Successful Intrauterine Pregnancy following salpingostomy; Case Report

Background: Ectopic pregnancy occurs more in young women who still desire children. Because of tubal rupture, salpingectomy which leads to tubal loss and reduced reproductive potentials is the commonest management option. This is a case report of a primipara who had ruptured left tubal ectopic pregnancy managed by salpingectomy and later had unruptured heterotopic pregnancy involving the contralateral tube and managed by salpingostomy, after which she had spontaneous abortion of the associated intrauterine pregnancy. Result: Initial marital disharmony, followed by an uneventful intrauterine pregnancy carried to term with caesarean delivery of a live female baby. Conclusion: In well-selected cases, conservative tubal surgeries should be encouraged in preference to radical surgeries in the management of unruptured tubal pregnancies. Keywords: ectopic pregnancy, heterotopic pregnancy, conservative surgery Nigerian Journal of Medicine Vol. 17 (3) 2008: pp. 360-36

Unilateral ptosis: an uncommon presentation of chronic sinusitis - A case report

Chronic sinusitis is an inflammatory lesion that involves the paranasal sinuses with symptoms and signs that are beyond 12 weeks in duration. It commonly presents with nasal stuffiness, mouth breathing, purulent nasal discharge, post natal drip, snoring, cough, headache, facial fullness, hyposmia, sore throat and halitosis. Features of ocular and cerebral complications may be present at diagnosis but are uncommon and can thus result in misdiagnosis. A 15 year old male presented with sudden onset ptosis and other symptoms that initially suggested an intracranial SOL or a Cavernous sinus thrombosis. A CT scan of the head and neck structures identified chronic sinusitis as the only likely pathology. We present this case to highlight an unusual ocular complication of chronic sinusitis

The Youth Advisory Centre and Contraception: Perception of Female Medical Undergraduates in Ebonyi State, South East Nigeria

Background: Contraception prevents unwanted pregnancy. However, there remains an unmet contraceptive need and one of the contributory factors has been poor utilization resulting from lack of privacy, especially for the youths, at institutions offering family planning or contraceptive services.Youth friendly centres are established to ameliorate this. However, the extent to which the youths are aware of the existence of these centres and their services remains in doubt.Aim and Objective: This study seeks to evaluate the sources of contraceptives amongst Female medical undergraduates and their awareness of the Youth Friendly Centres.Materials and Methods: A cross sectional survey of female medical undergraduates of Ebonyi State University was done in November 2007 using self-administered questionnaires and focus group discussion was carried out. Information obtained was analyzed using Epi-info 2005 version 3.3.2. Statistical packageResult: Two hundred medical students at 100-600 levels participated in the study but 170 were analyzed. The respondents were aged 19 to 34 years, with a mean of 25.6 (+ 8) years. The modal age range was the20 to 24 year age group (42.4%). Sixty-six or 38.8% were sexually active of whom 60 or 90.9% used contraception. Thirty-six or 60.0% of the subjects who used contraception were introduced to it by their friends or peers. The condom (58 or 96.7%) and the pills (20.0%) were the commonly ever used methods. Students sourced contraceptives from pharmacy shops 83.3% (50) and private clinics 53.3%(32) among others. Only 14.1% (24) of the respondents were aware of the existence of the Youth Advisory Centre at Ebonyi State University Teaching Hospital, Abakaliki but none had ever utilized its servicesConclusion: the Youth Friendly Centre is not being utilized by the youths for contraceptive services. There is need for mass campaign amongst the youth on the existence of this centre and the services it offers.Key Words: Youth Friendly Centre, Source, Contraception, Undergraduat

Factors affecting compliance to treatment among children with epilepsy attending at a paediatric neurology clinic of a tertiary hospital in Enugu

BACKGROUND:This study aimed to determine the factors affecting compliance to treatment among children with epilepsy in Enugu,Nigeria.METHODS: Children with diagnosis of epilepsy were consecutively recruited.Their 6 months retrospective and 1 month prospective data were collected;and analyzed using SPSS version 20.0 (p < 0.05).RESULTS: Fifty six children with epilepsy (mean age= 9.7 ± 4.1 years) were studied. Generalized tonic clonic epilepsy was noted in 41.1% (23/56) of them.Thirty six (64.3%) complied strictly with the treatment regimen. Polytherapy, high cost of drugs, multiple drug dosages and drug related side effects affected compliance. Majority (79.4%, 27/34) of patients on monotherapy and a few (27.2%, 6/22) on poly-therapy had good seizure control (p<0.001).CONCLUSION: Poor drug compliance is a major constraint to adequate seizure control in children with epilepsy in our setting.Addressing the problem of poor compliance will enable them to achieve optimal seizure control.KEY WORDS: Epilepsy, Treatment Compliance, Associated Factors;Childre

Intentions of Registered Antenatal Clinic Patients About Utilizing Labour and Delivery Services if They Tested HIV-Positive

Background: Nigeria bears a sizeable proportion of the global HIV burden; mother to child transmission as a major contributor and prevention of mother to child transmission the hope for a HIV-free generation.Objective: To find evaluate how booked antenatal attendees intend to utilize the labour and delivery services of the state teaching hospital in Abakaliki in their index pregnancies and if they tested HIV positive.Methods: This was a cross-sectional survey of the attendees to the booking clinic. Data on patients' ages, marital status, past obstetric history, where clients would deliver their index pregnancies normallyand if they tested positive to HIV, and the reasons behind their decisions, were collected with pretested self-administered questionnaires and analyzed using SPSS version 15.Results: Four hundred and twenty-three (84.6%) of the questionnaires were analyzed. There were 288 patients who had been previously pregnant, of whom 274 (95.1%) booked for antenatal care, with 90.5%of the booking occurring after the first trimester. About 16.7% delivered in facilities without skilled professional care. A total of 90.8% of the respondents desired to deliver their index pregnancies in the teaching hospital because the hospital is equipped for emergency obstetric care. If HIV positive in index pregnancy, 93.9% will prefer to deliver in the teaching hospital mainly to prevent mother to child transmission. However, 6.1% of the respondents did not desire to deliver in the teaching hospital even ifpositive, with some even preferring to deliver at home.Conclusion: A HIV-free generation can be achieved if pregnant mothers are encouraged to utilize labour and delivery services that help prevent mother to child transmission of HIV by provision of free maternal services, conduction of staff education to correct unfriendliness, refitting the labour and delivery wards, introduction of community PMTCT, continued awareness creation and economic empowerment.Keywords: Utilization, Labour, Booking, Antenatal Clients, Nigeri

Ureterouterine Fistula Complicating Primary Caesarean Section In A Grandmultiparous Woman

Most urinary fistulae of obstetric origin involve the bladder, the ureter being rarely injured1. Obstetric ureteric injuries occur most commonly following emergency Caesarean section2, and may lead to ureterouterine fistula, a complication that usually manifests two to three weeks post-operation and may pose diagnostic and therapeutic difficulties1,3. Ureterouterine fistulae are rare, accounting for 1.6% of all urinary fistulae of obstetric origin1,3. They have also been reported in association with cervical dilatation and endometrial curettage, and ureteric stones4,5. A case is presented of a woman with ureterouterine fistula that resulted from emergency Caesarean section performed for obstructed labour and fetal distress. Ebonyi Medical Journal Vol. 6 (2) 2007: pp. 110-11

Ruptured Uterus At Afikpo, Southeast Nigeria.

Context: Ruptured uterus is an obstetric catastrophe associated with high maternal and perinatal mortality. Objectives: To determine the incidence, causes, management and fetomaternal outcomes of ruptured uterus in Afikpo, Southeast Nigeria. Methods: Delivery records, theatre registers and case notes of all ruptured uterus seen at Mater Hospital Afikpo, between January 2001 and December 2007 were analyzed. Results: Fifty one cases (1.2%) of ruptured uterus occurred out of 4,361 deliveries, giving an incidence ratio of 1:86. Mothers aged 30-34 years, multiparous and un-booked were worse affected. Multiple predisposing factors were noted with obstructed labour, mismanagement, grand multiparity and previous caesarean scars recorded in decreasing order. Uterine repair alone was performed in 88.2% of cases. Maternal mortality was 5.9% and perinatal mortality 84.6%. The incidence appears to be rising. Conclusion: Provision of quality antenatal care and emergency obstetric care in secondary hospitals, and supervision of Traditional Birth Attendants will reduce this menace. Keywords:Antenatal, Care, emergency, maternal, perinatal, quality. Ebonyi Medical Journal Vol. 7 (1&2) 2008: pp. 36-4