Contraceptive use among female traders in Ibadan, Nigeria

Context: Female traders are a part of the informal sector which is characterized by flexible timing, easy entry and exit, proximity to residence and compatibility between work and family responsibilities especially child care. More than half of Nigerian women are traders and are reported to have the highest fertility rates. The ability to regulate and control fertility has tremendous impact on women's health by reducing rates of unintended pregnancies and the need for unsafe abortion.Objectives: The study was designed to assess use of contraceptives and associated factors among female traders in a well-defined market.Methods: A descriptive cross-sectional survey was carried out among a total sample of 225 female traders aged 15-49years in Sango market, Ibadan, south west Nigeria. An interviewer administered questionnaire was used to collect information on their socio-demographic characteristics and contraceptive use.Main Outcome Measures: Prevalence of ever and current contraceptive use, types and factors associated with contraceptive use was determined.Results: Their mean age was 32.3± 8.2 years, 172 (76.4%) were married and 102 (45.3%) had secondary education. Ever and current use of contraceptive was reported by 34.7% and 25.3% of respondents respectively. The Intrauterine Contraceptive Device (IUCD) was the most used method (30.0%). Current contraceptive use was highest among respondents aged 30-39 years (p=0.009).Conclusions: Level of contraceptive use among female traders in Nigeria is quite low. Efforts should be made to increase use through market based family planning programmes.Key words: Contraceptive use, reproductive age, female traders, well-defined market

Posterior perforation of gastric ulcer: a rare surgical emergency

BACKGROUND:Gastric ulcer perforation is a rare surgical emergency.Posterior gastric ulcer is even rarer and usually has a delayed presentation with attendant greater morbidity and mortality.AIM:To report a case of posterior perforation of gastric ulcer and review the literature.CASE REPORT:A 65yr old driver was seen in the hospital with a 4- day history of epigastric pain which became generalized. Examination revealed a patient in shock with a board-like rigidity of the abdomen. Chest x-ray confirmed pneumoperitoneum. He had an exploratory laparotomy. Findings at surgery include moderate peritoneal fluid collection and 1.5cm diameter perforation on the posterior gastric wall which was closed primarily with an omental patch. Biopsy of the ulcer edge was negative for malignancy. He was discharged 10 days after surgery.CONCLUSION:To the best of our knowledge,perforation of a posterior gastric ulcer is an unusual encounter in surgery.A high index of suspicion is needed to prevent high mortality.KEY WORDS: Posterior,Gastric,Rare,Ulcer

Variations in in vitro and in vivo indices of photoperiod sensitivity among kenaf (Hibiscus cannabinus) accessions in Nigeria

In equatorial climates, fibre yield is higher in photo-insensitive kenaf cultivars. To develop a rapid screening method, in vivo and in vitro indices were evaluated. Seven genotypes were grown at natural photoperiod and growth rates before and after flowering, days to flowering and fibre yield were recorded. In vitro, stem and leaf explants of genotypes Tainung and V400 which showed contrasting photoperiodic responses in vivo, were tested for callus induction at 0 and 12 h photoperiod. Calli were transferred to differentiation medium at 12 and 9 h photoperiod and numbers of green spots and embryogenic callus clusters were recorded. Flowering was delayed by at least 27 days in V400 relative to other genotypes. Growth rate reduced by 30% after flowering in all genotypes except V400 where it increased by 60%. Highest yield of 76 g / plant was recorded in V400. Eighty-four percent degree of callus formation by stem was higher than 51% by leaf explants of V400 irrespective of light regime. In Tainung, callus formation varied with explants and photoperiod. Green spots and embryogenic clusters were three times more in Tainung than V400. Both in vivo and in vitro results showed Tainung as photosensitive and V400 as photoinsenstive. Incubating kenaf callus in differentiation medium in 12 h light and evaluating for greenness was useful in screening for photoperiod sensitivity.Keywords: Kenaf, Hibiscus cannabinus, photosensitivity, in vitro screening, somatic embryogenesisAfrican Journal of Biotechnology Vol. 12(19), pp. 2581-258

Effects of plant growth regulators on callus, shoot and root formation in fluted pumpkin (Telfairia occidentalis)

Root and stem explants of fluted pumpkin were cultured in medium containing different types and concentrations of plant growth regulators (PGRs). The explants were observed for callus, root and shoot formation parameters after four months. Differences among explants, plant growth regulators and their interaction were not significant for number of roots per plantlet. Callus formation was higher in stem than root explants. Stem explants formed more callus in medium containing naphthalene acetic acid than that containing indole acetic acid while the trend was opposite with root explants. Root explants did not form shoots, leaves or nodes in any of the PGR regimes, while a concentration of 1.5 mg/l benzylaminopurine (BAP) induced the highest numbers of shoots, nodes and leaves per stem explant. There was no callus, shoot, node and leaf formation by both explants when cultured in medium without PGRs while root formation was minimal

Prognostic Significance Of QT Interval Prolongation In Adult Nigerians With Chronic Heart Failure.

Prognostic survival studies for heart-rate corrected QT interval in patients with chronic heart failure are few; although these patients are known to have a high risk of sudden cardiac death. This study was aimed at determining the mortality risk associated with prolonged QTc in Nigerians with heart failure. Ninety-six consecutive patientswith heart failurewere recruitedwith 90 age and sexmatched controls.All the subjects had a 12-lead electrocardiogramat a paper speed of 25mm/sec and a rhythm strip (lead II) at 50mm/sec.The latterwas used to calculate theQTc using the Bazett\'s formula. Left ventricular systolic and diastolic functions were assessed using 2D guided M-mode and Doppler echocardiogram respectively.Theywere followed-up for sixmonths. Ninety-one patients and 90 controls completed the study. Five patients were lost to follow-up. The mean age (51.9±16 years) of the patientswas similar to that of the controls (50.3±15) (P= 0.475).Twenty-eight (30.8%) patients died after 6months of follow-up against none of the controls.The mean QTc was significantly longer in the non-survivors (0.494±0.027) than in the survivors (0.462±0.035) (P = 0.0001). The percentage mortality in patients with prolonged QTc against those with normal QTc was 41% and 14% respectively (P = 0.001). In the stepwise regression analysis, QTc was an independent predictor of mortality (R = 0.412, R = 0.17, P= 0.001). QTc prolongation is a predictor of mortality in CHF and may be an important adjunct in risk stratification of patientswith heart failure. Keywords: Chronic Heart Failure, QTc Prolongation, Mortality Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 336-34

Prediction of functional capacity during six – minute walk among patients with chronic heart failure

Formulae for predicting functional capacity during 6-minue walk are lacking and the accuracy of the existing formulae has been challenged in deferent populations. The purpose of this study was to develop an equation that would be useful in predicting functional capacity in form of maximum oxygen consumption) (V0 ) in Chronic Heart Failure Patients (CHF) during exercise.Sixty-five subjects were recruited for the study. The procedure required the subjects to walk on a self paced speed on a 20 meter marked level ground for 6 minutes. The distance covered in 6 minutes was measured and the speed calculated.The result showed that the distance covered was highly correlated with the VO2 (0.65, p< 0.01). The regression analysis revealed that a linear equation model developed was a good predictor ofV0 for the group.The study concluded that in situation where sophisticated equipments are lacking, this equation might be useful during exercise supervision for patients withCHF. [VO2 (ml kg-1 min-1) = 0.0105 x distance (m) + 0.0238 age (yr) - 0.03085 weight (kg) + 5.598]

Cardiovascular responses to treadmill exercise in Nigerian hypertensives with left ventricular hypertrophy

Background: Left ventricular hypertrophy (LVH) is an independent risk factor for adverse cardiac outcomes in hypertensive patients.Objective: This study is designed to assess the cardiovascular responses to treadmill exercise among Nigerian hypertensives with echocardiographically proven LVH.Materials and Methods: Fifty hypertensive patients with LVH (27 males and 23 females) between 30 and 65 years of age were studied in Nigeria. 50 hypertensive patients without LVH and 50 normal subjects who were age and sex matched served as controls. All patients and control subjects underwent M-mode, 2-D and Doppler ECHO-studies and the Bruce protocol treadmill exercise test.Results: The study showed that the estimated maximal oxygen consumption (MVO2) in MET reduced progressively from 8.39 &#177; 1.26 (normotensive control) to 7.62 &#177; 1.33 (hypertensive without LVH), 6.27 &#177; 0.99 (hypertensive with LVH) (P&lt;0.0001ANOVA). The duration of exercise (s) was also reduced in that order from 455.4 &#177; 79.1 to 411.6 &#177;8 2.3, 315.8 &#177; 75.6 respectively (P&lt;0.0001). The systolic blood pressure (SBP) and pressure rate product (PRP) during maximal exercise were also increased in hypertensives with LVH and hypertensive without LVH when compared to normotensive controls. The hypertensives with LVH and hypertensives without LVH also showed significant limitation to heart rate increase with exercise compared to normotensive controls (P&lt;0.003).Conclusion: This study demonstrated significant impairment of exercise capacity in hypertensives with or without LVH compared to normotensive subjects. Both earlier recognition and improved understanding of LVH may lead to more effective therapeutic strategies for this cardiovascular risk factor

Prediction of breast self-examination in a sample of Iranian women: an application of the Health Belief Model

<p>Abstract</p> <p>Background</p> <p>Iranian women, many of whom live in small cities, have limited access to mammography and clinical breast examinations. Thus, breast self examination (BSE) becomes an important and necessary approach to detecting this disease in its early stages in order to limit its resultant morbidity and mortality. This study examined constructs arising from the Health Belief Model as predictors of breast self examination behavior in a sample of women living in Bandar Abbas, Iran.</p> <p>Methods</p> <p>This study was conducted in eight health centers located in Bandar Abbas, Iran. The sample consisted of 240 eligible women who were selected from referrals to the centers. The inclusion criteria were as follows: aged 30 years and over; and able to read and write Farsi. Women with breast cancer, who were pregnant, or breast feeding, were excluded from the study. Data were collected by using a self administered questionnaire which included demographic characteristics and Champion's Health Belief Model Scale. This instrument measures the concepts of disease susceptibility (3 items), seriousness (6 items), benefits (4 items), barriers (8 items) and self-efficacy (10 items).</p> <p>Results</p> <p>The subjects' mean age was 37.2 (SD = 6.1) years. Just under a third of the subjects (31.7%) had performed BSE in the past and 7.1% of them performed it at least monthly. Perceived benefits and perceived self-efficacy of the women who performed BSE were significantly higher compared with women who did not practice BSE (p < 0.03). Furthermore, perceived barriers were lower among those who had performed BSE (p < 0.001). Logistic regression analysis indicated that women who perceived fewer barriers (OR: 0.70, 95% CI: 0.63-0.77, p < 0.001) and had higher self-efficacy (OR: 1.08, 95% CI: 1.02-1.13, p = 0.003) were more likely to perform BSE (R²= 0.52).</p> <p>Conclusion</p> <p>Findings from this study indicated that perceived barriers and perceived self-efficacy could be predictors of BSE behavior among the sample of women. Therefore, BSE training programs that emphasize self-efficacy and address perceived barriers are recommended.</p

Characterisation of heart failure with normal ejection fraction in a tertiary hospital in Nigeria

<p>Abstract</p> <p>Background</p> <p>The study aimed to determine the frequency and characteristics of heart failure with normal EF in a native African population with heart failure.</p> <p>Methods</p> <p>It was a hospital cohort study. Subjects were 177 consecutive individuals with heart failure and ninety apparently normal control subjects. All the subjects underwent transthoracic echocardiography. The group with heart failure was further subdivided into heart failure with normal EF (EF ≥ 50) (HFNEF) and heart failure with low EF(EF <50)(HFLEF).</p> <p>Results</p> <p>The subjects with heart failure have a mean age of 52.3 ± 16.64 years vs 52.1 ± 11.84 years in the control subjects; p = 0.914. Other baseline characteristics except blood pressure parameters and height were comparable between the group with heart failure and the control subjects. The frequency of HFNEF was 39.5%. Compared with the HFLEF group, the HFNEF group have a smaller left ventricular diameter (in diastole and systole): (5.2 ± 1.22 cm vs 6.2 ± 1.39 cm; p < 0.0001 and 3.6 ± 1.24 cm vs 5.4 ± 1.35 cm;p < 0.0001) respectively, a higher relative wall thickness and deceleration time of the early mitral inflow velocity: (0.4 ± 0.12 vs 0.3 ± 0.14 p < 0.0001 and 149.6 ± 72.35 vs 110.9 ± 63.40 p = 0.001) respectively.</p> <p>The two groups with heart failure differed significantly from the control subjects in virtually all echocardiographic measurements except aortic root diameter, LV posterior wall thickness(HFLEF), and late mitral inflow velocity(HFNEF). HFNEF accounted for 70(39.5%) of cases of heart failure in this study.</p> <p>Hypertension is the underlying cardiovascular disease in 134(75.7%) of the combined heart failure population, 58 (82.9%) of the subjects with HFNEF group and 76(71%) of the HFLEF group. Females accounted for 44 (62.9%) of the subjects with HFNEF against 42(39.3%) in the HFLEF group (p = 0.002).</p> <p>Conclusion</p> <p>The frequency of heart failure with normal EF in this native African cohort with heart failure is comparable with the frequency in other populations. These groups of patients are more likely female, hypertensive with concentric pattern of left ventricular hypertrophy.</p

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe