Effect of Intramuscular Hyoscine-N-Butyl Bromide on Tubal Spasm and Pain Perception in Women with Infertility Undergoing Hysterosalpingography: A Randomised Controlled Trial

Background: A tubal patency test is essential in evaluating women with infertility. Hysterosalpingography (HSG) is the investigation of choice for assessing tubal patency. Objective: To evaluate the effect of intramuscular hyoscine-N-butyl bromide on tubal spasms and pain perception during hysterosalpingography. Methods: This randomized, controlled trial was conducted at the Radiology Departments and Infertility Clinics of four health institutions in Bayelsa State, Nigeria, between January 2021 and April 2022. Five hundred and twenty infertile women undergoing hysterosalpingography were randomized into two groups. Women in group I (control) received a placebo, while women in Group II (experimental) received 20 mg of intramuscular hyoscine-N-butyl bromide. Pain scores at different steps of the procedure were recorded. Results: The overall mean pain scores progressively decreased from contrast instillation (4.97 ± 2.08) through 30-minutes post-procedure (3.54 ± 1.54) to 24 hours post-procedure (1.96 ± 1.78). Pain scores at contrast instillation, 30 minutes and 24 hours after HSG were significantly lower in the hyoscine group compared to the placebo group (p = 0.001 each). There were significantly fewer women with tubal blockage in the hyoscine group compared to the placebo group [78 (30.0%) vs 131 (50.4%); p = 0.001]. Conclusion: Intramuscular hyoscine-N-butyl bromide before hysterosalpingography significantly reduces pain and tubal spasm during the procedure

Relationship Between Subchorionic Haematoma and Abdominal Massage in Pregnancy in the Niger Delta Region of Nigeria: A Pilot Study

Background: Abdominal massage (AM) in pregnancy is a common practice in the Niger Delta region of Nigeria. AM may cause events such as subchorionic haematoma (SAH) and increase the risk of miscarriages and adverse maternal and perinatal outcomes. Objective: To determine the relationship between AM and SCH in the Niger Delta region of Nigeria. Methods: A cross-sectional study was conducted from January to June 2022 at the Obstetrics and Radiology Units of four health facilities in Bayelsa State, Nigeria. Consenting eligible pregnant women presenting to the antenatal clinic during the first trimester were consecutively included. An obstetric ultrasound scan was performed transabdominal. Results: Of the 403 women recruited, 241 (59.8%) were aged (20 – 29 years). The mean age was 28.02 ± 5.99 years. The mean body mass index was 23.82±4.60 kg/m2. While 170 (42.2%) had undergone AM in the first trimester of the index pregnancy, 126 (31.3%) had vaginal bleeding, and SCH occurred in 109 (27.0%) women. Women who had AM had 210 (CI: 58 – 878) times the odds of having SCH and 3.3 (CI: 2.14 – 5.15) times the odds of vaginal bleeding than women who did not have AM. Only 2 (1.8%) women with SCH did not have AM. Conclusion: There exists a strong association between the occurrence of SCH among pregnant women who have had AM. More health education is needed for women in the Niger Delta region and Nigeria to eradicate the archaic practice and improve pregnancy outcomes

Vulva Haematoma following Sexual Assault in an Adolescent Nigerian Girl: A Case Report

Non-obstetric vulva haematomas are uncommon, with an incidence of 3.7% accounting for less than 1% of gynaecologic emergencies. Non-consensual sexual intercourse constitutes the most common aetiology. A 15-year-old adolescent Nigerian girl, who presented to the Gynaecologic Emergency Unit of the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria, with vulva haematoma following sexual assault, is presented. She had surgical management, screening and prophylaxis for sexually transmitted infections, emergency contraception, and psychosocial therapy and was discharged after 24 hours, following an unremarkable postoperative period. This case is being reported to draw attention to the serious global public health problem of adolescent sexual abuse, highlight that though rare, vulva haematomas, which could be life-threatening, can be a complication of sexual assault, and review the literature on its management

Environmental challenges in Nigeria’s Delta Region and Agriculture

The paper discussed the environmental challenges in the Niger-Delta region of Nigeria with emphasis on the impacts on agricultural production. It thus discussed the concepts of Niger-Delta, Environmental pollution, Niger-Delta crises and Agriculture. The paper posits that there are positive relationships between these concepts justified on the basis of socio-Economic, political, health and agricultural under-development. The paper hence sees a looming bleak and dead-end to agricultural production and food security in Niger-Delta. Based on these theoretical positions, it recommends for active and pro-active measures to the environmental challenges in Niger-Delta region of Nigeria

Decision-to-Delivery Interval and Obstetric Outcomes of Emergency Caesarean Sections in a Nigerian Teaching Hospital

Background: Prolonged Decision-to-Delivery interval (DDI) is associated with adverse maternal-foetal outcomes following emergency Caesarean section (EmCS). Objectives: To determine the DDI, predictive factors, and the foeto-maternal outcomes of patients that had EmCS in a Nigerian Teaching Hospital. Methods: A descriptive study of all EmCS performed at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria, from 1st June 2020 to 31st May 2021, was conducted. Relevant data were extracted from the documentations of doctors, nurses and anaesthetists using a designed proforma. The data obtained were analysed using the IBM SPSS Statistics for Windows, version 25. Results: The median (IQR) DDI was 297 (175-434) minutes. Only one patient was delivered within the recommended DDI of 30 minutes. The most common cause of prolonged DDI was delay in procuring materials for CS by patients’ relatives(s)/caregiver(s) (264, 85.2%). Repeat CS (AOR = 4.923, 95% CI 1.09-22.36; p = 0.039), prolonged decision-to-operating room time (AOR = 8.22, 95% CI 1.87-8.66; p 150 minutes was significantly associated with maternal morbidity (p = 0.001), stillbirth (p = 0.008) and early neonatal death (p = 0.049). Conclusion: The recommended DDI of 30 minutes for CS is challenging in the setting studied. To improve foeto-maternal outcomes, efforts to reduce the DDI should be pursued vigorously, using the recommended 30 minutes as a benchmark

Knowledge, Attitude and Uptake of Pap Smear among Female Healthcare Professionals in a Nigerian Teaching Hospital

Background: Despite the high prevalence of cervical cancer (CC) in Nigeria, the uptake of screening services, including Pap smear, remains poor, even amongst healthcare providers. Objective: To assess Pap smear knowledge, attitude, and uptake among female healthcare professionals (FHPs). Methods: A cross-sectional descriptive study was conducted at the University of Ilorin Teaching Hospital (UITH), Kwara State, Nigeria, using a self-administered questionnaire. Results: A majority (343, 98.6%) of the FHPs knew Pap smear. Five (26.3%) medical laboratory scientists did not know what a Pap smear was. All the nurses, doctors, pharmacists, physiotherapists and medical social workers knew Pap smear. Only a fifth (71; 20.4%) of the FHPs had ever done a Pap smear. The most common reason cited for not having done a Pap smear was lack of time (109; 31.3%). There was a relationship between age and uptake of Pap smear (p = 0.024). Only 188 (54%) of the FHPs had ever recommended Pap smear to other women. Conclusion: Despite the high level of knowledge of Pap smear amongst FHPs in Nigeria, attitude and uptake remain poor. There is a need for further training and education of FHPs on the benefits of CC screening to increase their uptake and improve their effectiveness in promoting positive attitudes towards CC screening and prevention in the general population