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

High Energy X-Ray Dosimetry Using (ZnO)0.2(TeO2)0.8 Thin Filmbased Real-time X-Ray Sensor

This study reports the dosimetric response of a (ZnO)0.2(TeO2)0.8 thin film sensor irradiated with high-energy X-ray radiation at various doses. The spray pyrolysis method was used for the film deposition on soda-lime glass substrate using zinc acetate dehydrate and tellurium dioxide powder as the starting precursors. The structural and morphological properties of the film were determined. The I-V characteristics measurements were performed during irradiation with a 6 MV X-ray beam from a Linac. The results revealed that the XRD pattern of the AS-deposited thin film is non-crystalline (amorphous) in nature. The FESEM image shows the non-uniform shape of nanoparticles agglomerated separately, and the EDX spectrum shows the presence of Te, Zn, and O in the film. The I-V characteristics measurements indicate that the current density increases linearly with X-ray doses (0-250 cGy) for all applied voltages (1-6 V). The sensitivity of the thin film sensor has been found to be in the range of 0.37-0.94 mA/cm2 /Gy. The current-voltage measurement test for fading normalised in percentage to day 0 was found in the order of day 0 > day 15 > day 30 > day 1 > day 2. These results are expected to be beneficial for fabricating cheap and practical X-ray sensors

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

Knowledge, practice and acceptability of HPV vaccine by mothers of adolescent girls in Ilorin, Nigeria

Background: Human Papilloma Virus (HPV) is a sexually transmitted cause of carcinoma of the cervix. An important determinant of the success of a primary preventive strategy like HPV vaccination is the knowledge and willingness of parents to vaccinate adolescents before sexual debut. Materials and methods of study: A cross sectional descriptive survey of mothers of girls in 8 secondary schools in Ilorin was carried out from February to April 2015. Schools were selected using multi staged sampling. Descriptive and inferential statistics were performed with Chi Square and ANOVA. Results: There were 470 questionnaires returned for analysis out of 600, giving a response rate of 78.3%. One hundred and sixty-one (34.3%) knew HPV to be sexually transmitted infection and 40.4% knew it was the cause of cervical cancer. While 35.1% were aware of HPV vaccine, only 1.9% had ever vaccinated their children.Less than half (44.9%) were willing to vaccinate their children. Women with good knowledge of HPV and cervical cancer were more willing to vaccinate their children than women with poor knowledge (P <0.001). Conclusion: There is poor knowledge of HPV and practice of vaccination among mothers in llorin. Willingness of mothers to vaccinate their daughters is suboptimal. Mother’s knowledge is an important determinant of HPV vaccination of adolescents

The burden of diabetes mellitus during pregnancy in low- and middle-income countries : a systematic review

Peer reviewedPublisher PD

Abdominal ultrasonography in HIV/AIDS patients in southwestern Nigeria

<p>Abstract</p> <p>Background</p> <p>Though the major target of the HIV-virus is the immune system, the frequency of abdominal disorders in HIV/AIDS patients has been reported to be second only to pulmonary disease. These abdominal manifestations may be on the increase as the use of antiretroviral therapy has increased life expectancy and improved quality of life. Ultrasonography is an easy to perform, non invasive, inexpensive and safe imaging technique that is invaluable in Africa where AIDS is most prevalent and where sophisticated diagnostic tools are not readily available. Purpose: To describe the findings and evaluate the clinical utility of abdominal ultrasonography in HIV/AIDS patients in Ibadan, Nigeria</p> <p>Methods</p> <p>A Prospective evaluation of the abdominal ultrasonography of 391 HIV-positive patients as well as 391 age and sex-matched HIV-negative patients were carried out at the University College Hospital, Ibadan.</p> <p>Results</p> <p>Of the 391 cases studied, 260 (66.5%) were females; the mean age was 38.02 years, (range 15–66 years). The disease was most prevalent in the 4th decade with an incidence of 40.4%. Compared with the HIV-negative individuals, the HIV+ group of patients had a significantly higher proportion of splenomegaly (13.5% vs. 7.7%; p < 0.01), lymphadenopathy (2.0% vs. 1.3%; p < 0.70), and renal abnormalities (8.4% vs. 3.8%; p < 0.02). There were no differences in hepatic and pancreatic abnormalities between the HIV+ and HIV- groups. There were significantly fewer gallstones in the HIV+ group (1.4% vs. 5.1%; p < 0.01).</p> <p>Conclusion</p> <p>AIDS is a multi-systemic disease and its demographic and clinical pattern remains the same globally. Ultrasonography is optimally suited for its clinical management especially in Africa. Its accuracy and sensitivity may be much improved with clinico-pathologic correlation which may not be readily available in developing countries; further studies may provide this much needed diagnostic algorithms.</p

Atypical Presentation of Novel COVID 19 Disease: A Case Report and our Experience

Introduction: COVID 19 virus infection commonly presents with respiratory symptoms which has posed a serious public health concern due to its mode of transmission from direct contact. A different mode of presentation was noticed in our establishment which appeared atypical. The Aim: The aim of this report is to show this atypical presentation of the novel corona virus disease, its impact in our environment and possible solution. Presentation of Case: This is a male 60 year old, who presented with anterior neck wound and unconsciousness of 2 weeks duration associated with fever, which was unremitting despite high dose antibiotics. He tested positive to COVID 19 virus disease, exposing all the managing team to risk of the infection. Discussion: All the exposed health workers tested negative, but the spouse of the patient was COVID 19 positive, this shows the importance of use of protective gadgets against COVID 19 virus infection. Conclusion: COVID 19 infection presentation can be atypical. All patients should be regarded as carriers until proven otherwise. The solution to reduce exposure of many staff to this disease is screening of every patient at presentation

Exploring the future impacts of urbanization and climate change on groundwater in Arusha, Tanzania

We combine satellite imagery, urban growth modelling, groundwater modelling and hydrogeological field expeditions to estimate the potential impacts in 2050 of rapid urbanization and climate change on groundwater in Arusha, Tanzania, and by extension similar areas in Sub-Saharan Africa. Our analysis suggests that a reduction of groundwater recharge by 30–44% will cause groundwater levels to drop by up to 75 m, mainly due to increased evapotranspiration and to an expansion in paved surface. If this scenario becomes reality, we predict that wells will run dry, creating health, social and environmental risks

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&nbsp; 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&nbsp; 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&lt;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