Echocardiographic findings in non-hypertensive subjects in Bayelsa, Nigeria

Background: Echocardiography is one of the tools for the assessment of patients with hypertensive disease. Differences in  parameters have been described based on race, gender and environment.Aim: In order to define what should be considered abnormal, we set to find out what the normal cardiac parameters are in our environment. Methods: This was a cross sectional of 80 non hypertensive adults. Transthoracic 2D echocardiography was performed with patients in the left decubitus position using standard techniques. Results: From this study, we found the left ventricular mass to be 129 ± 37.61, the ejection fraction (%) 62.77 ± 10.55 and the fractional shortening (%) to be 34.18 ± 7.49. Values for the intraventricular septal thickness, posterior wall diameter, left ventricle internal diameter (in diastole and systole) are (0.92±0.19, 1.43±0.24), (0.91±0.17, 1.47±0.23) and (4.32±0.50, 2.83±0.42) respectively. All the  parameters other than relative wall thickness and ejection fraction showed  statistically significant difference (P<0.05).Conclusion: We hope that the findings from this study will provide direction on what to consider as normal regarding echocardiographic findings in our environment.Key words: Echocardiography, hypertension, cardiometabolic disorder, cardiovascular disorder, BMI, ventricular mas

Effect of Intramuscular Hyoscine-N-Butyl Bromide on Tubal Spasm and Pain Perception in Women with Infertility Undergoing Hysterosalpingography: A Randomised Controlled Trial

Background: A tubal patency test is essential in evaluating women with infertility. Hysterosalpingography (HSG) is the investigation of choice for assessing tubal patency. Objective: To evaluate the effect of intramuscular hyoscine-N-butyl bromide on tubal spasms and pain perception during hysterosalpingography. Methods: This randomized, controlled trial was conducted at the Radiology Departments and Infertility Clinics of four health institutions in Bayelsa State, Nigeria, between January 2021 and April 2022. Five hundred and twenty infertile women undergoing hysterosalpingography were randomized into two groups. Women in group I (control) received a placebo, while women in Group II (experimental) received 20 mg of intramuscular hyoscine-N-butyl bromide. Pain scores at different steps of the procedure were recorded. Results: The overall mean pain scores progressively decreased from contrast instillation (4.97 ± 2.08) through 30-minutes post-procedure (3.54 ± 1.54) to 24 hours post-procedure (1.96 ± 1.78). Pain scores at contrast instillation, 30 minutes and 24 hours after HSG were significantly lower in the hyoscine group compared to the placebo group (p = 0.001 each). There were significantly fewer women with tubal blockage in the hyoscine group compared to the placebo group [78 (30.0%) vs 131 (50.4%); p = 0.001]. Conclusion: Intramuscular hyoscine-N-butyl bromide before hysterosalpingography significantly reduces pain and tubal spasm during the procedure

Relationship Between Subchorionic Haematoma and Abdominal Massage in Pregnancy in the Niger Delta Region of Nigeria: A Pilot Study

Background: Abdominal massage (AM) in pregnancy is a common practice in the Niger Delta region of Nigeria. AM may cause events such as subchorionic haematoma (SAH) and increase the risk of miscarriages and adverse maternal and perinatal outcomes. Objective: To determine the relationship between AM and SCH in the Niger Delta region of Nigeria. Methods: A cross-sectional study was conducted from January to June 2022 at the Obstetrics and Radiology Units of four health facilities in Bayelsa State, Nigeria. Consenting eligible pregnant women presenting to the antenatal clinic during the first trimester were consecutively included. An obstetric ultrasound scan was performed transabdominal. Results: Of the 403 women recruited, 241 (59.8%) were aged (20 – 29 years). The mean age was 28.02 ± 5.99 years. The mean body mass index was 23.82±4.60 kg/m2. While 170 (42.2%) had undergone AM in the first trimester of the index pregnancy, 126 (31.3%) had vaginal bleeding, and SCH occurred in 109 (27.0%) women. Women who had AM had 210 (CI: 58 – 878) times the odds of having SCH and 3.3 (CI: 2.14 – 5.15) times the odds of vaginal bleeding than women who did not have AM. Only 2 (1.8%) women with SCH did not have AM. Conclusion: There exists a strong association between the occurrence of SCH among pregnant women who have had AM. More health education is needed for women in the Niger Delta region and Nigeria to eradicate the archaic practice and improve pregnancy outcomes

Hysterosalpingography: Still relevant in the evaluation of infertility in the Niger Delta

Background: Hysterosalpingogram is an important tool in the management of female infertility. It outlines the fallopian tubes and uterine cavity. Aim: To review the hysterosalpingographic (HSG) findings in women investigated for infertility in a tertiary care center in the Niger Delta. Methods: The study reviewed 137 consecutive HSG films of women investigated for infertility between 1st January to 30th May, 2014. Result: The commonest age group was 26-30yrs (46.7%). Majority of the women were investigated for secondary infertility 98 (71.5%). Abnormal findings were found in 99(72.3%) and the commonest abnormality was tubal 67(48.9%) with bilateral tubal blockage in 20 (14.6%). Other findings include submucous fibroids in 28 (20.4%), uterine synechia 26(19.0%) and bi-cornuate uterus in 1(0.7%). Conclusion: HSG is relevant in the investigation of infertile women. Bilateral tubal occlusion from pelvic inflammatory disease, puerperal sepsis and unsafe abortions remains a major challenge in the Niger delta.Key words: Hysterosalpingography, infertility, fallopian tube, patency, laparoscopy, endometriu