Intrauterine adhesions in the University of Uyo Teaching Hospital, Uyo, South‑South, Nigeria: A ten year review

Background: Asherman’s syndrome is a clinical entity that can cause menstrual abnormalities and infertility.Objectives: This study was done to determine the risk factors, and management outcome of intrauterine adhesions in our hospital. Subjects and Methods: We carried out a retrospective study of the patients who were treated for intrauterine adhesions at the University of Uyo   Teaching Hospital over a 10 years period‑from January 1st 2006 to   December 2016. Results: During the study period, a total of 1977 gynecological surgeries were performed of which 83 were for intrauterine adhesions, giving a rate of 4.2%. However, only 52 folders were retrieved, giving a retrieval rate of 62.5%. Analyses, using ratios and percentages, was based on these. Most patients belonged to the 30‑34 age group (28.9%) followed by the 20‑24 age group (25.0%). The majority of the patients were nulliparous (58.9%), married (65.4%) and had a tertiary education (50.0%). Dilatation and curettage for induced abortion (42.3%), open myomectomy (26.9%), and caesarean section (19.2%) were the common risk factors. Amenorrhoea (65.4%), and hypomenorrhoea (30.8%) were the commonest modes of presentation. All the patients were managed by blind adhesiolysis, done overwhelmingly by the resident doctors, under anaesthesia with a significant percentage (65.3%) showing that there is no change in menstrual condition. Conclusion: Ashermans syndrome is a relatively common condition, and it is necessary to train doctors in the use of, and acquire, a hysteroscope, for the proper management of this condition. Meanwhile, more senior  personnel should be involved in the blind adhesiolysis, and Foley catheter that appears superior as a uterine splint to the intrauterine contraceptive device.Key words: Adhesiolysis, intrauterine adhesions; Uyo

Awareness and Practice of Contraception among Female Secondary School Students in Uyo, Nigeria

Adolescent sexual activity is very prevalent in many countries. Unprotected premature sexual intercourse results in a high incidence of induced abortion, unwanted pregnancy and sexually transmitted infections. Objective: The aim of this study was to determine the degree of awareness of contraception and its practice among female secondary school students in Itu, Akwa-Ibom State, Nigeria. Method: A descriptive cross sectional study design was used to recruit 378 consenting female students selected by simple random sampling. Semi-structured, self-administered questionnaires were administered after explanation of the study and assurance of confidentiality. Three hundred and twelve forms were properly filled and analysis was done manually on these using simple proportions and percentages. Results: Majority of the respondents were Ibibio 220 (70.5%) and between 13 and 17 yrs old (89.6%). Two hundred and thirty six (75.6%) were aware of contraception. Twenty nine (16.0%) of those who were sexually active had ever practice any form of contraception. The three common forms of contraception known were the male condom (36.0%), the calendar method (34.0%) and the oral contraceptive pills (25%). The foremost sources of information about contraception were from TV/radio (36.0%), parents (25.0%) and female friends (14.8%). Of those who were sexually active 116(64.8%) had sexual debut at 11-15years of age. Conclusion: This study demonstrated that the level of awareness of contraception was high but the practice of contraception was comparatively low. It also demonstrated that the age at sexual debut was early and the rate of sexual intercourse high. This emphasizes the need for provision of timely and accurate contraceptive information through sex education in secondary schools in our environment. Key words: Contraception, Awareness, Practice, Sexual debu

The prevalence of syphilis in pregnant women in Akwa Ibom State, Southern Nigeria

Background: Treponema pallidum, the causative organism of syphilis has been a public health challenge for centuries. Syphilis is a significant cause of morbidities and mortalities in pregnant women, and information regarding its prevalence in Nigerian pregnant women is scanty particularly from the south‑south zone. Objective: To determine the prevalence of syphilis in women receiving antenatal care in twelve health care centres in Akwa Ibom State, Nigeria. Methodology: Pre‑coded structured questionnaires were administered to 911 participants over an eight week period. Venous blood samples were collected from each participant and tested with a Treponema pallidum immunochromatographic test. Results: There were about 18 women (1.98%) tested positive to syphilis. Prevalence rates in urban and rural areas were 2.63% and 1.32% respectively. The women from urban areas had a 3.22 (95% CI 1.05‑9.85) increased risk of acquiring syphilis when compared to the rural dwellers. Women with tertiary level of education had a significantly reduced risk of acquiring syphilis compared to those with primary level education while having an unemployed husband increased the risk of acquiring the infection by 10 times. Conclusion: Though VDRL is part of routine antenatal care screening, a policy of its use in the screening of all women receiving antenatal care in Akwa Ibom state should emphasized and it should be incorporated into the state Government’s free antenatal care program. Preferably, a single rapid test should be employed for screening, so that women testing positive could be treated at same clinic visit. Economic empowerment of women should be accorded priority and the practice of safe sex and use of contraception, especially barrier methods should be promoted

A molecular and parasitological survey of Hepatozoon canis in domestic dogs in Turkey

In this study, asymptomatic dogs in nine provinces of Turkey were surveyed to investigate the prevalence and intensity of Hepatozoon canis infection. DNA obtained from blood samples collected from 694 domestic dogs (243 stray, 288 shelter, and 163 pets) of both genders and varying ages were evaluated by polymerase chain reaction (PCR). In addition, 285 thin blood smears prepared from these blood samples were also evaluated for microscopic examination. Direct microscopy revealed Hepatozoon gamonts in the peripheral blood of three of 285 (1.0%; 95% confidence interval (CI): 0.21–3.04) tested. Using PCR, 155 of the 694 (22.3%; 95% CI: 19.28–25.61) were found to be positive for the presence of H. canis DNA. The prevalence of infection was higher in adult dogs (26.2%; 95% CI: 22.1–30.7) than young animals (16.4%; 95% CI: 12.2–21.3). Although the prevalence determined by PCR was higher in male dogs (24.5%; 95% CI: 19.6–29.9) than in female dogs (20.8%; 95% CI: 16.9–25.1), gender differences were not significant. Pet dogs had a lower prevalence of infection (10.4%; 95% CI: 6.2–16.2) compared to stray (26.3%; 95% CI: 20.9–32.3) and shelter dogs (25.7%; 95% CI: 20.7–31.1), but no significant association between stray and shelter dogs was found for the presence of the parasite. Partial sequences of the 18S ribosomal RNA (rRNA) gene shared 99–100% similarity with the corresponding H. canis isolates. This epidemiological survey revealed a high prevalence of H. canis in dogs from several provinces in Turkey, and it suggests that the age and origin are associated with the parasite

Molecular detection of tick-borne rickettsial and protozoan pathogens in domestic dogs from Turkey

Background: Canine tick-borne parasites have emerged in recent years, showing a wider geographic distribution and increased global prevalence. In addition to their veterinary importance, domestic dogs play an important role in the transmission cycles of some agents by acting as reservoirs and sentinels. This study investigated Babesia, Theileria, Anaplasma, and Ehrlichia species in asymptomatic dogs in ten provinces of Turkey. Methods: DNA obtained from blood samples collected from 757 domestic dogs (243 stray, 351 shelter, 163 pet) of both sexes and various ages were evaluated using PCR and reverse line blotting (RLB) assays. Results: Of the 757 dogs tested, 41 (5.4%) were found to be infected with one or more parasites. Ehrlichia canis (37/757, 4.9%) was the most common canine tick-borne pathogen, followed by Anaplasma platys (4/757, 0.5%). Babesia canis and Theileria annulata were each detected in 1 (0.13%) sample. Combined infection of E. canis and A. platys was detected in 2 (0.3%) samples. The prevalence of tick-borne pathogens was higher in adult dogs (6.8%) than in those under one year old (3.1%). Difference in infection rate of male and female dogs was not significant. Pet dogs had a lower prevalence of infection (1.2%) compared to stray (7.4%) and shelter dogs (6%) although the difference between stray and shelter dogs was not significant. Conclusions: Babesia canis, T. annulata, A. platys, and E. canis species were identified at the molecular level in dogs in several provinces of Turkey, with E. canis being the most common species among tick-borne pathogens. Detailed studies should be conducted regarding the existence and prevalence of B. canis and Dermacentor reticulatus in eastern Turkey

Intrauterine adhesions in the University of Uyo Teaching Hospital, Uyo, South-South, Nigeria: A ten year review

Background: Asherman's syndrome is a clinical entity that can cause menstrual abnormalities and infertility. Objectives: This study was done to determine the risk factors, and management outcome of intrauterine adhesions in our hospital. Subjects and Methods: We carried out a retrospective study of the patients who were treated for intrauterine adhesions at the University of Uyo Teaching Hospital over a 10 years period-from January 1st 2006 to December 2016. Results: During the study period, a total of 1977 gynecological surgeries were performed of which 83 were for intrauterine adhesions, giving a rate of 4.2%. However, only 52 folders were retrieved, giving a retrieval rate of 62.5%. Analyses, using ratios and percentages, was based on these. Most patients belonged to the 30-34 age group (28.9%) followed by the 20-24 age group (25.0%). The majority of the patients were nulliparous (58.9%), married (65.4%) and had a tertiary education (50.0%). Dilatation and curettage for induced abortion (42.3%), open myomectomy (26.9%), and caesarean section (19.2%) were the common risk factors. Amenorrhoea (65.4%), and hypomenorrhoea (30.8%) were the commonest modes of presentation. All the patients were managed by blind adhesiolysis, done overwhelmingly by the resident doctors, under anaesthesia with a significant percentage (65.3%) showing that there is no change in menstrual condition. Conclusion: Ashermans syndrome is a relatively common condition, and it is necessary to train doctors in the use of, and acquire, a hysteroscope, for the proper management of this condition. Meanwhile, more senior personnel should be involved in the blind adhesiolysis, and Foley catheter that appears superior as a uterine splint to the intrauterine contraceptive device

Growth and Yield of Soybean (Glycine max (L.) Merr.) as Influenced by Combined Application of Cowdung and NPK Fertilizer in Ogoja, Southeastern Nigeria

Field experiment was conducted in 1990 and 1991 sowing seasons at the University of Cross River State Teaching and Research Farm, Ogoja campus, Nigeria to evaluate the productivity of soybean under diverse soil fertility levels. The findings suggest that combined use of Cowdung and NPK appears a better option

Combined Oral Contraceptive Pills: Profile of Acceptors in a Tertiary Hospital in South-South Nigeria

Background: Combined oral contraceptive pills were the first contraceptive method to provide sexual freedom of choice for women through reliable, personal and private control of fertility. They are the most widely used hormonal contraceptives and also the most popular non-surgical method of contraception. Objective: To review the profile of acceptors of combined oral contraceptive pills at the University of Uyo Teaching Hospital, Uyo. Methodology: An 8 year review of all clients that accepted combined oral contraceptive pills in the family planning clinic. Results: There were 1,146 new contraceptive acceptors during the period of study out of which 309 (27.9%) accepted the pills. Majority of the clients were between 20 and 29 years of age (54.0%), were multiparous (72.8%), Christians (99.7%) and 61.2% had tertiary level education. Two hundred and fifty-five women (82.5%) desired to use combined oral contraceptive pills to space births while 7.8% wanted to limit child bearing. There was a high discontinuation rate among the women (45.0%) and out of these 87.9% of the clients changed to other contraceptive methods. All the clients commenced their pills within seven days of menstruation and only the low dose monophasic preparations were available in the family planning unit and thus were given to the clients. Conclusion: Women who accept to initiate combined oral contraceptive pills in our center are young, well educated, multiparous women who want to space their pregnancies. However, due to the high discontinuation rate among the clients, there is need for further studies evaluating reasons for the high discontinuation rate, exploring interactions between clients and providers′ and also providers′ attitude towards combined pills in our environment