Abdominal myomectomy: A retrospective review of determinants and outcomes of complications at the University of Ilorin Teaching Hospital, Ilorin, Nigeria

Background: The aim of this study was to describe the pattern, outcomes, and determinants of perioperative complications of abdominal myomectomy at the University of Ilorin Teaching Hospital, Ilorin, Nigeria.Methods: This was a retrospective review of cases of abdominal myomectomy between January 2010 and December 2013. Data were obtained from ward and operating theatre case records and analysed using SPSS version 20. The continuous variables were analysed with Student’s t-test. The categorical variables were analysed with the chi-square test. P-values of 0.05 or less was taken to be significant.Results: Total sampling yielded 204 cases, of which 170 records (80%) were adequate for analysis. Using criteria developed by Garry et al., major and minor complications occurred in 43.6% and 32.9% of procedures, respectively, while 23.5% of the patients had no complications. The commonest complication was intraoperative haemorrhage requiring blood transfusion. Mean estimated blood loss was 630.88 ± 392.42 mL. There were no cases converted to hysterectomy, and no deaths were recorded. Uterine size equivalent to 16 weeks’ gestation or more was significantly associated with heavier blood loss, blood transfusion, and fever (P = 0.034). Other significant determinants of major intraoperative haemorrhage with or without blood transfusion were menstrual flow of 6 days or more, preoperative anaemia, previous surgery, posterior incision, and surgery duration longer than 4 hours (P < 0.05).Conclusions: Outcome of abdominal myomectomy is generally favourable even if uterine size is greater than 16 weeks by palpation. Nevertheless, patients should be counselled preoperatively on the risk of blood loss and the possibility of blood transfusion

Female adolescents and the future of female genital mutilation/cutting: a report from an endemic area

Background: Despite collaborative efforts aimed at its eradication, Female Genital Mutilation/Cutting (FGM/C) continuesin endemic areas. Objective: To evaluate the experience and preparedness of female adolescents to protect their future daughters from FGM/C. Methods: A cross-sectional survey involving adolescent secondary school girls in North Central Nigeria. Participants were secondary school students who completed the study’s self-administered questionnaire after informed parental or participant’s consent. Data management was with SPSS 20.0 (IBM, USA), P-value <0.05 was significant. Results: There were 2000 participants aged 13-19 years (mean 15.56±1.75), prevalence of FGM/C was 35.0%, awareness was 86.1%, mutilation was performed between infancy and eight years of age (mean 3.85±3.24 years), 644(32.2%) desire to mutilatetheir future daughters, 722(36.1%) expressed support for FGM/C and 63.1% of victims of FM/C reported adverse post-mutilation experiences. Support for FGM/C was associated with low social class (P0.0010), opinion that FGM/C has benefit (P0.001) and desire to mutilate future daughters (P0.001) while awareness of efforts to eradicate FMG/C was 813(40.7%). Conclusion: FGM/C remains prevalent with potential support for its continuation among female adolescents despite reported adverse post-mutilation experiences. The multi-pronged approach to eradicate FGM/C should prioritize re-orientation for adolescent girls, rehabilitation of mutilated girls and girl child formal education. Keywords: Female genital mutilation/cutting; female circumcision, harmful traditional practices, adverse childhood experiences

Violence against women: A comparative study of the pattern and experience before and during pregnancy among antenatal clinic attendees at University of Ilorin Teaching Hospital, Nigeria

Background: While violence against women is increasing globally, its prevention and evaluation in pregnancy has not receiving  adequate attention.Aim: To evaluate the occurrence and pattern of violence against women before and during index pregnancy.Methods: A prospective, comparative study comprising 200 antenatal clinic attendees categorized into two groups of 100 each was conducted at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Group I consisted of women who had suffered violence  previously while those in group II did not have such experience. Participants were recruited at the antenatal clinic and informed consent obtained. Participants were screened using a modified version of Abuse Assessment Screen from Centre for Disease Control; the data was analyzed using SPSS version 20.0 and p<0.05 was significant.Result: There was similarity in the age (p0.688), marital status (p0.605), level of education (p0.914) and gestational age at booking (p0.490) among the two groups. Alcohol consumption was significantly higher (21 vs. 10; p0.045) among partners of victims of violence (group I). Physical violence decreased from 47% before to 22% during index pregnancy while sexual violence reduced from 53% vs. 50%. A total of 68 cases of psychological violence (68%) occurred during pregnancy. The partner was responsible in 78.7% of physical and 84.7% of sexual violence cases before pregnancy as well as 91.0% of physical, 100.0% of sexual and 78.0% of psychological violence which occurred during index pregnancy.Conclusion: Violence against women (especially psychological violence) is heightened during pregnancy. Routine screening for violence during pregnancy is justified because it is associated with poor maternal/fetal outcomes while its prevalence is higher than other conditions routinely screened for in pregnancy

Parental perception of human papillomavirus vaccination of prepubertal girls in Ilorin, Nigeria

Context: Human papillomavirus (HPV) vaccination of young girls is yet to be a routine practice in Nigeria and parents' acceptance may influence immunization of their children. Aims: The aim of this study is to determine beliefs and concerns of parents about HPV vaccination of girls. Subjects and Methods : A cross-sectional survey of parents of girls between 10 and 15 years in 12 selected secondary schools of Ilorin using a self-administered questionnaire designed by researchers was conducted. Statistical Analysis Used: Data analysis involved univariate and bivariate analyses with SPSS version 20. The level of significance for all tests was set at 5%. Results: The respondents were 470 mothers between 31 and 50 years, 58.1% had at least secondary school education, 70.2% were employed, and 22.8% belonged to the upper social class. Of the study participants, 35.1% were aware of HPV vaccine and 33.8% knew that the vaccine was available in Nigeria. While 55.8% of mothers believed that all girls should be vaccinated, 19.5% responded that only sexually active girls should have it. Among all respondents, full protection, need for repeated doses, and age of the girls were significantly related to willingness to vaccinate statistically (P < 0.05). These concerns were not significant among mothers that were aware of HPV vaccines. Conclusions: There is low awareness of HPV vaccine among mothers in Ilorin despite the high prevalence of cervical cancer in our environment. Parental perception of HPV vaccines in terms of concerns and beliefs was significantly related to willingness of mothers to vaccinate their daughters

Oral health status of pregnant women in Ilorin, Nigeria

Oral diseases have been shown to negatively affect pregnancy outcomes, yet, routine oral health care is not a component of the antenatal care package in Nigeria. This study was designed to describe the pattern of the oral conditions in pregnancy compared to the non-pregnant controls. Two hundred and twenty-five pregnant women and 166 non-pregnant controls were studied from two healthcare facilities in Ilorin. Oral-related complaints were assessed in the pregnant population while both of the groups had an oral cavity examination. The mean age of the respondents was 28.24 years ±4.77 and 80% had at least a secondary school level of education. The prevalence of oral complaints among the pregnant women was 19.1%. Gingivitis was more common among the pregnant women than the non-pregnant women, and more demonstrable on examination. Oral healthcare should be a component of the antenatal care in our environment. Impact statement What is already known on this subject? Women experience oral disorders in pregnancy, which may be worsened by the physiological changes in pregnancy. What do the results of this study add? This study has demonstrated a higher prevalence of gingivitis in the pregnant women than in the non-pregnant women on oral examination. The signs of gingivitis were higher than its related complaints. What are the implications of these findings for clinical practice and/or further research? Therefore, dental care and an examination should be part of a routine antenatal care package to prevent the unwanted pregnancy outcomes that are related to oral disorders