Psychosocial characteristics of infertile women in a Nigerian tertiary hospital

Introduction: High premium is placed on childbirth particularly after marriage in our society. Sub‑Sahara Africa is known to have the high incidence of infertility and the woman is usually blamed for the problem. Stress is known to have effect on ovulation and therefore conception thereby forming a vicious cycle. The study was to determine the psychosocial problems and psychiatric morbidity among infertile women and to determine the difference in psychosocial problems in primary and secondary infertility patients.Method: The Satisfaction with Life Scale (SWLS) questionnaire, the 12 ‑item General Health Questionnaire (GHQ‑12) and the HADS (Hospital Anxiety and Depression Scale) were administered to 111 patients.Result: The mean age for the respondents was 33.6 ± 5.8 years. There were more cases of secondary infertility 58 (52.3%) compared to primary fertility 53 (47.7%). The study revealed a fairly high degree of psychological morbidity among the respondents, a depressive rate of 39.6%, anxiety rate of 48.6% and psychiatry morbidity of 39.6%.There was no significant difference in prevalence of these morbidity between the patients with primary and secondary infertility.Conclusion: Both primary and secondary infertility are associated with significant psychosocial and psychiatric morbidity. Psychological strain itself can also be a cause or aggravate infertility therefore psychological assessment and co‑management with the psychiatrist should be encouraged.Keywords: Anxiety; depression; infertility; primary; psychosocial; secondar

Knowledge, attitude and prescription practice of menopausal hormone replacement therapy by doctors in UITH, Ilorin Nigeria

Objective: This study aimed to evaluate the knowledge, attitude and prescription practice of menopausal-HRT (mHRT) by doctors in UITH, Ilorin.Method: All consenting doctors in O&G, Internal Medicine, Family Medicine, Public Health and Interns at the UITH completed a structured questionnaire. SPSS software version 22 was used for analysis. Associations between categorical variables were tested using the chi-square (x2) while the student-t test was used for the continuous variables (p <0.05).Results: Eighty doctors, 56 males and 24 females responded. Majority (63.8%) rated their knowledge of mHRT average; (17.5%) believed they had good knowledge, while (18.7%) had poor knowledge. Gynaecologists had the highest mHRT Knowledge Score (72.4) while public health doctors had the lowest (33.7), (83.7%) had no formal training on the use of mHRT. Fifty-five percent did not think menopause should be treated. Just 25% prescribed mHRT where 58.8% had no reason for not prescribing. Only 18.8% had ever referred menopause patients to specialists. Forty percent use alternative therapies for menopausal symptoms, majorly vitamins and herbs.Conclusion: The knowledge, attitude and prescription practice of the studied doctors was poor. Trainings are still needed in this area.Keywords: Menopause; hormone replacement therapy; doctor

The impact of radiofrequency electromagnetic radiation from mobile phone on oestrous cycle and reproductive hormones in female wistar rats (Rattus norvegicus)

Aim of Study: The study was aimed at evaluating the impact of radiofrequency electromagnetic radiation (RF-EMR) from mobile phones on the oestrous cycle and reproductive hormones in female Wistar rats.Methods: Twenty-one Mature female Wistar rats weighing 180 to 250 grams were acclimatized for 2 weeks and divided into control (A), 4hrs (B) and 6hrs (C) groups and were exposed to RE-EMF for a period of 28 days. Oestrous cycle was monitored daily and hormonal level was determined using standardized enzymatic colorimetric methods. One-way analysis of variance was used to compare the mean values of variables among the groups accepting statistical significance at p≤ 0.05.Results: Oestrous cycle was deranged in experimental group compared to the control. Mean serum level of Follicle stimulating hormone (FSH) in control group remained low compared to the exposed groups. Luteinizing hormone (LH) levels in group A were almost double that of the group B and C, while the serum level of Oestrogen was lowest in group A. Progesterone level in the control group was higher than the experimental group.Conclusion: RF EMR showed an adverse effect on the weight and oestrous cycle but the effect on the reproductive hormones is not  significant although the effect appeared to be related to the duration of exposure.&nbsp

Psychosocial correlates of menopausal symptoms among women in Ilorin, Nigeria

Background: The increasing rate of social involvement among African women has made menopause of high concern today. The aim of thisstudy was to identify some psychosocial factors that determine how severely women in Ilorin, Nigeria perceive menopausal symptoms. Method: Women who attained menopause naturally between 40-60 years of age were interviewed using structured questionnaires to obtain certain demographic and psychosocial information following informed consent. Perception of menopausal symptoms was assessed using the Menopause Rating Scale (MRS). The psychosocial parameters were then correlated with MRS scores. Data were analysed using SPSS software version 22. Associations between categorical variables were tested using the chi-square (÷2), the student-t test was used for the continuous variables (p <0.05) while linear regression was used to identify independent determinants. Results: Three hundred and eighty-five women aged 51.3±0.3 years on the average participated in the study, 331(86%) were Yoruba, 16 (4.2%) were Ibo, 3 (0.8%) Hausa and 35 (9%) were of other ethnic minorities. The total Menopause rating score was 14.02±0.44 out of a maximum score of 44 which indicated a generally mild perception. Joint pain ((1.77±0.16) was however the most perceived symptom. There is a significant association between all the psychosocial parameters assessed and MRS scores (p < 0.05). However societal support was the only independent determinant of menopause severity. Conclusion: Social support is by far the most important determinant of menopausal symptom severity in our study subjects. Effort to enhancesocial support in Nigeria will help the women cope better with menopausal symptoms and improve their overall quality of life. Keywords: Nigeria; Women; Menopause; Quality of Life; Social Suppor

Comparative Assessment of Health Workers Performance and The Per­formance Factors at Primary, Secondary and Tertiary Hospitals in Kwara State, Nigeria

Performance measurement is a process by which an organization monitors important aspects of its programs, systems, and care processes. Although the logic of looking at workers' overall environ­ment when analysing productivity has been widely docu­mented, there is need for empirical research exploring the relationships between worker performance and the per­formance factors. Main goal of the study was to determine and compare the factors associated with healthcare provider performance. A cross sectional study was carried out among eight hundred and sixty-six (866) health care providers randomly selected from primary, secondary and tertiary hospitals. Health workers’ age was between 19 to 66 years with mean age of 37.9±9.83, there were more females than males with majority of them are married. All respondents claimed to have received job description. Most of the respondents working at primary healthcare hospitals (PHCHs) 193(75.4), secondary healthcare hospitals (SHCHs) 178(68.5) and tertiary healthcare hospitals (THCHs) 221(63.1) are not well motivated in term of bonuses or praises for good work, while some respondents working at PHCHs 35(13.7%), at SHCHs 48.0(18.5%), and(THCHs) 109(31.1%) received non-monetary incentives from employers. There were opportunities for promotion of healthcare providers at all levels. Few of the healthcare provider’s working in PHCHs 61(23.8%), SHCHs 87(33.5%) and THCHs 82(23.4%) respectively had not received training on quality of health care. On the one-to-one relationships, 10 of the 15 variables tested had very high significant effect on performance of health workers which was independent of types of health facilities. It is recommended that health manager or administrators in the hospital at any level should provide all the composite performance factors and combine monetary and non-monetary incentives with others performance interventions such as training and good feedback to healthcare providers.Keywords: Health Worker Performance Factors Hospitals Nigeria

Sociodemographic Characteristics and Pregnancy outcome of Referred and Booked Parturients in a Nigerian Teaching Hospital

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Antiseizure effects of ketogenic diet on seizures induced with pentylenetetrazole, 4-aminopyridine and strychnine in wistar rats

The ketogenic diet (KD) is a cheap and effective alternative therapy for most  epilepsy. There are paucity of experimental data in Nigeria on the usefulness of KD in epilepsy models. This is likely to be responsible for the poor clinical acceptability of the diet in the country. This study therefore aimed at providing experimental data on usefulness of KD on seizure models. The study used 64 Wistar rats that were divided into two dietary groups [normal diet (ND) and ketogenic diet (KD)]. Animal in each group were fed for 35days. Medium chain triglyceride ketogenic diet (MCT-KD) was used and it consisted of 15% carbohydrate in normal rat chow long with 5ml sunflower oil (25% (v/w). The normal diet was the usual rat chow. Seizures were induced with one of Pentelyntetrazole (PTZ), 4-Aminopyridine (AP) and Strychnine (STR). Fasting glucose, ketosis level and serum chemistry were determined and seizure parameters recorded. Serum ketosis was significantly higher in MCT-KD-fed rats (12.7 ±2.6) than ND-fed (5.17±0.86) rats [p=0.003]. Fasting blood glucose was higher in ND-fed rats (5.3±0.9mMol/l) than in MCT-KD fed rats  (5.1±0.5mMol/l) with p=0.9. Seizure latency was significantly prolonged in ND-fed compared with MCT-KD fed rats after PTZ-induced seizures (61±9sec vs  570±34sec) and AP-induced seizures (49±11sec vs 483±41sec) p<0.05. The difference after Str-induced seizure (51±7 vs 62±8 sec) was not significant (p>0.05). The differences in seizure duration between ND-fed and MCT-KD fed rats with PTZ (4296±77sec vs 366±46sec) and with AP (5238±102sec vs  480±67sec) were significant (p<0.05), but not with STR (3841±94sec vs 3510±89sec) [p>0.05] respectively. The mean serum Na+ was significantly higher in MCT-KD fed (141.7±2.1mMol/l) than ND-fed rats (137±2.3mMol/l) with p<0.05. There was no significant difference in mean values of other serum electrolytes between the MCT-KD fed and ND-fed animals. MCT-KD caused increase resistance to PTZ-and AP-induced seizures, but has no effect on STR-induced seizures. This antiseizure property is probably mediated through GABAergic receptors (PTZ effect) and blockade of membrane bound KATP channels (AP effect) with some  enhancement by serum ketosis.Keywords: Ketogenic diet, Antiseizure, Pentylenetetrazole, Amino-Pyridine, Strychnin