The pattern and challenges of infertility management in Lagos, Nigeria

Background: Infertility remains a threat to successful reproduction by couples desirous of pregnancy.Objective: To determine the pattern of infertility cases amongst infertile couples seeking care in Lagos University Teaching Hospital as well as challenges in their management.Methods: A review of the management of couples referred for infertility to the gynaecological outpatient clinic of the Lagos University Teaching Hospital (LUTH), Nigeria from 1st January 2005 to 31st December 2006.Results: The incidence of infertility was found to be 26.8% of the gynaecological consultations with a mean duration of infertility of 4.3 ± 3.4 years. The mean age of the women was 33.8 ± 5.2 years and 66.1% were nulliparous. Secondary infertility accounted for 80% of cases. Male factors only was the cause in 11.1%, female factor only in 37.8%, both male and female factors in 40% while no cause was identifiable in 11.1%. There was no association between tubal occlusion and a history of induced abortion in this study (p >0.05). There was a high rate of discontinuation of care by their large numbers lost to follow up.Conclusion: Infertility is still a public health problem in Lagos, Nigeria.Keywords: Infertility pattern: causes, incidence, outcome and challenges in careAfrican Health Sciences 2013; 13(4): 1126 - 112

Evaluation of the Mode of Referral of Patients for Physiotherapy by Physicians

The physiotherapy profession has emerged not only as an important medical and rehabilitation complement in health care delivery but also as a vital therapeutic tool with defined scientifically based protocols. In Nigeria, it is used as a prescription rather than as a referral, on a consultation basis, but its use as a prescription is gradually being discouraged in some developed countries. There seems to be a low level of awareness of this development, particularly in the developing countries. This study was therefore designed to evaluate the physicians’ mode of referral of patients for physiotherapy in Nigeria. A total of 1192 physicians participated in the survey, a 78 per cent response rate. They were required to complete a 22-item self developed closed-ended questionnaire using a sample of opportunity. The questionnaire obtained information on demographic data, educational attainment, university of graduation, year of graduation and mode of referral for physiotherapy. A total of 1054 (88.4%) respondents agreed that physiotherapists were trained enough to make clinical decisions on the treatment of their patients and 678 (56.9%) referred patients for physiotherapy. Of the respondents who agreed that physiotherapists are trained well enough to make clinical decisions on the treatment of their patients, 786 (74.6%) graduated from universities that also have a physiotherapy training programme. The majority 442 (68.2%) of these respondents and 603 (79.4%) of the respondents who received some form of lectures in physiotherapy during their medical training or whose universities had a physiotherapy training programme did not include prescriptions in their referrals. KEY WORDS: physicians, mode of referral, physiotherap

Comparison of Cardiorespiratory fitness of Nigerians with Low back pain and apparently Healthy Adults

The objective of this study was to compare Cardiorespiratory fitness (CRF) of Nigerians with low back pain (LBP) and apparently healthy counterparts. A total of Seventy (70) subjects participated in the study; 35 of them were low back pain patients, while the remaining 35 were apparently healthy adults. For low back pain group 22 (62.9%) of them were chronic low pain, while 13 (37.1%) were acute low back pain. Cardiorespiratory fitness of the subjects was determined using Cooper's 12 – minute walk. Student t-test showed a statistical significant for cardiorespiratory fitness (t = 0.006) between LBP subjects and apparently healthy adults. However, there was no statistical significant difference in Cardiorespiratory fitness between acute low back pain and chronic low back pain subjects (t = 0.06). There was least positive correlation between low back pain and cardiorespiratory fitness (r =0.40). It was concluded from this study that apparently healthy adults had higher cardiorespiratory fitness level than low back pain subjects and there was significant correlation between back pain and cardiorespiratory fitness. Health enlightenment campaign to prevent and minimize complications of LBP is needed and fitness program should be incorporated in the management of low back pain subjects. KEY WORDS: Caridorespiratory fitness, low back pain, acute, chronic and exercise. Nigerian Journal of Health and Biomedical Sciences Vol.3(2) 2004: 105-10