The effects of etonorgestrel implant (ImplanonR) on the lipid profile of Nigerian women

Background: Provision of contraceptive methods with minimal side effects will enhance uptake of contraception particularly in Nigeria where contraceptive prevalence rate remains low. The safety profile of ImplanonR, a long‑acting hormonal subdermal contraceptive containing etonogestrel, has not been adequately evaluated among Nigerian women.Objective: To assess the effects of etonogestrel subdermal implant (ImplanonR) on lipid profile among Nigerian women.Materials and Methods: The study was a longitudinal follow‑up of 54 consenting women selected over a 6‑month period at the Family Planning Clinic of the University College Hospital, Ibadan. After ImplanonR insertion, each woman was followed‑up monthly for a period of 12 months. Fasting venous blood samples were collected for quantification of serum lipids prior to insertion of the implant, then at 1st, 3rd, 6th, 9th, and 12th months of follow‑up.Results: The mean age of the women was 34.4 ± 5.6 with a range of 22–47 years. The modal number of children was 2 ranging from 1 to 6. Total cholesterol (TC) levels showed a general tendency toward a rise. The rise was, however, only significant in the 3rd and 12th months of use. Serum triglycerides showed a tendency toward reduced levels, which were only significant at the 6th and 9th months of use. High‑density lipoprotein (HDL) levels were consistently and significantly elevated above baseline levels. Beyond the 3rd month, low‑density lipoprotein (LDL) levels were lower but not significantly compared with baseline levels. HDL/TC and HDL/LDL ratios were consistently and significantly elevated in comparison with baseline values.Conclusion: Etonogestrel implant seems to cause significant effects on the lipid profile of Nigerian women. The increases were mainly in the HDL fraction, which suggests that the atherogenic and cardiovascular disease risks are reduced. We recommend larger studies to confirm our findings.Keywords: Implanon; laevonorgestrel; subdermal implan

An assessment of the levels of phthalate esters and metals in the Muledane open dump, Thohoyandou, Limpopo Province, South Africa

<p>Abstract</p> <p>Background</p> <p>This work reports the determination of the levels of phthalate esters (dimethyl phthalate (DMP), diethyl phthalate (DEP), dibutyl phthalate (DBP), diethyl hexyl phthalate (DEHP)) and metals (lead, cadmium, manganese, zinc, iron, calcium) in composite soil samples. The soil samples were collected randomly within the Muledane open dump, Thohoyandou, Limpopo province, South Africa. Control samples were collected about 200 m away from the open dump. The phthalate esters were separated and determined by capillary gas chromatography with a flame ionization detector, whilst the metals were determined by atomic absorption spectrophotometry.</p> <p>Results</p> <p>Open dump values for the phthalate esters and metals to be generally higher in comparison to control samples for DMP, DEP, DBP and DEHP – the mean values calculated were 0.31 ± 0.12, 0.21 ± 0.05, 0.30 ± 0.07, and 0.03 ± 0.01 mg/kg, respectively, for the open dump soil samples. Nonetheless, the mean open dump values for lead, cadmium, manganese, zinc, iron and calcium were 0.07 ± 0.04, 0.003 ± 0.001, 5.02 ± 1.92, 0.31 ± 0.02, 11.62 ± 9.48 and 0.12 ± 0.13 mg/kg, respectively. The results were compared statistically.</p> <p>Conclusion</p> <p>Our results revealed that the discarding of wastes into the open dump is a potential source of soil contamination in the immediate vicinity and beyond, <it>via </it>dispersal. Increased levels of phthalate esters and metals in the soil pose a risk to public health, plants and animals. Sustained monitoring of these contaminants is recommended, in addition to upgrading the facility to a landfill.</p

Abdominal Hysterectomy for Benign Gynaecological Conditions at Ibadan, Nigeria

Context: Total abdominal hysterectomy is one of the commonly performed major gynaecological operations in our hospital and it is desirable to review its safety in view of the advanced pathology that is frequently encountered. Objective: To determine the indications for and the pattern of morbidity and mortality in abdominal hysterectomy done for benign conditions over a 10-year period. Study Design: A retrospective study of all cases of abdominal hysterectomy for benign conditions over a ten-year period. Main Outcome Measures: The relative proportion of cases of abdominal hysterectomy compared to the total number of operations, the prevalence of various peri- and post-operative complications or mortality. Results: Total abdominal hysterectomy accounted for 10.2% of all major gynaecological operations during the study period. The indication was uterine fibroids in 82% of cases done for benign indications. The crude morbidity rate was 31% and there was no mortality. Conclusion: In spite of advanced pathology, abdominal hysterectomy for benign conditions is a fairly safe procedure in UCH Ibadan. There is a need to further reduce the high morbidity rate associated with the procedure especially the use of peri-operative antibiotic prophylaxis. (Tropical Journal of Obstetrics and Gynaecology, 2001, 18(1): 19-23

Intra-abdominal gossypiboma with feacal fistula, laparotomy, removal and drainage

Retained surgical sponge (gossypiboma) is a rare complication of abdominal surgery, however, it is the most common surgical item that is found to be retained. Whenever a gossypiboma occurs in the abdominal cavity following abdominal surgery, it is associated with severe morbidity and mortality, as well as medicolegal consequences. Risk factors for this problem include both patient care processes and working environment issues. The discovery may take months or years after the surgery was performed, and the complications at presentation also vary. This case followed an emergency caesarean section with the delivery of a live male infant, and the diagnosis was made 1 year after surgery. She presented with a 1-year history of intermittent abdominal pain, which became excruciating with accompanying discharge of pus from the abdomen shortly before presentation. She had exploratory laparotomy and developed a faecal fistula on the fourth day following the extraction of the retained abdominal pack, which was conservatively managed. She was discharged on the 19 th postoperative day to the outpatient clinic for further care

Correction: Determinants of change in long-acting or permanent contraceptives use in Ethiopia; A multivariate decomposition analysis of data from the Ethiopian demographic and health survey.

[This corrects the article DOI: 10.1371/journal.pone.0227218.]