Incidence of uterine perforation during hysteroscopy in a teaching hospital, in north western Nigeria.

Background: Uterine perforation during diagnostic hysteroscopy is relatively rare event in an experience hand. They however occur more frequently with operative hysteroscopy than with diagnostic hysteroscopy. The exact incidence differ from centre to centre depending on the indication for the procedure and the experience of the surgeon. This centre has a five year experience in diagnostic hysteroscopy, and occasionally therapeutic hysteroscopy in adhesiolysis and retrieval of missing intrauterine contraceptive device.Objective: To evaluate the rate of uterine perforation during different hysteroscopic procedures, whether it can be predicted by specific patient characteristics or the indication for the hysteroscopic procedure.Study design, settings and subjects: This is a retrospective analytical study, conducted at Aminu Kano Teaching Hospital, which involved all the patients that had hysteroscopy from 2009 – 2012.Method: Case files of all patients that had diagnostic hysteroscopy in Aminu Kano Teaching Hospital, Kano, within a three year period(from 5th January, 2009 – 5th of January, 2012), were reviewed.Results: A total of 36 patients had hysteroscopy for various indications within the 3 yr study period.4 patients had uterine perforation. All the 4 patients, had hysteroscopy for Asherman's syndrome.Conclusion: The risk of uterine perforation was higher during hysteroscopy for patients with Asherman's sydrome than during other procedures. Special precaution should therefore be taken in this group of patients during hysteroscopy to avoid uterine perforation.Keywords: Incidence, uterine perforation, hysteroscopy, Asherman's syndrome

Jadelle subdermal contraceptive implant in Aminu Kano teaching hospital Kano, northern Nigeria

Background: Jadelle is a set of two flexible cylindrical implants consisting of a dimethylsiloxane/ methylvinylsiloxane copolymer core enclosed in thin-walled silicone tubing. It is an improved version of Norplant. Worldwide, it is found to be effective, safe, reversible and convenient for many users.Objective: To determine the acceptance rate, the Socio-demographic profile of the clients, post insertion complications and reason for discontinuation of the method among its acceptors in Aminu Kano Teaching Hospital, Kano.Study design: This is a retrospective descriptive study, involving all acceptors of Jadelle Subdermal implant in the family planning unit of Aminu Kano Teaching Hospital Kano, North western Nigeria.Results: A total of 1505 clients accepted contraceptive methods during the study period. Out of these, 102 had Jadelle inserted, giving a rate of 6.8%. All the clients who accepted Jadelle had it inserted for child spacing. The mean age of the clients at insertion was 28.9 years ± 6.1, the mean parity at insertion was 3.3± 1.8, while the mean weight at insertion was 63Kg ±11.4. About 94% of the clients had secondary and tertiary education. 42.2% of the clients had used a modern contraceptive method previously while the remaining 57.8% were using a modern method for the first time. Nine clients reported post insertion complication, pain at the site of insertion was reported by three clients, and pruritus was reported by one client and intermenstrual bleeding by five of the clients. Five women discontinued the method; 3(60%) was due to menorrhagia.Conclusion: The continuation rate of the method is high (95.1%). Majority of the acceptors (98%) had formal education, only 2% of the acceptors were illiterate. Public enlightenment will improve its use among the non literate women.Keywords: Jadelle, Subdermal implant, Kano, Northern Nigeri

Ectopic pregnancy at Aminu Kano Teaching Hospital, Kano, Nigeria

Background: Ectopic pregnancy is an important cause of maternal morbidity and mortality in developing countries like Nigeria. The incidence of ectopic pregnancy is on the increase worldwide.Objective: To determine the influence of age and parity on the incidence of ectopic pregnancy, findings at operation and pattern of treatment of ectopic pregnancy at Aminu Kano Teaching Hospital (AKTH), Kano,Nigeria.Methods: It was a descriptive retrospective study of 178 patients that were admitted with ectopic pregnancy at Aminu Kano Teaching Hospital between January 2006 and December 2009.Results: The incidence of ectopic pregnancy was 11.7 per 1000 deliveries, 14.7% of all gynaecological operations and 74.8% of all gynaecological emergency operations. Modal age and parity were 25-29 years age group, and para 1. Ruptured ectopic pregnancy ( 75%), right tubal ectopic pregnancy (58%) and ampullary implantation (66.9%) were the most common presentations. Hemoperitoneum of greater than 1 litre occurred in 62.7% of the cases, but only 11.8% had autotransfusion of blood. There was a rising trend in the incidence of ectopic pregnancy during the study period.Conclusion: Ectopic pregnancy is the commonest gynaecological emergency at AKTH. Early girl marriage made ectopic pregnancy to be more associated with older parous women. Ruptured ectopic pregnancy was the commonest presentation, which calls for community campaign to encourage early presentation in the hospital. Autotransfusion where not contraindicated should be used more in the management of ruptured ectopic pregnancy.  Key words: Ectopic pregnancy, incidence, operative findings, pattern of treatmen

Placenta praevia: prevalence and risk factors at aminu kano teaching hospital, kano, Nigeria.

In an attempt to reduce maternal mortality from obstetric haemorrhage worldwide, obstetrician now offer routine ultrasound scan for placental localization in the mid trimester more readily to pregnant women, especially those who have risk factor(s). Knowledge of the risk factors of placenta praevia in our hospital will be necessary. Hospital, Kano, Nigeria. Methods: This is a case control study of fifty-two women who were confirmed to have placenta praevia (cases) and were compared with the next four women who delivered after without placenta previa (control) from January 2007 to December 2008. The study variables of interest were prevalence, age, and parity of the patients, gestational age, and risk factors of placenta praevia. Chi-square test was used to determine significant association between categorical variables, Results: The prevalence of placenta praevia was found to be 0.7%. Women in the 30-34 years age group (OR- 2.03, CI= 1.02-4.02, P= 0.042), Multiparae (OR= 2.81, CI= 1.42 -5.61, P= 0.002), early pregnancy bleeding (OR= 8.66, CI= 3.73 -20.33, P<0.001), previous uterine/caesarean section scar (OR= 4.21, CI= 1.97 - 9.02, P<0.001) and previous placenta praevia (OR= 4.32, CI= 1.03 -18.11, P= 0.030) all conferred increased risk placenta praevia Conclusion: Maternal age 30-34 years, multiparity, early pregnancy bleeding, previous uterine/caesarean section scar and previous placenta praevia were found to have significant association with placenta praevia in this study

Gender and Human Security: Reflections on the

This paper examines the relationship between gender, human security and HIV/AIDS epidemic in Nigeria. It explores this by critically examining the factors that promote the susceptibility and vulnerability of women/girls to contracting HIV/AIDS infection in Nigeria. It argues that in a patriarchal society such as Nigeria, gender is the prop on which vulnerability to HIV/AIDS and threats to human security rest. It further examines how cultural, political, socio-economic, and governance variables interplay to create and exacerbate the vulnerability of women/girls to contracting HIV/AIDS. Although the prevalence of the disease has declined since 2003, the paper observed that HIV/AIDS in Nigeria has disproportionately affected women. To better respond to the scourge of HIV/AIDS in Nigeria, the paper calls for the refocusing of campaign efforts on the rural areas; appropriate funding of the health sector; empowerment of women through proactive legislations; and greater representation of women in governance institutions to ensure that the formulation of public policies as well as the management of public resources is attuned towards greater responsiveness to the peculiar needs and challenges of women.

Maternal health in Central America: The role of medicinal plants in the pregnancy-related health and well-being of indigenous women in Central America

Over the past 20 years, Central America (CA) has made considerable progress in improving the health status of its populations. However, in some countries, the overall health status remains below average with poor outcomes concentrated geographically among the poor and Indigenous populations. Although Indigenous people make up the second largest population in CA, these populations have less access to healthcare, and funding for initiatives to improve maternal health is scarce. In many communities across CA, women continue to rely heavily on plant-based medicines for health and well-being, and yet there is a paucity of information regarding the safety and efficacy of these therapies. Sourced from available academic, governmental, and gray literature, in both English and Spanish, this chapter reviews maternal health issues among the Indigenous, Ladino, and other ethnic women of CA, evaluates the role of traditional medicine practices and their influence on maternal health outcomes, and reviews the existing scientific evidence supporting the use of traditional (i.e., plant-based) medicines for pregnancy-related health conditions.UCR::Vicerrectoría de Docencia::Ciencias Básicas::Facultad de Ciencias::Escuela de QuímicaUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Básicas::Centro de Investigaciones en Productos Naturales (CIPRONA