A review of pregnancy outcomes following laparoscopic ovarian drilling for infertile women with clomiphene resistant polycystic ovarian syndrome (PCOS) at a public health facility in Ilorin, Nigeria.

Background: Polycystic ovarian syndrome (PCOS) is the common endocrine disorder in women and its prevalence is on the increase due to availability of diagnostic tools. It is usually managed medically but for some resistant cases may require surgical intervention in the form of laparoscopic ovarian drilling (LOD). LOD is a one-off therapy avoids the need of medical therapy and its attendant complications.Aim and Objectives: The objective of this study was to determine the impact of LOD on reproductive outcomes of infertile women with clomiphene resistance PCOS among clients attending the Assisted Reproduction Technology unit of University of Ilorin Teaching Hospital.Materials and Methods: This is a prospective / longitudinal study of twenty three (23) patients of clomiphene resistant PCOS who underwent LOD between January and December 2012.Results: The patients were aged 24-45years with a mean age of 31.7 ± 5.2 years. Twenty (87%) out of twenty three were nulliparous and majority (87%) belong to middle social class. Eleven (47.8%) had primary infertility while 12 (52.2%) had secondary infertility. The mean duration of infertility is 4.5 ± 2.9 years and the number of drills per ovary ranged from 4 to 15 (mean, right ovary=8.6±3.24; left ovary=9.3±3.4). Majority (95.7%) had at least one patent tube. The mean age of patients' husbands is 38.8 ± 5.7 years with majority (82.6%) having normozoospermia. In the follow-up period, all 23 patients (100%) resumed menstruation and achieved ovulation (ovulation rate= 100%). The mean time of menstruation and ovulation were 4.1± 1.9 days and 5.3 ± 3.2 weeks respectively. Seven pregnancies were recorded from 23 patients giving a cumulative pregnancy rate of 30.4%. Of the remaining four pregnancies, one of the patients had successfully delivered, giving a live birth rate of 14.3%, while others are on-going. The mean time interval from LOD to pregnancy was 4.7 ± 1.6 months. The pregnancy outcomes had no significant association with age of the women, parity, duration of infertility and types of infertility with p > 0.05. Conclusion: LOD is a safe and effective one-off treatment for PCOS related infertility in patients who failed to respond to CC with efficacy equal to gonadotrophins and metformin. We recommend the need for its domestication in our locality.Keywords: Anovulatory infertility, Laparoscopic ovarian drilling, Polycystic ovarian syndrome, Live birt

Randomised Controlled Trial Study of the Effect of TENS and NSAID (Opoid) Drug in the Management of Post Operative Gynaecological Pain

Background: TENS is a non-invasive, safe nerve stimulation intended to reduce pain, both acute and chronic. However there is controversy regarding its effectiveness in relieving this pain.Objective: This study was designed to establish the effectiveness of TENS compared with NSAID drugs in the management of patient with post  operation pain due to gynaecological conditions  (Hysterectomy/myomectomy) and caesarean section.Methods: Thirty (30) patients with diagnosis of fibroid for  hysterectomy/myomectomy, caesarian section and surgical procedures were assigned into three groups of 10 patients each.Group 1: treated with NSAID drugsGroup 2: treated with NSAID drugs with TENSGroup 3: treated with TENSPain intensity was assessed using the Visual Analogue Scale (VAS) at the beginning pre-treatment and at the end of every week for three  uninterrupted weeks in each group and compared.Results: The groups were comparable with VAS scores over three weeks post operative period. A statistically significant difference was found in all the three groups between the mean pre-treatment and post-treatment pain intensities for the three weeks (p=0.00). The mean VAS score decreased with each groups; however the mean VAS scores of TENS with drug decreased significantly compared with drug and TENS alone groups (p<0.05). Although NSAID alone controlled the pains better than TENS alone this superiority was not appreciated until the third week (p= 0.01).Conclusion: We conclude that TENS with NSAID was more effective than either NSAID or TENS alone in the management of post operation painKeywords: Transcutaneous electrical nerve stimulation, Non steroidal anti inflammatory drugs, Gynaecological condition

Gynecological laparoscopic surgeries: A 4‑year audit at the University of Ilorin Teaching Hospital, Nigeria

Background: In addition to a shorter hospital stay and better cosmetic results, laparoscopic surgery also offers patients fewer postoperative complications compared to conventional open gynecological surgeries. With expertise and better facilities, it has come to stay as an alternative surgical approach to gynecological diagnosis and treatment.Aims and Objectives: The aim of this study was to assess the indications, intraoperative findings, and types of laparoscopic surgeries performed at the University of Ilorin Teaching Hospital, Ilorin.Materials and Methods: A retrospective observational study of 150 patients who underwent laparoscopic procedures between January 1, 2012 and December 31, 2015, at the Assisted Reproduction Technology (ART) unit of the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria.Results: Within the period of our review, there were 1,256 gynecological operations and 150 laparoscopies, thus giving a period prevalence of 11.2%. The patients were aged 20–59 years with a mean age of 32.1 ± 3.9 years. Of the 150 laparoscopies, 30 (20%) had diagnostic laparoscopies while 120 (80%) had therapeutic laparoscopies. Of the 30 patients who had diagnostic laparoscopies, 5 (16.7%) presented with primary infertility and 12 (40%) with secondary infertility. The commonest indication for therapeutic laparoscopy was clomiphene‑resistant polycystic ovary syndrome (PCOS) and was found in 81 (67.5%). One (0.7%) was converted to open surgery due to technical difficulties. There was a case of iatrogenic sigmoid colon injury and no mortality recorded.Conclusion: Laparoscopic surgery offers patients a novel choice of intervention that affords establishing definitive diagnosis, shorter hospital stay, better cosmetics, and reduced morbidities/mortalities compared to open gynecological surgeries.Key words: Gynecological; Ilorin; laparoscopy; Nigeria

Knowledge and prevalence of risk factors for arterial hypertension and blood pressure pattern among bankers and traffic wardens in Ilorin, Nigeria

Background: High job strain, mental stress, sedentary lifestyle, increase in BMI are among the factors associated with significantly higher incidence of hypertension. The job of bank employees is both sedentary in nature and accompanies high mental stress. The aim of this study is to assess the level of knowledge of risk factors among respondents and to compare the blood pressure pattern of bankers and traffic wardens.Methodology: The study design is a descriptive cross-sectional conducted among bankers and traffic wardens in Ilorin to determine the pattern and knowledge of blood pressure. Self-administered questionnaires, weighing scale (Omron Digital scale), stadiometer and sphygmomanometer were used as the research instruments. Simple random sampling was used to select respondents involved in the study.Results: The prevalence of hypertension in this study was 34.4% in bankers and 22.2% in traffic wardens. The risk factors the bankers commonly had knowledge of are alcohol, obesity, high salt intake, certain drugs, stress, emotional problems and family history while the traffic wardens commonly had knowledge of all these in addition to cigarette smoking. Also, more bankers (32.2%) than traffic wardens (13.3%) were smoking cigarette and more of these cigarette smokers that are bankers (17.8%) had elevated blood pressure compared to the traffic wardens (3.3%).Conclusion: Workers in the banking industry as well as traffic wardens should be better educated about the risk factors of hypertension and bankers should be encouraged to create time for exercise.Key words: Hypertension, risk factors, bankers, traffic warden

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Pregnancy Outcomes Following Assisted Reproduction Technologies For Infertile Women At A Public Health Institution In Nigeria

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Female surgical sterilization at University of Ilorin Teaching Hospital, Ilorin: 10-year review

Background: Given technological advances over the past few decades, female surgical sterilization has become a safe, convenient, easy, and highly effective birth control method for the long term.Objective: This study aims at determining the uptake, indications, timing, surgical technique and complications of voluntary surgical sterilization in Ilorin.Methodology: A retrospective study involving all clients who have undergone female sterilization by mini-laparotomy at the University of Ilorin Teaching Hospital Family Planning Clinic between January 2002 and December 2011. Clinical data were retrieved from the case notes and the information obtained was analyzed with SPSS version 16 of the computer. All the case notes had adequate information for the study, and none was missing.Results: There were 25,418 deliveries with 205 cases of female surgical sterilizations out of which 95 were through mini-laparotomy, giving an incidence of 8% and 3.7 per 1000 deliveries, respectively. The mean age at sterilization was 38.9years. Grand-multiparity and completed family size were the main indications. Seventy-nine percent of the clients had interval procedure and Pomeroy’s method was used among 70.5% of the clients. Local infiltration was used for most (60%) of the clients. Complication attributable to the procedures occurred in 5.3% of the clients. These include, wound sepsis (2.1%), urinary tract infection (1.05%) and one failed sterilization (1.1%).Conclusion: Concerted efforts at female reproductive health education and counseling will help to dispel some of the rumours and misconceptions associated with the procedure

Condom use among people living with HIV/AIDS attending Abejukolo General Hospital in Kogi State, North Central Nigeria

Background: Condom programming is an integral component in a range of HIV/AIDS prevention strategies and with repeated sexual contact among HIV.discordant couples, 98.100% of those who used latex condoms  correctly and consistently did not become infected. The objective of this study is to determine condom use among people living with HIV/AIDS (PLWHA).Methods: This is a cross.sectional survey carried out among 231 PLWHA and receiving care and treatment at General Hospital Abejukolo in Kogi State, Nigeria. The research instrument was interviewer.administered questionnaire. The data obtained were analysed using EPI.INFO version 3.4.1 software and P-value of < 0.05 was significant for the study.Results: About three.quarters (70.6%) of the respondents had ever used condom. Reasons given by respondents who did not use condom were: Desire for children (39.7%), and reduction of sexual pleasure (17.7%) and partner preference. More than half (56.0%) of the respondents with multiple partners did not use condom. About half 119 (51.5%) have used condom in the last sexual encounter. Gender, literacy level and disclosure of HIV status to partners significantly influence condom use during sexual intercourse.Conclusion: The poor uptake of condom among PLWHA underscores the need for government and other stakeholders in the management of HIV/AIDS to provide more enlightenment opportunities to address the gaps in condom use and disclosure of HIV status to partners.Key words: Condom use, HIV/AIDS, Nigeria, PLWH

Hysterectomy at the University of Ilorin Teaching Hospital, Ilorin, Nigeria: A ten year review

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Mayer – Rokitansky Syndrome Type 1 With Karyotype XY Variant: A Case Study

No Abstract Keywords: primary ammenorrhea, coital laceration, karyotype Xy varian