Vulvovaginal Candidiasis in Aminu Kano Teaching Hospital, North‑West Nigeria: Hospital‑Based Epidemiological Study

Background: Vulvovaginal candidiasis (VVC) remains a common problem worldwide and the role of douching as a predisposing factor is unclear.Aim: This study was undertaken to highlight the prevalence and predisposing factors of VVC in North‑west Nigeria. Subjects and Methods: This was a prospective study done at Aminu Kano Teaching Hospital (AKTH), North‑west. AKTH is a 500‑bed tertiary hospital located in Kano, the most populous state in Nigeria. Ethical clearance was obtained. Three hundred patients with VVC were recruited from the gynaecologic and general outpatients’ clinics of AKTH. Research structured questionnaires were used to obtain sociodemographic and clinical information. The data obtained were analyzed using SPSS version 16.0 statistical software (SPSS Inc., Chicago IL, USA). Frequency, mean and simple percentages were used to analyze data.Result: Candida albicans was the most frequent cause of the positive high vaginal swabs constituting 84.5% (316/374) while Proteus vulgaris was the least frequent cause constituting 0.53% (2/374). Fifty‑three percent (143/270) of those with VVC were aged 26–35 years; the married were 80% (216/270) and those who were unmarried were 20% (54/270). Douching was the commonest predisposing factor occurring in 42.5% (115/270) of cases.Conclusion: VVC was the most prevalent cause of vaginosis in North‑west Nigeria, and douching was the commonest predisposing factor.Keywords: Epidemiology, Hospital, Nigeria, North‑west, Vulvovaginal candidiasi

Job satisfaction among resident doctors in a tertiary healthcare facility in Northern Nigeria, a cross sectional

Background: Over the past few years the number of doctors choosing to work abroad or in non-medical professions has been growing. Among those doctors who have remained in the workforce, there is a similar dissatisfaction, reflected in part by a general strike in 2010 by Nigerian doctors especially Association of Resident Doctors (ARD) in favour of higher wages and better working conditions. Job demands and workload of hospital doctors are increasing.The aim of this paper is to assess job satisfaction among junior and senior resident doctors of different specialties in Aminu Kano Teaching Hospital (AKTH) and to compare the level of satisfaction between these two groups of professionals with the purpose of making recommendation for improvement to health human resource managers.Method: This was a cross- sectional study that involved 150 resident doctors of different cadre and specialization between 1st December, 2011 and 28th January, 2012. The questionnaire was used to assess the socio-demographic information of the respondents, job satisfaction and work related conditions.Result: Most of the doctors (41.3%) were aged 31-35 years. The mean age of junior residents was 32.6±3.7 years, while that of senior residents were 35±4 years. This differences was not statistically significant (p=0.094).Most resident doctors (64.2%) worked for 7-9hours daily. All doctors worked for average duration of 9.4±2.6 hours. Junior residents worked for mean duration of 9±2.3 hours while senior residents worked for 9.1±3.2 hours. This was not statistically significant p=0.075. Most of the resident doctors (56.7%) had been in the service of the hospital for 1-3 years. The mean duration of service was 3.5±2.1. Most of the doctors (78%) had 7-9 dependents. The average number of dependents for junior residents was 4±3, while for senior residents was 6±2 and this was statistically significant (p=0.03). The mean number of dependents was 5±3. Most doctors (60%) had their last promotion less 1 year prior to the study with mean of 0.9±0.9years.80.1% of doctors were satisfied with their job, 17.3% were undecided and 5.2% were dissatisfied. More senior residents (82.2%) felt satisfied with their jobs than junior residents (77.9%) and this was statistically significant, p=0.035.Job satisfaction among doctors was more among those who were aged 41-45(100%) but there was a very weak positive correlation (r=0.21) between age and job satisfaction. Job satisfaction was more in those who have worked for at least 4 years with a weak positive coefficient of correlation (r=0.28).Length of service correlates more with job satisfaction than any other factors among doctors.Job satisfaction was highest among resident doctors in chemical pathology and radiology and lowest among resident doctors in obstetrics and gynaecology.Increase in manpower employment by management so as to reduce work hour per day may improve satisfaction among obstetrics and gynaecology residents.Conclusion: Job satisfaction among the doctors in this study was higher when compared with other studies within Nigeria and other developing countries. However, Job satisfaction may increase if physicians experienced more opportunities to advance their careers, team spirit, and better supervision.Keywords: Job Satisfaction, Dissatisfaction, Resident Doctors, Tertiary Healthcare, Northern Nigeria, Cross Sectional SurveyTrop J Obstet Gynaecol, 30 (1), April 201

Gynecological malignancies in Aminu Kano Teaching Hospital Kano: A 3 year review

Objective: To study the pattern of gynecological malignancies in Aminu Kano Teaching Hospital.Materials and Methods: This was a retrospective observational study carried out in the Gynecology Department of Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria between October 2008 and September 2011. Casenotes of all patients seen with gynecological cancers were studied to determine the pattern, age and parity distribution.Results: A total of 2339 women were seen during the study period, while 249 were found to have gynecological malignancy. Therefore the proportion of gynecological malignancies was 10.7%. Out of the 249 patients with gynecological malignancies, most (48.6%) had cervical cancer, followed by ovarian cancer (30.5%), endometrial cancer (11.25%) and the least was choriocarcinoma (9.24%). The mean age for cervical carcinoma patients (46.25 ± 4.99 years) was higher than that of choriocarcinoma (29 ± 14.5 years) but lower than ovarian (57 ± 4.5years)and endometrial (62.4 ± 8.3 years) cancers. However, the mean parity for cervical cancer (7.0 ± 3) was higher than those of ovarian cancer (3 ± 3), choriocarcinoma (3.5 ± 4) and endometrial cancer (4 ± 3). The mean age at menarche for women with cervical cancer (14.5 ± 0.71 years) was lower than for those with choriocarcinoma (15 ± 0 years), ovarian (15.5 ± 2.1 years) and endometrial (16 ± 0 years) cancers. There was one case of vulva cancer and none with vaginal cancer.Conclusion: Cervical cancer was the most frequent malignant tumor and the least was choriocarcinoma. Estimates of this important public health problem need to be addressed in various regions of Nigeria.Key words: Cancers, gynecological, nigeria, north-west, pattern, tertiary hospita

Umbilical cord infection prevention practices among rural women attending immunization clinic in kumbotso, Kano state, Nigeria

Umbilical cord infections are more prevalent in developing countries because of the high rates of unhygienic cord care practices. Objectives: This study was undertaken to explore the various practices related to umbilical cord care among rural community women attending an immunization clinic in Kumbotso, Kano State, Nigeria. Method: A descriptive cross-sectional study design was used for the study. This study was carried out in immunization clinic at Kumbotso CHC of Kumbotso Local Government Area (LGA), Kano state Nigeria. Sample size was 265. Data was collected with interviewer administered semi-structured questionnaire and analyzed using Statistical Package for Social Science (SPSS) version 20 software. The result obtained was presented in the form of tables. Results: Majority, 200 (75.5%) of respondents' hands were gloved. In 126 (47.5%) of respondents, new razor blades were used, in 117 (44.2%) of respondents' scissors was used and the remaining 22 (8.3%) of respondents used razor blade or knife to cut the umbilical cord. Up to 159 (60%) of respondents applied mentholated spirit. One hundred and sixty-nine (63.8%) of respondents were informed of safe umbilical cord practices by health workers. Cord infection rate occurred in 53 (20.1%) babies. Conclusion: Cord infection prevention and control practices were high in this community with a relatively low cord infection rate. Even though Chlorhexidine was not used, health workers should emphasize and as well recommend its use in cord care. Community-based study is recommended to generate data about cord infections and practices inside the community

An Audit of Gynaecological Procedures Performed at Aminu Kano Teaching Hospital, Kano

Background: Audit of all gynecological procedures as one of the commonest operations performed in medical practice is not routinely done in developing countries, including Nigeria. Aim: The study was aimed at determining the rate of all gynecological procedures performed; the common gynecological procedures and their indications, and the cadre of surgeons that performed different gynecological procedures within the period under review.Materials and Methods: A 1‑year retrospective chart analysis of all gynecological procedures performed at Aminu Kano Teaching Hospital (AKTH) between 01/10/2012 and 30/09/2013 was conducted. Patients with complete relevant information in the registers were included in the audit and those with incomplete data were excluded. Data was further cleaned and analyzed using Microsoft Excel for Mac 2011, for frequencies and percentages. Results were presented by simple statistical tables.Results: A total of 6,604 patients were gynecological attendees, out of which 646 patients had gynecological procedures performed, giving an institutional gynecological procedure rate of 9.8% (646/6,604), within the period under review. Emergency gynecological procedures accounted for 5.9% (38/646), while the elective cases accounted 4.0% (26/646). Majority of the gynecological procedures was among the 20–40 years age group. About 20 different types of gynecological procedures were done and manual vacuum aspiration (MVA), for incomplete miscarriage accounted for 58.8% (380/646), while excision of transverse vaginal septum was the least at 0.3% (2/646) of all the gynecological procedures. Interns, registrars, senior registrars, and consultants were involved in performing the different gynecological procedures. Between 69 and 100% (446/646‑646/646) of some of the major gynecological procedures were carried out by consultants, 14–27% (90/646‑174/646) by senior residents (SRs), while the junior residents and interns performed only MVAs among the gynecological procedures at 53.1% (343/646) and 7.3% (47/646), respectively. Conclusion: The common gynecological procedure performed in AKTH is MVA by all cadres of surgeons, and consultants performed the highest number of all the gynecological procedures except MVA. A more regular audit of services rendered by the department is advocated. This may help to identify the gaps in training and services.KEY WORDS: Aminu Kano teaching hospital, audit, gynecological procedures, Kan

A 10‑year Review of the Clinical Presentation and Treatment Outcome of Asherman’s Syndrome at a Center with Limited Resources

Background: Many women suffer from some degree of intrauterine adhesions (IUAs) presenting with various clinical symptoms and signs. Hysteroscopy is the mainstay of diagnosis, classification, and treatment of the IUA. Aim: This study was undertaken to review the clinical features and treatment outcome in patients diagnosed with Asherman’s syndrome at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, over a 10 years period, 1997–2006. Subjects and Methods: This is a retrospective study of cases of Asherman’s syndrome managed at the UMTH over a 10‑year period, from January 1, 1997 to December 31, 2006. Case records of the patients were retrieved from medical records’ Department. Sociodemographic and clinical information relating to clinical presentations, treatment modalities, and outcomes were collated. The data were analyzed using SPSS 16.0 Statistical Computer Package (SPSS Inc., IL, USA 2006). Chi‑square and binary logistic regression were used for inferential statistics. Results: Asherman’s syndrome constituted 8.1% (81/996) of all gynecological operations in UMTH during the study period. The case records retrieval rate was 96.3% (78/81 folders). Most of the patients, 59% (46/78) were in their third decade and majority 85.9% (67/78) were married. The most common risk factor was pregnancy‑associated, accounting for 61.5% (48/78). Infertility and hypomenorrhea were the most common mode of presentations in 55.1% (43/78) and 32.1% (25/78) of cases, respectively. Most of the patients 85.9% (67/78) were treated by blind dilatation and curettage (D/C), Foley’s catheter insertion and estrogen‑progesterone combination. Correction of menses was seen in 37.2% (29/78) of the patients while the pregnancy rate was 32.1% (25/78). On binary logistic regression age of the respondents, multigravidity, and previous pelvic surgeries for pregnancy (C/S and D/C for abortion) emerged as the only respondent’s related risk factors associated with the development of Asherman’s syndrome. Conclusion: Asherman’s syndrome is relatively common due to complications of pregnancy and delivery, and blind D/C has a relatively poor outcome. Age of the respondents, multigravidity, and previous pelvic surgeries for pregnancy (C/S and D/C for abortion) were associated with the development of Asherman’s syndrome. Therefore, other methods of adhesiolysis such as hysteroscopic adhesiolysis should be explored.Keywords: Asherman’s syndrome, Clinical presentation, Maiduguri, Treatment outcom

Nutritional Practices and Taboos Among Pregnant Women Attending Antenatal Care at General Hospital in Kano, Northwest Nigeria

Background: Food taboos among rural women have been identified as one of the factors contributing to maternal undernutrition in pregnancy. Aim: The aim of this study was to explore some of the taboos and nutritional practices among pregnant women attending antenatal care at a General Hospital in Dawakin Kudu LGA, Kano, Nigeria. Subjects and Methods: This was a cross‑sectional study involving 220 pregnant women. Interviewer‑administered structured questionnaire was used to interview the respondents, which showed various sociodemographic information, cultural nutritional processes, taboos of the community, and a 24 h food recall. The ages, parities, and gestational ages of the women were collated. Descriptive statistics was used. Data were analyzed using SPSS statistical software Version 17.0 (SPSS Inc., Chicago, IL, USA). Association between sociodemographic factors and nutritional practices and taboos was determined using Chi‑square test and P < 0.05 was considered statistically significant.Results: At the end of the study, 200 participants (91%) gave complete information. Most of the women, 70% (140/200) were in the 20–39 years age range with mean (standard deviation [SD]) age of 23.7 (6.1) years, mostly uneducated, 70% (140/200), and unemployed, 51% (102/200). Most of the women did a child spacing of 12–24 months, 62% (124/200) with mean (SD) child spacing interval of 26.32 (10.19) months. Gestational age at booking was mostly 13–26 weeks, 48% (96/200) with an average of 26.60 (8.01). Most of the women had 1–4 children, 54.5% (109/200) with mean (SD) of 2.47 (2.50). Most of the women agreed that they had adequate intake of oil, 86% (172/200), meat/fish, 92% (194/200), fruit/vegetables 56% (112/200), and had 3 meals/day 80% (152/200), and did not practice pica 83% (166/200). All of the women, 100% (200/200) believe that women should eat more during pregnancy in order to have healthy babies. They were mostly supported by their husbands, 53% (106/200) and less likely by the community, 34% (17/200). The nutritional practices and taboos of the women showed a statistically significant association with age, parity, and support received from husband and community (P < 0.05). Educational status is not associated with their nutritional practices and taboos. Conclusion: Although sociocultural indices of the respondents were poor, their intake of good nutrition and abstinence from nutrition taboos were satisfactory. Further studies are intended to objectively study the nutritional practices/taboos in pregnancy.Keywords: Northwest Nigeria, Nutritional practices, Pregnant women, Taboo

Antimicrobial sensitivity pattern of symptomatic urinary tract infection in pregnancy in Aminu Kano Teaching Hospital

Objective: To determine sensitivity pattern of antimicrobial organism in women presenting with features of urinary tract infections in pregnancy in Aminu Kano teaching hospital Kano.Methods: Retrospective study carried out between January to December 2010, amongst pregnant women attending our antenatal clinic. Those with urinary symptoms had their urine sent for bacteriological examination. Sociodemographic information, results of urine investigations obtained from patients' case records, and analyzed using EPI info statistical software version 6. Significant associations tested using chisquare test and p<0.05 was considered significant.Results: Seventy-two women had positive results. 7565 women attended antenatal clinic , incidence of UTI 1.3%. Six bacterial isolates identified. Most common was Proteus Mirabilis 24(33.3%), E. Coli 25(25%), staphylococcus Saprophyticus 12(16.6%) Kleibsella aerogenes 10(13.9%), Enterococcus Faecalis 6(8.3%) and Pseudomonas aeriginosa 2 (2.8%), differences were statistically significant (p = 0.015). Sensitivity patterns forProteus Mirabilis 12(50%) gentamicin, 7(29.1%) nitrofurantoin, 4(16.7%) augmentin and 1(5.6%) ofloxacine , differences statistically significant (p = 0.0037). Highest number of bacterial isolates obtained in women 20-25years (40.28 %) statistically significant, p = 0.0005. UTI commoner among women parity 1-2 (54.2%), not statistically significant, p = 0.35.Conclusion: Commonest organism causing UTI in pregnancy in this study was proteus mirabilis, and is most sensitive to gentamicin.Summary: Urinary tract infections (UTI) in pregnancy have clinical presentation. A retrospective study of seventytwo pregnant women was carried out in AKTH to determine the antimicrobial sensitivity pattern, in pregnant women presenting with features of UTI. The commonest organism isolated from the urine of these women was proteus mirabilis (33.3%), which was sensitive to gentamicin (50%) compared to augmentin (16.7%)  Keywords: prevalence, aetiology, antimicrobial sensitivity, UTI pregnant women, AKT

Reported sexual violence among women and children seen at the gynaecological emergency unit of a rural tertiary health facility, northwest Nigeria

Background: Various forms of sexual violence including: Coerced marriage or wife inheritance, female genital mutilation, forced exposure to pornography, rape by intimate partner or strangers, unwanted sexual advances, and sexual abuse occurs, especially in vulnerable groups. However, most of these cases are not reported. Aim: The aim was to review reported cases in the facility, determine the prevalence and pattern of presentation. Subjects and Methods: This was a prospective longitudinal study undertaken at the Gynecological Emergency Unit of a Tertiary Health Facility in a rural setting Northwest Nigeria. A study of survivors of alleged sexual violence who presented to the hospital from the September 1, 2011 to August 31, 2013. Results: During the study period, there were 24 cases of sexual violence (22 were alleged rape and 2 were others) of 973 gynecological consultations at the emergency unit, giving a prevalence of 3% (24/973) for sexual violence and 2.3% (22/973) for alleged rape. Majority 91.7% (22/24) of the cases were children < 16 years; 45.8% (11/24) had no formal education while 33.3% (8/24) hawked homemade drinks and snacks. The assailants were known in 83.3% (20/24) of the cases; of which 45.8% (11/24) were neighbors, 29.2% (7/24) were buyers of snacks and drinks while 8.3% (2/24) were family members. Conclusion: The prevalence of reported sexual violence in this facility was low with the majority of the survivors being children and nonstranger assailants’, mostly neighbors.Keywords: Sexual abuse, Sexual assault, Sexual violenc