Effect of sward height and concentrate supplementation on forage dry matter intake, digestibility and grazing time of spring-calving beef cows

To establish the effect of sward height (SH) and concentrate supplementation on performance of grazing cattle, twenty-four cross bred Angus beef cow-calves were randomly assigned to two SH treatments (4--8 or 8--11 cm) with three supplement levels: 6.24, 3.12 or 0 kg/d. The study was conducted in three periods (P): May (P1), June/July (P2) and August (P3) in 1996. There was no SH x supplement level x period or SH x supplement level interaction (P \u3e .10) on forage DMI, DMD or grazing time (GT). Cows on low SH had greater (P \u3c .08) DMI and GT (P \u3c .01) than cows on high SH. Forage DMI, DMD and GT decreased (P \u3c .05) with supplementation. Grazing efficiency declined with supplementation and advancing grazing season (P \u3c .01). Cows consumed more forage DM (P \u3c .01) in P1 and P2 than P3. Forage DMI and grazing efficiency decreased with supplementation suggesting that supplemented cattle can optimally be grazed at SH \u3c 8 cm

Obstetric complications of cervical stenosis: Case report

A case of cervical stenosis is presented. We present a case of a patient who despite experiencing irregular scanty menses, was able to get pregnant.The enigma is that she did not experience any lochia loss post partum.Cervical stenosis is a known predisposing factor to infertility, but it can also have other presentations as are described in this case report

An aberrant uterus: Case report

A case of an aberrant uterus is presented and literature reviewed. The patient presented with abnormal uterine bleeding, left iliac fossa pain and was managed by excising the aberrant uterus. This case was an enigma as it didn’t present in the classical way one with anomalies of the uterus would present. Despite knowledge on the classical types of uterine anomalies, awareness of other possibilities is important

Endometriosis in unicornuate uterus with non-communicating rudimentary horn

Endometriosis, defined as the presence of endometrial tissue outside the uterine cavity, is itself an enigmatic  and multifaceted pathology, a puzzle whose manifold piece remain largely disconnected despite some decades  of investigation. Its medical history and clinical presentation is heterogeneous. Endometriosis affects  approximately 10% of women of reproductive age, given its high prevalence and that women with endometriosis may have severe pelvic pain and infertility, endometriosis poses a significant health problem.  Evaluating and understanding the pathogenesis, clinical presentation, diagnosis of the endometriosis is critical  in the management of this debilitating disease. A rare case of endometriosis in a patient with congenital  anomaly-Unicornuate uterus with one unconnected rudimentary horn is presented

Knowledge, attitudes and practices of infertile couples on male participation in infertility management at the Kenyatta National Hospital

Objective: To determine knowledge, attitudes and practices of infertile couples on male involvement in the management of infertility.Design: Hospital based cross-sectional study.Setting: Kenyatta National Hospital, Nairobi, Kenya.Subjects: One hundred sixty three infertile couples attending the gynaecological and infertility clinics at the Kenyatta National Hospital.Main outcome measures: Knowledge, attitudes and practices of infertile couples on male participation in infertility management.Results: A total of 163 infertile couples(with only 34 men accompanying their wives in this study period) were recruited into the study. Sixty nine point nine percent(114) of the women who participated in this study were ever accompanied to the clinic by their spouses, but only 20.9%(34) were accompanied during the study period. Couple awareness on male participation in infertility was 61.8% by the men and 67.5% by the women but they all agreed that it would improve the care given. The male partners who came to the clinic were more involved in the care of their partners, in terms of paying hospital bills, having investigations performed on them, participating in the decision making process and accepting treatment (p<0.05). On multiple logistic regression, it was found that male partners of accompanied women were paying the medical bills (p value = 0.017, OR=3.0[1.2-7.4]), being investigated (p-value=0.011, OR=3.1[1.3-7.5]), helping decide the treatment the partner receives (p-value = 0.04, OR=2.5[1.0-5.9]) and accepting treatment if found to have a problem (p-value=0.005, OR=4.0[1.5-10.5]).Conclusion: Male participation in infertility management was low 34(20.9%) and structures need to be put in place to improve male partner participation in infertility management

Pregnancy outcome among adolescents and non-adolescents delivering at Kiambu Country Hospital, Kenya

Objective: To determine the pregnancy outcome among adolescents and non-adolescents.Design: A retrospective cross sectional study.Setting: Kiambu County Hospital, Kenya.Subjects: Three hundred and thirty six patients who delivered at Kiambu County Hospital.Main outcome measures: Maternal and foetal morbidity and mortality.Results: More adolescent were single and of lower level of education than the nonadolescents with a statistical significance of 0.025 and 0.031 respectively. Anaemia occurred in 16.0% of adolescents compared to 2.4% among the non-adolescents with a statistical significance of p(<0.001). Cepholopelvic Disproportion (CPD) occurred in 8% of the adolescents vs.1.6% among the non-adolescents vs. 1.6% among the non –adolescents with a statistical significance (P<0.018). Preterm deliveries occurred in 5.6% of the adolescents compared to 0.8% with a statistical significance of 0.031. Postpartum haemorrhage occurred in 7.2% of the adolescents compared to 0.8% of the non-adolescents with a statistical significance of P<O.O1. Puerperal sepsis occurred in 7.2% of the adolescent vs 1.6% among the non-adolescents (P<0.031). The mean birthweight of the adolescents was 2.9 kgs compared to 3.1 kgs with the difference being statistically significant with a P-value of 0.015.Conclusion: Socio-economic status was worse among the adolescents. Intra-partum complications like malpresentation, cephalopelvic disproportion and preterm deliveries were more common among the adolescents than the non-adolescents. Mean birth weight was lower for the adolescents. Post-partum complications like haemorrhage and sepsis were also more common in the group. Adolescent pregnancy is high risk and should be prevented but if it occurs, comprehensive antenatal follow-up is mandator

Successful IVF-ICSI with live baby in an azoospermic patient with cryopreserved sperms: Case report

Male factor is one of the most frequent cause of infertility and presents a variety of endocrine, genetic and immunological etiologies, as well as sexual malfunction, varicocele and genital infections. A case of a couple with primary infertilityfor two years is presented. Both partners were evaluated thoroughly, with a finding of male infertility. The man was found to be azoospermic after two semenalysis were performed. The Follicle Stimulating hormone (FSH) was raised with low testosterone levels indicating testicular failure. The recommended treatment was testicular biopsy with cryopreservation of the sperm and subsequent Intra cytoplasmic Sperm Injection (ICSI). This treatment option was undertaken with successful implantation and live baby delivery. The case study presents the diagnostic modalities and management of male infertility with azoospermia

Heterotopic pregnancy in an assisted reproduction conception; case report and literature review

Infertility management by assisted reproduction techniques has had rapid increase. While there is robust evidence supporting the efficacy and safety of assisted reproduction technique (ART), complications are encountered. Heterotopic pregnancy, defined as the presence of both an intrauterine and an ectopic gestation, is a rare eventuality of early pregnancy. A 42 years old patient (Para 0+1) with a diagnosis of secondary infertility is presented; she had In Vitro fertilization (IVF) with egg donation. Two weeks after the IVF, a positive serum Beta Human Chorionic Gonadotropin confirmed the pregnancy and she continued with intake of progestins for luteal phase support. At 7 weeks gestation she presented at a local hospital with acute pelvic pain. A diagnosis of heterotopic pregnancy was made after transvaginal showed right slow leaking ectopic pregnancy andintrauterine missed abortion. Laparoscopic surgery, right salpingectomy and manual vacuum aspiration were performed with good subsequent recovery. The case presented, discusses the aetiology, clinical presentation, diagnosis and management of heterotopic pregnancy

Premature ovarian failure in twins: case report

Premature ovarian failure (POF)is a serious life-changing condition that affects young women, remains an enigma and the researchers’ challenge. POF, premature ovarian insufficiency (POI), premature menopause, premature dysfunction (POD), or hypergonadotropic hypogonadism is one of the most perplexing disorders with aheterogeneous origin. Infertility, social and psychological stress are common consequences of this entity. This paper presents a rare condition where both twins had presented with POF

The Structured Operational Research and Training Initiative (SORT IT), second workshop using the national tuberculosis routinely collected program data

No Abstrac