SAP malpractices were due to the lack of knowledge about SAP and poor awareness regarding antibiotic resistance. More than 90% agreed that education, audit and feedback, and guidelines would improve compliance with SAP. Respondents with 6–10 years working experience had significantly higher knowledge score than those with 1 –5 years experience. Respondents who had not attended any workshop or course pertaining to SAP had more positive perception.Conclusion: Respondents demonstrated inadequate knowledge of SAP and most of them were aware that inappropriate use of SAP could lead to antibiotic resistance. Key words: Gynecologists; knowledge; obstetricians; perception; surgical antibiotic prophylaxis

Post abortal Staphylococcal sacroilitis: a case report

Septic sacroilitis is a rare complication of abortion. We present a 34 year old woman, who presented with three days history of pain in the right buttock, inability to walk and a large induration over the right sacro-illac joint. These followed spontaneous abortion at 21 weeks gestational age. Nigerian Journal of Surgical Research Vol. 7(3&4) 2005: 317-31

Outcome Following Ovarian Drilling in Nigerian Women with Polycystic Ovary Syndrome: A Systematic Review

Background: Polycystic ovary syndrome (PCOS) is a common condition characterized by endocrinopathies which can lead to infertility. Various modalities of treatment have been employed including ovarian drilling, but the outcome of such ovarian drilling in Nigerian women is not known. Aim: This is a systematic review of the outcome of ovarian drilling on the menstrual pattern and pregnancy rate in Nigerian women. Materials and Methods: Google scholar and PubMed databases were searched for studies that relate to PCOS management using ovarian drilling and other modalities in Nigeria. The citation lists of relevant articles and studies were also searched. Case reports, retrospective studies, and prospective studies were included. Review articles, systematic reviews, and meta‑analysis were excluded. Six studies were found to be suitable and consisted of two case reports and prospective studies each, respectively, and one clinical trial and retrospective study each, respectively. Results: There were a total of 107 patients aged 17–49 years. While all the patients presented with a complaint of abnormal menstruation, 50%–70% complained of inability to conceive. All the patients had used clomiphene citrate as first‑line drug to manage their complaints. Ovarian drilling was carried out using the conventional unipolar diathermy and 4 or more drills per ovary. Following the procedure, 76% resumed normal menstruation and 30% conceived. Conclusion: Reports of ovarian drilling in Nigeria reveal a positive outcome but the number of published studies are few and quality of evidence low. Further well‑designed studies including randomized controlled trials are needed to make definite conclusions

Seroprevalence of brucellosis among women with miscarriage at Ahmadu Bello University Teaching Hospital, Zaria

Background: Brucellosis in animals has been identified as a common cause of miscarriage. It is the most common zoonotic disease that leads to considerable morbidity in humans. It is rarely diagnosed in hospitals in Nigeria, and debate exists as to whether it is a more common cause of miscarriage in humans compared to other infective agents, especially with the finding of antibrucella activity in human amniotic fluid. Brucellosis in humans is a treatable disease and risk factors for transmission are prevalent in Zaria. Objective: The objective of this study was to determine the seroprevalence of brucellosis among women with miscarriage. Materials and Methods: This was a descriptive cross-sectional study involving 121 women aged between 15 and 49 years with miscarriage who presented to Ahmadu Bello University Teaching Hospital (ABUTH), Zaria from August 2014 to May 2015. Information on socio-demographic characteristics, reproductive profile, and risk factors for contracting Brucella infection were obtained using a questionnaire. Blood samples were obtained and analysed for Brucella IgG and IgM using indirect enzyme-linked immunosorbent assay kits. The data was analysed with SPSS, version 20.0. Results: The mean age of the participating women was 29.07 years [standard deviation (SD) ±6.74]. The seroprevalence of brucellosis was 19.0%; 17.4% of the women had a recent infection, and 1.7% had a chronic infection. Age, history of previous miscarriage, consumption of milk products and consumption of roasted meat/barbecue had positive relationships with recent Brucella infection (χ2 = 9.706, P = 0.046; χ2 = 7.300, P = 0.026; χ2 = 3.169, P = 0.049; χ2 = 3.012, P = 0.050, respectively). Chronic Brucella infection had a positive relationship with number of pregnancies (χ2 = 8.036, P = 0.018). Regression analyses showed that age, history of previous miscarriage and history of recent miscarriage in animals reared were positively correlated with Brucella seropositivity and miscarriage (χ2 = 13.200, P = 0.022; χ2 = 9.795, P = 0.007; χ2 = 7.890, P = 0.005, respectively). Conclusion: There is a high prevalence of brucellosis among women with miscarriage in Zaria. The burden of the disease should be appreciated and routinely tested to prevent reoccurrence