A six year review of hysterectomy for benign gynaecological conditions at the Federal Medical Centre, Owerri

Background: Hysterectomy is one of the commonest major gynaecological surgeries performed for both benign and malignant conditions. Hysterectomy for benign gynaecological conditions is usually done to improve the quality of life of women who suffer from these disorders. Aim of current study was to analyze hysterectomies performed in the centre for benign gynaecological conditions during the period of the study.Methods: This was a retrospective descriptive study of all cases of hysterectomy (for benign gynaecological disorders over a 6 year period (January 1, 2006 - December 31, 2011) at Federal Medical Centre, Owerri. Information on socio-demographic characteristics, clinical presentation, indication for surgery, type of hysterectomy, operative findings, and postoperative complications during admission were retrieved and analyzed.Results: Hysterectomy for benign gynecological conditions accounted for 14.1% of all major gynecological surgeries. The leading indications for hysterectomy were uterovaginal prolapse (47.3%), uterine fibroid (33.6%), and dysfunctional uterine bleeding (DUB) (9.1%). Abdominal hysterectomy accounted for 55.0% while vaginal hysterectomy accounted for 45.0% of hysterectomies performed for benign gynecological conditions. A post-operative morbidity rate of 23.7% was found. Post-operative fever, requiring investigation and treatment, was the leading complication. No mortality associated with hysterectomy was recorded.Conclusions: Hysterectomy for benign gynaecological conditions is relatively common and safe in our centre, but there is need for improvement on the high post-operative morbidity rate

Serum adiponectin and metabolic profile in women with polycystic ovarian syndrome in relation to body mass index

Background: Polycystic ovarian syndrome is a common endocrine disorder which affects approximately 5-10% of women in reproductive age. It is both a reproductive endocrinopathy and a metabolic disorder.Methods: 160 women aged 18 to 40 years attending obstetrics and gynaecology clinic at Federal medical centre, Owerri, Imo State Nigeria were recruited and divided into 2 groups (women diagnosed with PCOS using Rotterdam criteria and control) of 80 participants each. Anthropometric data were collected, and participants categorized into 3 based on BMI. Fasting blood samples was collected for biochemical analyses. Data were analyzed using the Statistical Package for Social Sciences SPSS version 23.0, and level of significance set at p<0.05.Results: The mean serum levels of adiponectin and high density lipoprotein (HDL-C) were significantly lower while fasting plasma glucose, serum insulin, homeostatic model assessment for insulin resistance, total cholesterol, low density lipoprotein (LDL-C), very low density lipoprotein (VLDL-C) and triglyceride were significantly higher in women with PCOS when compared with the control (p<0.05) as well as in obese when compared with normal weight women with PCOS (p<0.05). BMI negatively correlated with serum adiponectin and HDL-C, but positively correlated with FPG, insulin, HOMA-IR, TC, TG, LDL-C and VLDL-C in women with PCOS (p<0.05).Conclusions: This study highlights the prevalent biochemical and metabolic derangements in PCOS patients and was more evident in the obese and overweight patients. Early detection with subsequent application of preemptive measures including lifestyle modifications are therefore essential in the management of PCOS patients

Comparison of serum levels of calcium and magnesium among preeclamptic and normotensive pregnant women at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

Background:Despite numerous studies, the exact aetiology of pre-eclampsia remains unknown. Some studies have shown that supplementation of calcium and magnesium could ameliorate the effects of pre-eclampsia. The objective of this study was to compare the calcium and magnesium levels in the serum of Nigerian women with or without pre-eclampsia.Methods:In this study, serum calcium and magnesium levels were determined using atomic absorption spectrometry in 54 patients and 48 healthy normotensive pregnant women. The mean, standard deviation, Student’s‘t’ test and Pearson correlation were employed.Results:Serum calcium was significantly lower in patients than controls (9.17 ± 0.6 vs. 7.22 ± 0.5 mg/dl. P <0.001) (t test). Plasma Magnesium was significantly lower in patients than controls 13.19 ± 1.1 vs. 9.81 ± 0.7 mg/dl. P <0.001). The systolic and diastolic blood pressure showed significant inverse correlation with both calcium and magnesium (P<0.01).Conclusion:There was significant reduction in the levels of calcium and magnesium in patients with pre-eclampsia. Dietary supplementation of these trace elements may help to prevent pre-eclampsia

Effect of moderate - vigorous intensity physical exercise on female sex hormones in premenopausal university students in Nnewi, Nigeria

Background: Sedentary lifestyle and diseases associated with it is on the increase in our communities, state and country as a whole. The objective was to determine the effect of exercise on ovarian reserve status of the participants using day 3 FSH, LH and estrogen values and the ovulatory status of the participants using day 21 progesterone values. Methods: The study was a prospective comparative study. A total of 30 participants were recruited for this work. They were divided into 2 groups: 15 subjects that did exercise for 1 month and 15 controls that didn’t do any form of exercise. Baseline blood samples were collected from the two groups on day 3 and day 21 of the menstrual cycle. The subjects started exercise on day 1 of the next menstrual cycle. Blood samples were collected from the subjects and control on day 3 and day 21 of the next menstrual cycle. Results:There was significant reduction in weight and therefore BMI of the study group compared to control group and study group baseline after one month of exercise (P<0.05). There were no significant differences in the baseline levels of Estrogen, FSH, LH and progesterone between the subjects and control groups before the exercise, but after 1 month of exercise, there were significant differences in the levels of estrogen, FSH, LH and progesterone in these groups (P<0.01). Among the study group there were significant differences in the baseline and final levels of Estrogen, FSH, LH and Progesterone (P<0.01). Conclusions: The hormonal pattern shows that moderate-vigorous exercise may increase the responsiveness and sensitivity of the follicles to FSH and LH with attendant increase in ovulatory status of young females.

Knowledge, perception and willingness to receive the current COVID-19 vaccine among residents of Awka metropolis, Anambra State, Nigeria

Background: Vaccines can effectively reduce most morbidities and mortalities caused by infectious agents. The emergence of the COVID-19 vaccine may be accompanied with huge success in containing the pandemic. The aim of the study was to assesses knowledge, perception and willingness to receive the current COVID-19 vaccine among residents in Awka metropolis, Anambra State, Nigeria.Methods: Using a pre-tested semi-structured questionnaire, this study was conducted in Awka metropolis Anambra State, Nigeria among 393 respondents (aged 18 years and above), and analyzed to assess their knowledge, perception and willingness to receive the current COVID-19 vaccine. Statistical package for social sciences software (SPSS) version 23.0 was used, descriptive statistics were reported in frequencies and percentages, Chi-square test was used to assess the association between socio-demographic characteristics and willingness to receive the vaccine, and level of significance was set at p<0.05.Results: The results showed that all respondents (100%) have good knowledge of the vaccine availability. Only 25.7% were willing to receive the vaccine, although 57.3% were willing to receive any other vaccine apart from the COVID-19 vaccine. Very few respondents (18.3%) thinks the vaccine is accessible to all. Most of the respondents (72%) did not support mandatory implementation of COVID-19 vaccine in Nigeria. Among the socio-demographic characteristics, only occupation was significantly associated with willingness to receive the vaccine (p=0.010, χ2=20.214).  Conclusions: This study highlighted the need to effectively educate the masses through appropriate public health literacy programs and enlightenment campaigns on the role of the vaccine in curbing this pandemic

Effect of omega-3 supplementation on serum adiponectin and fertility hormones in women with polycystic ovarian syndrome

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrinopathy affecting women of reproductive age with prevalence of about 4%–20%. Aim: This study aims to evaluate serum adiponectin and fertility hormones in women with PCOS, and the subsequent effect of omega-3 supplementation. Subjects and Methods: One hundred and fifty women aged 18–40 years were assigned into groups A and B comprising women with PCOS and control, respectively. Group A was further subdivided into groups 1 and 2 receiving omega-3 and placebo daily for 12 weeks, respectively. Blood samples were collected before and after 12 weeks of supplementation for analysis of adiponectin, follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone, prolactin, estradiol, progesterone, and sex hormone binding globulin (SHBG). Statistical Package for Social Sciences (SPSS) version 23.0 was used for data analysis, and the level of statistical significance was set at P < 0.05. Results: Serum adiponectin, progesterone, and SHBG were significantly lower while FSH, LH, testosterone, prolactin, and estradiol were significantly higher in women with PCOS when compared with the control (P < 0.05). Adiponectin and progesterone levels increased significantly while FSH, LH, testosterone, prolactin, and estradiol levels decreased significantly after 12 weeks of omega-3 supplementation when compared with the levels at baseline as well as when compared with those on placebo (P < 0.05). Statistical Package for Social Sciences (SPSS) version 23.0 was used for data analysis. Conclusion: Omega-3 may be beneficial in improving certain hormonal alterations in women with PCOS. Omega-3 supplements may therefore be used as part of the regimen in the management of patients with PCOS

Association between serum chlamydial antibody levels and tubal infertility in tertiary health facility in South-East Nigeria: a case-control study

Objectives: This study evaluates the association between genital Chlamydial infection and tubal factor infertility in a tertiary health facility in South-East Nigeria.Design: This was a case-control analytical study.Setting: Gynaecology Clinic and Maternity Unit of the Department of Obstetrics and Gynaecology of the Federal Medical Centre (FMC), Owerri, Imo State, Nigeria.Participants: Ninety-six (96) women with confirmed tubal factor infertility served as the cases, and 96 women with normal intra-uterine pregnancy matched in age served as the control.Data Collection/Intervention: A structured questionnaire was used to extract information on the sociodemographic data and the sexual history of the participants. About 2mls of blood was collected, the blood was allowed to clot, and the sera were used for the test.Statistical analysis/Main outcome measure: Pearson Chi-square, Fisher’s exact test, likelihood ratio and multivariate logistic regression were used to determine risk associations and identify factors independently related to tubal factor infertility. P-value &lt; 0.05 was considered significant.Results: The sociodemographic characteristics of both cases and control did not differ (P = 0.975). The Chlamydial antibody seropositivity was significantly higher in the cases than the control 78(81.2%) versus 13(13.5%) respectively {(P &lt; 0.001; OR (95% CI) = 27.7(12.7-60.2)}. Only lower abdominal pain {(P = 0.011); OR (95% CI) = 4.3(1.4-13.3)}; was independently associated with tubal factor infertility.Conclusion: Tubal factor infertility is strongly associated with chlamydial IgG antibodies, and a history of lower abdominal pain significantly predicted tubal factor infertility