Assessing Sexual Function of Women after 12 Months of IUD Usage

The Intrauterine Device (IUD) is a well-accepted method of contraception. Most women are currently using it because of its effectiveness, longevity, and affordability. Moreover, users need no strict routine instructions for IUD. However, many women in the absence of any pre-existing conditions that may impair sexual functions discontinue the method due to poor sexual satisfaction. This paper aims to assess and measure the effects of IUDs on sexual function in women with no underlying condition over a period of 12 months. This study employed a longitudinal approach. To be eligible to participate, the study enrolled 260 women who have chosen to use IUDs willingly on their own at these selected centers during this period and are aged 20 years and above. It collected data at baseline and at 12 months of use. Measurements at these two timelines were done using the Female Sexual Function Index (FSFI). The prevalence of female sexual dysfunction among participants after 12 months was 47.7% (124). In the analysis of Mean scores, FSFI at baseline and at 12 months was 31.31 and 24.76 respectively (p<0.05). Significantly reduced scores (p=0.001), for all the six domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) of sexual function were noted. Desire and pain were the most affected areas of sexual function with very low scores. Without any underlying and related triggers of sexual health, the study discovered that IUDs have the potentials to cause female sexual dysfunction in almost half of its users

The effects of etonorgestrel implant (ImplanonR) on the lipid profile of Nigerian women

Background: Provision of contraceptive methods with minimal side effects will enhance uptake of contraception particularly in Nigeria where contraceptive prevalence rate remains low. The safety profile of ImplanonR, a long‑acting hormonal subdermal contraceptive containing etonogestrel, has not been adequately evaluated among Nigerian women.Objective: To assess the effects of etonogestrel subdermal implant (ImplanonR) on lipid profile among Nigerian women.Materials and Methods: The study was a longitudinal follow‑up of 54 consenting women selected over a 6‑month period at the Family Planning Clinic of the University College Hospital, Ibadan. After ImplanonR insertion, each woman was followed‑up monthly for a period of 12 months. Fasting venous blood samples were collected for quantification of serum lipids prior to insertion of the implant, then at 1st, 3rd, 6th, 9th, and 12th months of follow‑up.Results: The mean age of the women was 34.4 ± 5.6 with a range of 22–47 years. The modal number of children was 2 ranging from 1 to 6. Total cholesterol (TC) levels showed a general tendency toward a rise. The rise was, however, only significant in the 3rd and 12th months of use. Serum triglycerides showed a tendency toward reduced levels, which were only significant at the 6th and 9th months of use. High‑density lipoprotein (HDL) levels were consistently and significantly elevated above baseline levels. Beyond the 3rd month, low‑density lipoprotein (LDL) levels were lower but not significantly compared with baseline levels. HDL/TC and HDL/LDL ratios were consistently and significantly elevated in comparison with baseline values.Conclusion: Etonogestrel implant seems to cause significant effects on the lipid profile of Nigerian women. The increases were mainly in the HDL fraction, which suggests that the atherogenic and cardiovascular disease risks are reduced. We recommend larger studies to confirm our findings.Keywords: Implanon; laevonorgestrel; subdermal implan

Pattern of mental ill health morbidities following hysterectomy for benign gynaecological disorders among Nigerian women

<p>Abstract</p> <p>Objective</p> <p>to compare the pre and post hysterectomy mental ill health (MIH) status and also, to determine whether there is any association with the surgical indication.</p> <p>Methodology</p> <p>An observational study, conducted among women scheduled for hysterectomy at the University College Hospital, Ibadan from January till June 2005. The MIH morbidities were assessed using a validated general health questionnaire (GHQ) before and after the surgery by trained research assistant. The score of 4 and above was used as the cut off. Cross tabulations were performed to detect any association and also to compare pre and post hysterectomy mental health status. The level of statistical significance was set at P < 0.05.</p> <p>Results</p> <p>Of the 50 women recruited, 45 participated in the study. The age range of the participants was 35 to 63 years with a mean of 48.6 (SD = 0.6) years. Anxiety related disorder was present in 20 (44.4%), and depression in 3 (6.7%) before hysterectomy. Post surgery, there was significant increase in those with anxiety by 6.8% and a reduction in the proportion of depressive illness by 2.3%. Uterine fibroid as a preoperative diagnosis, had significant association among those with anxiety related disorder (68.4%) and depression (10.5%).</p> <p>Conclusion</p> <p>This study suggests that mental ill health may complicates hysterectomy for benign uterine pathology among Nigerian women, and that anxiety related disorders increases after operation with the highest proportion in those with clinical diagnosis of Uterine Fibroid. We recommend adequate preoperative counseling using properly trained psychologists when affordable to minimize these morbidities.</p

Exploring patients’ viewpoints on uncomplicated malaria and its management in primary healthcare facilities of Plateau State, Nigeria: a qualitative study

Malaria infection is a major public health problem in Nigeria. The present study explored patients’ thoughts and feelings on uncomplicated malaria and its management practices in some primary healthcare (PHC) facilities of Plateau state, Nigeria. An in-depth interview was conducted on patients receiving treatment in some of the facilities in the state, who were recruited through purposive sampling method up to saturation point. All the information was audio-recorded and transcribed verbatim before analysis using the principles of thematic content analysis of inductive method. Generally, their views on malaria-related issues were categorised into four main themes based on their relevancies as: patients’ perceptions on malaria infection and anti-malarial drugs, the role of healthcare workers and family during treatment, medications taken and socio-economic-related factors, as well as their general views on healthcare facilities-related factors. The study showed patients’ perceptions of the aforementioned factors as influencing their treatment and management practices of the disease in the study area. Necessary interventions that would improve patients’ quality of management of the disease toward achieving the desired outcome of therapy are recommended

Exploring entrepreneurial theories in the study of Igbo business mentoring (NWA Boy), south-east Nigeria

Over the years, studies have explored the expediency of entrepreneurship in addressing social problems relating to unemployment, poverty, economic stagnation and societal inability to attain national development in developing societies. To this end, government of these nations seek to promote entrepreneurship as a means of economic revitalization and sustainability mostly in rural areas. However, the success of entrepreneurship in any country may depend on several factors that could be explained theoretically. In social and behvioural sciences, theories have been constantly employed to provide explanations to social life issues bothering mankind. This article employed such theories to explain Igbo business mentoring (nwa boy) which most entrepreneurs in South-East GeoPolitical Zone of Nigeria seem to have engaged in establishing their businesses. These include: (i) Sociological Theory of Entrepreneurship; (ii) Anthropological Entrepreneurship Theory; (iii) Opportunity-Based Entrepreneurship Theory (iii) Resource-Based Entrepreneurship Theories; and (iv)The Dreyfus Model of Skill Acquisition, among others. Historical data was used to examine these theories in connection with the Igbo business mentoring (nwa boy) in order to enrich the body of knowledge on the social life reality of its contributions to entrepreneurial development in Nigeria. The importance of this effort is hinged on the fact that none of these theories has hitherto been applied to the Igbo business mentoring (nwa boy) in business and academic literature. The study concludes that the understanding the 'nwa boy' mentoring concept in the light of these theories could provide leverage for a successful entrepreneurial activities, mostly among youth. © 2019 International Business Information Management Association (IBIMA)

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children &lt;18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p&lt;0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p&lt;0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p&lt;0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely