Outcomes of surgical treatments for acquired gynatresia in a tertiary institution in Ibadan, Nigeria

A 16-year review of causes, clinical presentation and management outcomes of Acquired gynatresia (AG) at University College Hospital, Ibadan, Nigeria. Information was obtained using a proforma and data analysed using SPSS version 20.0. The mean age of the 31 women with AG was 35.6 ± 6.2 years. The majority (90.3%) were married and had a tertiary level of education. The mean parity was 0.74 ± 1.1 and 54.8% were nulliparous while 29.0% were primiparous women. The commonest cause of AG was the insertion of caustic substances into the vagina and this was mainly for the treatment of uterine fibroid (68.2%) and infertility (54.5%). Over three-quarters presented with dyspareunia while 54.8% had infertility. A majority (87.1%) had one-stage surgery with dissection/excision of fibrotic tissue being the commonest (45.2%) and sigmoid vaginoplasty the least performed. Postoperative complications were seen in 29.0% of cases. Acquired gynatresia remains a condition of public health interest despite an increase in female education and relatively improved health care in Nigeria.Impact statement What is already known on this subject? Acquired gynatresia (AG) could be of chemical and non-chemical origin and result from certain cultural beliefs and practices. What do the results of this study add? Irrespective of the women’s level of education, there is inadequate awareness of the implications of inserting caustic materials into the vagina. However, there is a high success rate of treatment of AG. What the implications are of these findings for clinical practice and/or further research? There is a need to increase health education and awareness of the populace on the causes of AG and its associated complications

Hypoglycaemic and Antioxidative Properties of Freeze-Dried Garcinia Kola Seeds in Type 2 Diabetics and Non-Diabetics with Chronic Foot/Leg Ulcer in Ibadan, Nigeria: A case-control clinical study

Introduction: The antidiabetic and antioxidative properties of Garcinia kola (GK) seed extracts have been well documented in animal studies; however, data on freeze-dried powder of GK seeds (FDGK) in humans are scarce. This study investigated the effect of 8-weeks supplementation of FDGK on glycaemic control and oxidative stress levels in Type 2 diabetics with or without foot/leg ulcer and compared with non-diabetics with or without chronic foot/leg ulcer in Ibadan, Nigeria. Materials and Methods: Thirty diabetics with foot/leg ulcer (DFU), 30 diabetics without ulcer (T2DM), 30 non-diabetics with chronic foot/leg ulcer (NDCU) and 30 non-diabetics without ulcer (NDC) were divided into: subgroup-1 (250mgGK); subgroup-2 (500mgGK); subgroup-3 (No-supplementation). Plasma glucose (FPG), glycated haemoglobin-A1c (HbA1c), total plasma peroxides (TPP), total antioxidant status (TAS), oxidative stress index (OSI), antioxidant-micronutrients were determined in fasting blood samples. Wounds were clinically assessed and rated using modified ABDEFS. Results: All participants supplemented with 250mgGK or 500mgGK for 8 weeks showed decreases in TPP and OSI with improvement in wound healing, increases in TAS and antioxidant-micronutrients (p<0.05). In addition, significant decreases in FPG were observed in DFU and T2DM supplemented with 250mgGK, and also in NDC supplemented with 500mgGK. In non-supplemented subgroups, increases in TPP and OSI with decreases in TAS and antioxidant-micronutrients (p<0.05) were observed. Conclusion: Supplementation with Garcinia kola could be used as an adjunct for prevention and treatment of diabetes mellitus complicated with or without foot/leg ulcer Recommendations: Caution must be taken when used as prophylactic in non-diabetics to prevent occurrence of hypoglycaemia