A case report of premenarchial transverse vaginal septum at the University College hospital, Ibadan

Premenarchial Transverse vaginal septum is a benign condition. The septum may be found in the upper, middle or lower vagina. A case report of a premenarchial girl with transverse vaginal septum managed at the university college hospital, Ibadan, in January 2009. Diagnosis was made following a history of primary amenorrhea, cyclical low abdominal pain and pelvic examination which revealed a vaginal septum. She had surgical resection of the vaginal septum and a vaginal stent was left in-situ to keep the vagina patent during the healing process. The procedure was uneventful and she was able to achieve menstrual flow following surgery. Follow up visits were essentially unremarkable.Keywords: Premenarchial, Transverse vaginal septu

An appraisal of retained placentae in Ibadan: a five year review

Objectives: To determine the frequency of retained placenta at the University College Hospital Ibadan (UCH). and to describe the socio-demographic characteristics of the patients and examine the risk factors predisposing to retained placenta.Methods: This is a descriptive study covering a period of 5 years from January 1st 2002 to December 31st 2006. During the study period, 4980 deliveries took place at the University College Hospital, Ibadan and 106 cases of retained placenta were managed making the incidence 2.13 per cent of all births.Results: During the five year period, there were 106 patients with retained placenta; of these, 90 (84.9%) case notes were available for analysis. The mean age was 29.37 ± 4.99 years. First and second Para accounted for 52 per cent of the patients. Majority of the patient were unbooked for antenatal care in UCH with booked patients accounting for 27.8 per cent of the cases. The mean gestational age at delivery was 34.29 ± 6.02. Three patients presented to the hospital in shock of which 2 died on account ofsevere haemorrhagic shock. Fifty-eight patients (64.8%) presented with anaemia (packed cell volume less than 30 per cent) and 35 patients (38.8%) had blood transfusion ranging between 1-4 pints. 1 patient required hysterectomy on account of morbidly adherent placenta. Eleven patients (12.2%) had placenta retention in the past, 28 patients (31%) had a previous dilatation and curettage, 14 patients (15.5%) had previous caesarean sections and 47 patients (41.3%) had no known predisposing factorsConclusion: Retained placenta still remains a potentially life threatening condition in the tropics due to the associated haemorrhage, and other complications related to its removal. The incidence and severity may be decreased by health education, women empowerment and the provision of facilities for essential obstetric services by high skilled health care providers in ensuring a properly conducted delivery with active management of the third stage of labour

Endometriotic ascites: A very rare presentation of pelvic endometriosis

A 30 year-old P0+1 lady who was referred to the gynaecology clinic on account of inability to conceive for 8 years duration and progressive  abdominal distension of 2 years duration. She had a history of severe cyclical dysmenorrhoea warranting occasional hospitalization. An abdomino-pelvic ultrasound revealed marked intra-abdominal collection. The uterus and ovaries appeared normal. She subsequently had laparoscopy and drainage of  6 litres of endometriotic ascites. Both fallopian tubes were diseased. She was followed up on an out-patient basis with sub-cutaneous goserelin injections and referred for assisted reproduction. Keywords: Endometriosis, Ascites, Infertility, Laparoscop

Symptomatology of menopause among suburban Nigerian women

Background: It is believed that the perception and attitude of women to menopause are strongly influenced by several variables which are largely social, cultural, and economic and may reflect in the differences in the mode of treatment. The objective of this study is to determine the age of attainment of menopause and the perception of the symptomatology of menopause among Nigerian women of different backgrounds.Materials and Methods: Information was obtained with the aid of a structured questionnaire from 543 women who had attained natural menopause. Data were analyzed using SPSS version 21. Data analysis was descriptive and inferential at 95% confidence interval, and P < 0.05 was considered statistically significant.Results: The mean menopausal age was 49.1 ± 4.54 years. The commonest early symptom of menopause was hot flushes (45.8%). The commonest late symptom of menopause was pain in the joints (57%). A majority of the women (82.4%) did not think that any of the symptoms may have been associated with cessation of their menses. However, the better educated the women were, the more knowledgeable they were about the symptoms of menopause P < 0.01.Conclusion: The age at which Nigerian women attain menopause is comparable to that of other populations. The manifestation of menopausal symptoms in our women may constitute a significant health burden and it is imperative that healthcare providers should be knowledgeable about the manner in which these groups of women perceive menopausal symptoms. Education improves perception and may be the link to promoting better health‑seeking behavior among menopausal women.Keywords: Menopause; suburban; symptomatolog

Malignant haemangiopericytoma of the left thigh with metastases to the bones and lungs: A case report

Haemangiopericytoma is an uncommon mesenchymal neoplasm. Haemangiopericytoma is believed to arise from the pericytes, contractile spindle cells that surround the capillaries and post-capillary venules. We present an unusual case of histologically confirmed malignant haemangiopericytoma of the left thigh in a 70 year old male with metastasis to the lungs and left femoral bone

Characterization of Thiosulphate: Cyanide sulphur transferase from the gut and body segments of Earthworm (Hyperiodrilus africanus)

Cyanide compounds that are by products of industrial activities are known to pose serious environmental pollution. The use of these cyanide compounds by the mining industry, along with limitations in the analysis and monitoring of these compounds, raises serious concerns regarding environmental protection and public safety. Hyperiodrilus africanus (earthworm) is directly employed within bioremediation strategies to promote biodegradation of organic contaminants and thus could be employed to rejuvenate cyanide contaminated soils. Cyanides detoxification could also prevent the risk of cyanide poisoning in poultry animals by converting cyanides in forages to a less toxic compound. This work is designed to extract and characterize rhodanese (thiosulphate: cyanide sulphur transferase, (EC 2.8.1.1) from the gut and body segments of H. africanus collected from the swampy area along Uren bank river in Ikenne community of Ogun State, Nigeria. Our results show total rhodanese activities of 1434.50 RU and 2274.28 RU and specific activities of 108.01 RUmg-1 and 83.1901 RUmg-1 in the gut and body segments of H. africanus respectively. The optimum temperature of 25 °C and optimum pH of 10.5 were obtained for both the gut and body segments enzymes. The enzyme obeyed Michaelis-Menten kinetics and the kinetic constants, Km and Vmax in the gut segment were 33.33 mM and 62.50 RU/ml for KCN substrate and 22.22 mM and 41.67 RU/ml for Na2S2O3 substrates. In the body segment, the Km and Vmax were 33.33 mM and 83.33 RU/ml; 15.38 mM and 4.00 RU/ml for the KCN and Na2S2O3 substrates respectively. Hence, we conclude that the enzyme is more specific for  Na2S2O3 than KCN as substrates, though maximum activity was observed in the body segment for KCN substrate. Ca2+, Mg2+, Ba2+, K+, Na+, Cu2+ and Zn2+ metal ion salts activated the body segment rhodanese at 1 mM and 5 mM concentrations while they have no effect on the gut segment rhodanese from earthworm. On the basis of these findings we conclude that earthworm could detoxify cyanide-containing wastes/forages and therefore promote biodegradation.Keywords: Rhodanese, earthworm, environmental protection, cyanide detoxification, bioremediatio

Multiple Brain Abscesses In A Child With Infective Endocarditis

Background: Infective endocarditis is a lethal infection affecting the endocardium of the heart and the valves.The causes are varied with staphylococcus aureus and streptococcus as the major causative agents.The triad of fever exceeding 38oc,vegetation in the heart and blood culture of the causative agents are the hallmarks of the diagnosis .The disease is known to be affect all ages with the very young age group, those with congenital heart disease and those on cardiac prosthesis as the most vulnerable. Septic emboli from the septic vegetation can spread to the brain, kidney, spleen, and lungs resulting in massive metastatic infections.It therefore has multisystemic manifestations and complications. Though neurological complications are common, brain abcess is known to be rare constituting only 1.0% of neurological complications. Objective: The study aimed at reporting occurrence of both cerebral and cerebellar micro- and macro-abscesses in a 3 year boy with infective endocarditis; a rare occurrence in the literature. Methods: This case report was carried out at University College Hospital Ibadan. Results: The boy presented with fever of 38oc for five weeks, convulsions and altered state of consciousness for ten days..In course of treatment patient however developed irritability and aggressive behaviour, which attracted the use of largactil to which he reacted with extrapyramidal signs and convulsions. Within the week he developed yellowness of the eyes and increase in abdominal girth. Patient had cranial computed tomography (CT) after plain skull X-rays and was referred to University College Hospital Ibadan as a result of the radiologically diagnosed brain abscess seen on CT images. child had grunting respiration with dyspnea, and the respiratory rate was 50/mm. However, the chest was clinically clear. In the cardiovascular system (CVS); the pulse was 140/mm, with moderate volume. The blood pressure (BP) was l60/110 mmHg. The first and second heart sounds were heard with a gallop rhythm. Cranial CT scan showed multiple ring enhancing hypodense lesions with surrounding hypodensity measuring 1cm in diameter and above with only a few measuring less than 1.0cm in both cerebral hemispheres and cerebelli in keeping with multiple cerebral and cerebellar abscesses. An echocardiography showed a brightly echogenic spot attached to the papillary muscle in the left ventricle suggesting vegetation consistent with an infective endocarditis. Retroviral test was negative for both type I and II.Blood culture — was negative, however urine culture yielded klebsiella sp. Serum urea, creatinine, Ca2+ and P04 were all elevated.The abdominal ultrasound scan confirmed the hepatosplenomegaly with decreased echogenicity but both kidneys appeared normal.There was no demonstrable ascitis. The boy was placed on antimicrobials; and had craniotomy for the drainage of the macroabscesses. He improved significantly. His renal and cardiac condition equally improved; he was subsequently discharged to continue treatment in the the paediaric outpatient. The infective endorcarditis still poses enormous challenge in management and the condition calls for multi disciplinary approach. It requires high index of suspicion for early detection; as well deployment of multiple imaging modalities by the cardiologists and radiologists to arrive at a more accurate diagnosis for effective patient management. This may save financial and material resources on part of the patients, care givers, the facility managers and the society at large