Sexual Violence Against Female Undergraduates in a nigerian Tertiary Institution

Background: Worldwide, violence against women is becoming an  increasingly recognized pandemic issue necessitating eradication and elimination. It occurs in various forms with resultant physical, sexual orpsychological consequences. However, there is still denial and paucity of literature about the magnitude and pattern of this problem in Nigeria.Objective: This study was designed to determine the patterns of sexual violence among female undergraduates including their perceptions and attitude.Methods: It was a descriptive cross-sectional questionnaire based study involving 388 female undergraduates of the University of Ibadan, Ibadan, Nigeria. Multistage sampling technique using their halls of residence was used to select participants. The results were analyzed using statistical package for SPSS software version 16.0. The p-value was set at 0.05.Results: The mean age of respondents was 20 years and 382 (98.5%) of them were single. Only 31.2% were sexually exposed and the average age of sexual debut was 18 years. Most (78, 64.1%) cases of the first sexual intercourse occurred voluntarily. Two hundred and sixty two (67.6%) respondents had experienced at least one form of sexual abuse in the past. The commonest coercive sexual behaviour experienced was unwanted touching (53.4%). The perpetrators were mostly casual friends (63.7%) and most reported these incidences to friends. The respondents  demonstrated good knowledge but poor attitude about sexual abuse.Eighteen (10.7%) admitted to prior rape which was mainly perpetrated by strangers with half admitting it adversely affected their relationship with the opposite sex.Conclusion: Sexual violence occurs in this environment but mainly goes unreported. There is good knowledge about the issues of sexual violence but there is need for improved attitude and reporting by victims

Health Risks of Obesity

Obesity is becoming of interest as a non-communicable disease. There is however a dearth of information on obesity in this environment, as literature in developing countries is limited. Review of health risks of obesity is useful in order to increase the pool of available information in Nigeria and to draw attention to obesity and its attendant health risks.Keywords: Health, risks, obesity

Informed consent for caesarean section at a Nigerian university teaching hospital: patients' perspective

Background: Caesarean section is one of the commonest obstetrics surgery and has become increasingly safer compared with the early 20th century. The practice of informed consent has also become universally adopted for surgical procedures. However, with increasing knowledge about ethics and rights, issues on consent isone of the frequent grounds for litigation and malpractice claims.Aims and Objectives: To audit the process of informed consent for emergency and elective caesarean section in a Nigerian tertiary health care setting.Methodology: This was a descriptive cross-sectional study involving 150 patients who had caesarean delivery at the study site within the study period.Results: The mean age of the respondents was 32±1.8 yearswith 118(79%) of the surgeries being emergency Cesarean sections. The consent for CS were mostly given by the patients (96, 64.0%) and husbands (43, 28.6%). Majority of the respondents 123(81.5%) had the consent obtained in the labour ward with profuse bleeding (86.0%) and blood transfusions (88.7%) being the most commonly discussed risks. Many of the respondents expressed satisfaction with the consent form and felt it was well written (75.3%), attractive (76.0%) and simple to read (75.3%).Conclusion: This study found out that although patients were satisfied with the consent process for caesarean section, only information about major risks was commonly discussed. There is therefore the need for customized and detailed consent formsto be adopted for different surgical procedures.Keywords: Caesarean section, Informed consent, patients' perspective, ris

Physical Functionality and Self-Rated Health Status of Adult Patients with Knee Osteoarthritis Presenting in a Primary Care Clinic

Background: Knee osteoarthritis is a chronic medical condition of public health importance in Nigeria which causes disability and impacts daily activities in the sufferers. This study aimed to describe the physical functionality and self-rated health status of adult patients with clinical knee osteoarthritis presenting at the Family Medicine Department, University College Hospital, Ibadan, Nigeria.Method: This was a cross-sectional study of 400 respondents. Knee osteoarthritis was diagnosed clinically using the criteria of the American College of Rheumatology. Morbidities, self-rated health status and physical functionality of the respondents were also assessed.Results: Knee osteoarthritis was diagnosed in 46(11.5%) respondents. Respondents with knee osteoarthritis significantly rated their health worse than those without knee osteoarthritis (p <0.0001). Experience of pain, stiffness and performance of daily activities were significantly worse among respondents with knee osteoarthritis. Those who had knee osteoarthritis had significantly higher waist (p <0.0001), hip (p <0.0001) and knee circumferences (p <0.0001) respectively. Logistic regression analysis showed increasing age (OR=1.103; 95% CI=1.022 – 1.191), self-rated health worse than six months ago (OR=12.562; 95% CI=1.178–125.243), experience of stiffness after waking up in the morning (OR=12.758; 95% CI=3.572–45.569), stiffness after sitting/lying down/resting (OR=21.517; 95% CI=2.213–209.220) and waist circumference (OR=1.225;95% CI=1.017–1.477) to be the most significantly associated with knee osteoarthritis.Conclusion: Knee osteoarthritis significantly impairs the health and daily activities of adult patients in Ibadan, Nigeria. Healthcare workers need to screen adult patients routinely at first-contact to detect knee osteoarthritis clinically early and manage appropriately.Keywords: Family practice clinic, functionality, health status, knee osteoarthritis, Nigeri

Plasma C-Reactive Protein and Selected Nutritional Indices in Elective Caesarean Section

Context: Caesarean Section (CS) is a major surgical procedure, often performed when a vaginal delivery is considered unsafe.Objective: This study was carried out to understand the interaction between acute phase proteins and nutritional factors consequent to caesarean section. The knowledge of this interaction is important for successful management of these patients.Methods: Plasma samples from fifty (50) pregnant women booked for elective caesarean section in Ibadan, Nigeria were collected on the day preceding surgery, one day and four days post-surgery to determine the levels of CRP, vitamin C, PCV, Total protein, albumin and globulin (Glb) levels. Results: The mean age of the patients studied was 32.29 + 3.66 years, range; 24 39 years. Significant elevations were observed in the levels of TP, Glb and CRP one day post-surgery (1DPS) compared with baseline (BS) (7.36 + 1.46) vs 6.56±1.30, (4.68 + 1.33) vs 2.70±1.51, (111.43 + 68.89) vs 6.00 ± 13.27 respectively, while albumin reduced significantly (2.68 + 1.08) vs 3.87±0 .63. Similar changes were observed on day 4. There was no significant change in the levels of Vitamin C.Conclusion: One of the positive predictive indicators of good outcome after caesarean delivery is adequate nutrition.Key Words: Elective caesarian section, acute phase proteins, nutritional factor

Awareness of cervical cancer and screening in a Nigerian female market population

Background: Cervical cancer, although largely preventable, remains a leading cause of cancer death among females in the developing world. The study was aimed at providing useful information on awareness of market women, who are from diverse social backgrounds, about cervical cancer and evaluate the extent of utilisation of Papanicolaou's smear by them. It was also aimed at determining the prevalence of risk factors for development of cervical cancer among the population. Methods: This cross-sectional descriptive survey was carried out among market women at Aleshinloye market in November 2003, among 483 randomly selected respondents. A questionnaire probing into their sexual history, awareness about cervical cancer and the extent of utilisation of Pap smear was the survey instrument.Results: The majority (79.5%) of the women were sexually active. One hundred and eighty-six (38.5%) had early sexual debut and 163 (33.7%) had multiple sexual partners. Only 197 respondents (40.8%) were aware of cervical cancer. Of these, 95 (19.7%) were aware of Pap smear as a screening test. The common media of awareness were radio and television (46.6%), public lecture (27.8%) and friends/ relatives (19.9%). However, only 25 respondents (5.2%) have had previous Pap smear done. Conclusion: Though the market women are at considerable risk of developing cancer of the cervix, they are poorly informed about the disease and its prevention. Therefore, there is need for continuous awareness campaign and well-organized screening programmes among this unique category of women.Keywords: cervical cancer, screening, awareness Annals of African Medicine Vol. 4(4) 2005: 160-16

Clinical audit of knowledge and practice of epidural labour analgesia amongst obstetricians in South-West Nigeria

Epidural analgesia (EA) is the most ideal method for pain relief during labour. We sought to highlight the current knowledge and practice of the obstetricians regarding epidural labour analgesia (ELA). An audit was conducted amongst obstetricians in two teaching hospitals in the south west of Nigeria. Most of our respondents received lectures about ELA but about half of them rated the lectures as inadequate. Though 37.8 % and 53.3% of respondents are of the opinion that there is interference with labour and increased incidence of instrumentation following epidural analgesia in labour respectively, however 84.4% agreed that the technique is not associated with adverse neonatal or maternal outcome and 97.8% will prefer their patients having epidural labour analgesia. We are of the opinion that education regarding ELA, both during and after obstetric speciality training, be improved, and well-established interpersonal relationship between obstetricians and anaesthetists will be needed to achieve this

Menstrual Health of In-School Adolescents in Ibadan: Knowledge, Attitudes and Consequences.

We evaluated the knowledge, attitudes to and consequences of menstrual morbidities among in –school adolescents in Ibadan and determined their effect on school attendance. The pattern of drug use for menstrual symptoms was also assessed. Self-administered questionnaires were given to 1194 respondents in secondary schools chosen by randomization. The mean age of respondents was 15.7+ years while 86.1% were aged between 10-17 years. The most prevalent menstrual disorder was dysmenorrhea (87.3%). The commonest source of information about the menstrual cycle was from mothers (71%) while 0.5% of adolescents obtained information from health care givers. Menstrual symptoms were treated with non-pharmacological means in 53.1%. Of girls using pharmacologic agents 44% of them obtaining over the counter medications (OTC). Forty four percent of respondents missed school for 6-7 weeks per session following dysmenorrhea while 19% of them required hospital admission. It was concluded that there is insufficient knowledge of the menstrual cycle and its abnormalities among adolescents.Menstrual health should be introduced as part of reproductive health programs in school curricula in Nigeria

Attitude To Caesarean Section Amongst Antenatal Clients In Ibadan, Nigeria

This was a cross-sectional study carried out on 372 clients receiving antenatal care at a rural, suburban and urban centres, in order to assess the acceptance of caesarean delivery amongst them and thefactors influencing their attitude. Caesarean section was acceptable to 65.7%. Many respondents will refuse the surgery, because they do not think abdominal delivery is natural or necessary. However, if indicatedby their health caregiver to be necessary to save life, 78.3% would comply. Others would leave for a religious healing home, another hospital, a traditional birth attendant or be delivered at home. The culturalreasons why some women decline include feeling that caesarean delivery is due to “spiritual attacks”, retribution for maternal infidelity and failure of awoman to fulfil her reproductive function. Respondents were more likely to accept the surgery if they had heard of it before or had a previous caesarean delivery. They were less likely to accept it if they wereChristians or attended the rural health centre. Age, parity and educational level had no influence. Only 4% of the respondents would request a caesarean section for non-medical reasons. Health education needs to becarried out in the community, as well as during antenatal classes, to address the cultural beliefs. Means of involving religious bodies in enlightenment campaigns to improve women's attitude should beexplored