Vesicovaginal fistula following an induced abortion with a huge bladder stone: case report

A case of a 26 year old P +1 woman who developed vesico-vaginal fistula (VVF) following an induced 1 abortion is presented. She presented with five year history of continous leakage of urine following a voluntary termination of pregnancy at about 11 weeks of gestation using metallic instruments in a chemist shop by a Nurse. When she was examined, she had a suprapubic mass of about 14 weeks size, tender and mobile. Pelvic examination revealed a 1.5 x 2.0cm juxta cervical fistula with healthy looking cervix. Abdominopelvic ultrasound scan showed a huge bladder stone that measured 10 x 15cm. She had cystolithotomy and fistula repair transvaginally and was discharged home after 21 days of admission.Keywords: Vesico-vaginal fistula, induced abortion, bladder stoneJos Journal of Medicine, Volume 7 No.

Caesarian Section Rate at Federal Medical Centre, Makudi, Revisited

Context: Regular auditing of caesarean section rate is important to establish trend, review indications, associated complications and offer possible solutions to improve outcome.Objective: To audit caesarean section rate done over a 3 year period from January 2010 to December 2012 and to compare such with the last reported study done at the same centre.Materials and Method: A three year retrospective study from January 2010 to December 2012 involving all women who had caesarean delivery at the Federal Medical Centre Makurdi was conducted.Results: The overall caesarean section (CS) rate was 15.2%. The CS rate in 2010, 2011 and 2012 showed a steady increase of 14.2%, 14.6% and 16.8% respectively.Cephalopelvic disproportion ( 25.3%) was the commonest indication for CS, followed by fetal distress (16.6%) and previous CS for booked patients. For unbooked patients, fetal distress (23.8%) and obstructed labour (20.4%) were the commonest indications. Over 80% of the procedure was carried out by registrars with consultants accounting for only 13.1%.Conclusion: The CS rate has steadily been on the increase in our facility compared with the last, though better than most, reported in this country. There is much room for improvement

The effect of HIV/AIDS on sexuality among HIV positive females attending specialist clinic

Introduction: The impact and stigma associated with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) has led to different sexual behaviours in affected individuals the resultant lack of proper sexual information and various accompanying misconception has led to a high transmission of HIV in Sub Saharan Africa.Methodology: This study was a cross sectional survey of HIV positive women attending the STI/family planning clinics of FMC Makurdi between January to December, 2010.Result: A total of 145 HIV positive women participated in this survey of which 118(81.4%) were sexually active, 60% of whom did not have their status affecting their sexual behaviour.Conclusion: Counseling on safe sexual practice should be stressed in among HIV positive individuals to reduce the spread of the disease.Jos Journal of Medicine, Volume 7 No.

Forgotten intra uterine contraceptive device: A rare cause of secondary infertility: A case report

Infertility is a very common disorder of reproduction and it’s considered high in Africa generally and Nigeria in particular.1. The ability to bear children is very important in an African marriage to the extent that the very existence and stability of marriage is hinged on it. 2, 3. Ironically fertility is also very high in Africa partly due to low contraceptive prevalence and awareness.4 Most of these pregnancies are unwanted necessitating voluntary termination of pregnancies. Because of unfavorable legislations most of the abortions are done by quacks that lack the necessary skills for counseling and post abortion contraception. 5 Because IUCDs 6 are relatively cheap, available, easy to insert and with little or no need for follow up they are often inserted during dilatation and curettage We report here an unusual case of secondary infertility of nine years duration due to a post abortal IUCD inserted during a D and C to terminate an unwanted pregnancy without the patient’s knowledge. Key words: IUCD, secondary infertility, hysterosalpingograph