Knowledge attitude and practice of cervical cancer screening among sexually active women in Onitsha, Southeast Nigeria

No Abstract

Laparoscopic Retrieval Of Perforated Intrauterine Device

We present a case of successful laparoscopic retrieval of a perforated intrauterine device (Lippes loop). The Lippes loop was inserted after manual intrauterine adhesiolysis as a treatment of uterine synaechia presenting as secondary amenorrhoea of 20 months duration. The uterine perforation in this patient did not occur at the time of insertion but possibly during the attempt at transcervical removal of the missing IUD by manipulation with the retrieval hook. Double puncture laparoscopic technique under ketamine general anaesthesia was performed to remove the IUDwithout complication and patientwenthome the same day. Keywords: Laparoscopy, Missing Intrauterine Device (IUD), Lippes Loop, Uterine Perforation Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 394-39

Complete Recovery of a Booked Primigravida with Hemorrhagic Stroke Due to Severe Preeclampsia

Stroke is a major contributor to morbidity and mortality during pregnancy and puerperium. Intracerebral hemorrhage (ICH), which is bleeding within the cerebral parenchyma as a result of rupture of a blood vessel, is the second most common type of stroke after ischemic stroke. We report a case of ICH due to severe preeclampsia that was suspected to have occurred shortly before cesarean section in a woman with prior normal prenatal care. She recovered completely without any neurological deficit.KEY WORDS: Complete recovery, intracerebral hemorrhage, Nigeria, preeclampsia, strok

An analysis of uterine rupture at the Nnamdi Azikiwe University Teaching Hospital Nnewi, Southeast Nigeria

Objective: Uterine rupture is a preventable condition which has persistently remained in our environment. The aim of this study therefore is to ascertain the incidence of uterine rupture, examine the predisposing factors and maternal and fetal outcome of patients managed of uterine rupture in a tertiary hospital.Materials and Methods: This descriptive case series was conducted at the department of Obstetrics and Gynaecology, Nnamdi Azikiwe, University Teaching Hospital Nnewi from March 2004 to February 2009.Results: The incidence of uterine rupture was 6.2 per 1000 deliveries. The commonest age range of occurrence was 30-34 years. Uterine rupture occurred predominantly among women of low parity. Previous caesarean section with concurrent use of oxytocics was the commonest risk factor documented.The maternal and perinatal mortality ratio was 94 per 100,000 deliveries and 6 per 1000 births respectively. Surgery was the main stay of treatment and the commonest procedure carried out was uterine repair only.Conclusion: Rupture of the gravid uterus is still a significant cause of maternal mortality and morbidity in our environment. The causes are commonly preventable. The provision of maternal care by skilled personnel, proper antenatal care, update training programmes for health care providers and appropriate legislation on maternal care will significantlyreduce the incidence of uterine rupture and improve its prognosis

Heterotopic Pregnancy in a Natural Conception Following Failed Contraceptive Practice

This report presents another rare case of spontaneous simultaneous intrauterine and extrauterine tubal pregnancies following failed progestogen-only injectable contraceptive. The ruptured heterotopic pregnancy was diagnosed in unruptured state but could not be treated because the couple did not believe/accept the diagnosis and consequently withheld their consent. The patient underwent emergency laparotomy and evacuation of products of intrauterine pregnancy. A high index of suspicion is necessary to ensure early diagnosis and management.KEY WORDS: Contraceptive, emergency, heterotrophic, laparotomy, pregnanc

Pregnancy following laparoscopic ovarian drilling for clomiphene resistant polycystic ovarian syndrome

No Abstract

Thermal Properties of Pineapple Leaf Composite and its Suitability as a Viable Alternative for Efficient Roofing Material

For self-cooling building designs, the thermal properties of pineapple (Ananas Comosus) stalk composite were investigated and compared with those of asbestos with a view to establishing its suitability as ceiling material. Sample boards from pineapple leaves were prepared by drying and grinding, then forming them into boards without an external binder. The major parameter, thermal conductivity К was determined using Lee’s Disc apparatus. Other parameters determined were specific heat capacity c, density ρ, thermal resistivity ρth, thermal diffusivity λ, and thermal absorptivity α, were determined by using the appropriate experimental methods or calculations. The thermal conductivity of Ananas Comosus was determined to be 0.0719±0.0007Wm-1K-1. Using the same Lee’s Disc apparatus method, the thermal conductivity of the commercial asbestos ceiling sheet was measured to be 0.195Wm-1K-1. This value is about 85% of the value (0.17Wm-1K-1) \) quoted in textbooks. Our pineapple stalk sheet is clearly a poorer heat conductor than the asbestos sheet.  Other parameters determined here – the specific heat capacity, the thermal diffusivity, etc, support our findings that the investigated material can serve as a good material for efficient “cool roof” building desig

Sexual practices of people living with HIV in south eastern Nigeria

Couples could be in serodiscordant or seroconcordant sexual relationship. The seroconcordant could be seroconcrdant positive or negative in a heterosexual or homosexual or bisexual relationship. The various sexual practices include vaginal sex; anal sex fisting; oral sex fellatio, cunnilingus; masturbation mutual or exclusive and a host of others. These sexual practices outside safer sex guidelines will lead to HIV transmission among couples. The study is set to determine the sexual practices of people livingwithHIV(PLWHA) in SoutheastNigeria. This is an analytical epidemiological study. A total of 300 subjects were studied using interviewer administered questionnaires. Data is presented in tables and figures. Analysis was done using SPSS 11.0 statistical package. Most respondents were in heterosexual relationship (97%). The married couples in serodiscordant relationship were 25.3% while the singles in serodiscordant relationship were 20%. About 56% do not use condom for the adopted sexual practice although 65% believe that condom use would protect against HIV transmission. Couples in seroconcordant seronegative relationship have it as a challenge to remain so. This study suggests that the PLWHA are very important in the spread of HIV infection as they are still sexually active, in non-cohabiting conjugal unstable relationship, and they do not use the condomconsistently. There is an urgent need to target this population with effective behavioural change communications thatwill translate to safer sexual behaviour. The practice of safer sex should be taught in every health care center, in schools and in village gatherings by qualified health care workers. This will help curb the transmission of HIV.

Emergency peripartum hysterectomy in Nnewi, Nigeria: A 10-year review

Background: Emergency peripartum hysterectomy has remained a challenging and very life saving surgical procedure in obstetrics. Its indications are emerging.Aims: This was to determine the incidence, indications, and outcomes of emergency peripartum hysterectomy at a tertiary hospital in Nnewi, south–east Nigeria.Materials and Methods: A retrospective study of the case files of patients requiring an emergency peripartum hysterectomy between January 2000 and December 2009 was conducted. Emergency peripartum hysterectomy was defined as one performed for hemorrhage unresponsive to other treatment within 24 hours of delivery. The findings were analyzed using Epi info version 3.5.1.Results: During the 10-year period, there were 6,137 deliveries and 38 cases of emergency peripartum hysterectomies, giving an incidence of 6.2 per 1000 deliveries. Of the 38 hysterectomies, only 29 (76.3%) case files were available for analysis. The mean age of the patients was 28.1 ± 5.4 years and 22 (75.9%) patients were unbooked. There were four primigravidae (13.8%) while 25 (86.2%) were parous. The main indications for hysterectomy were placenta praevia 14 (48.3%) and uterine rupture 10 (34.5%). Subtotal hysterectomy was performed in majority (72.4%) of cases. The commonest postoperative morbidities were postoperative fever (37.9%), postoperative anemia (24.1%), and wound infection (20.7%). The maternal case fatality rate was 31.0%, while the perinatal mortality was 44.8%. The mean duration of hospital stay was 9.8 ± 2.4 days.Conclusion: The incidence of emergency peripartum hysterectomy was high and majority of patients were unbooked. Placenta praevia has emerged as its primary indication. Booking for antenatal care, anticipation, prompt resuscitation, and early surgical intervention by a skilled surgeon are crucial

Determinants of Acceptance of Cervical Cancer Screening in Dar es Salaam, Tanzania.

To describe how demographic characteristics and knowledge of cervical cancer influence screening acceptance among women living in Dar es Salaam, Tanzania. Multistage cluster sampling was carried out in 45 randomly selected streets in Dar es Salaam. Women between the ages of 25-59 who lived in the sampled streets were invited to a cervical cancer screening; 804 women accepted and 313 rejected the invitation. Information on demographic characteristics and knowledge of cervical cancer were obtained through structured questionnaire interviews. Women aged 35-44 and women aged 45-59 had increased ORs of 3.52 and 7.09, respectively, for accepting screening. Increased accepting rates were also found among single women (OR 2.43) and among women who had attended primary or secondary school (ORs of 1.81 and 1.94). Women who had 0-2 children were also more prone to accept screening in comparison with women who had five or more children (OR 3.21). Finally, knowledge of cervical cancer and awareness of the existing screening program were also associated with increased acceptance rates (ORs of 5.90 and 4.20). There are identifiable subgroups where cervical cancer screening can be increased in Dar es Salaam. Special attention should be paid to women of low education and women of high parity. In addition, knowledge and awareness raising campaigns that goes hand in hand with culturally acceptable screening services will likely lead to an increased uptake of cervical cancer screening