Digital gangrene following primary postpartum haemorrhage

Digital gangrene is an uncommon complication following primary post partum heamorrhage. We report in this case, digital gangrene occurring in a 39 years old woman with history of long standing hypertension. The possible predisposing factor was arterial injury which could have resulted from the hypertension or the hypotension that followed the severe postpartum haemorrhage. The patient experienced progressive pain and swelling of the left hand, which eventually became gangrenous. Colour doppler was confirmatory. Early and appropriate interventions are encouraged in patients with similar presentation

Outcomes of triplet pregnancies in Sagamu, Nigeria

No Abstract. Nigerian Medical Practitioner Vol. 47(5) 2005: 99-10

Experience With The Laparoscope In The Evaluation Of Infertile Women In Sagamu

Objective: Laparoscopy has been found to be very useful in the evaluation of tubo-peritoneal factors in female infertility in Nigeria. This is because of the peculiarity of infective tubo-peritoneal disease as the main aetiological factor of infertility in the region. This study was carried out to report our experience with the laparoscope with aim of focusing attention on its desirability and what problems there may be with the use. Materials and methods: The laparoscopic findings in 215 infertile women over a period of seven years (1993-1999) at the infertility unit of the Ogun State University Teaching Hospital Sagamu were collated. Results: Eighty-two percent of the women had secondary infertility as against 18% with primary infertility. Pelvic adhesions were detected in 74.9% of the cases and patent tube(s) were found in 68.4%. Uterine fibroid was the commonest additional finding. Mild abdominal pain and subcutaneous emphysema were recorded in three (1.4%) and this necessitated admission for 24 hours in one patient with emphysema. Conclusion: Laparoscopy is a diagnostic method with a high positive yield and few complications. Its wider use as first line investigative tool in infertility evaluation is advocated. Nigerian Journal of Clinical Practice Vol.5(2) 2002: 127-12

Abdominal pregnancy: A cause of failed induction of labour

No Abstract. Nigerian Journal of Medicine Vol. 14(2) 2005: 213-21

Infant Feeding and Lactational Amenorrhea in Sagamu, Nigeria

Five hundred and twenty educated, breastfeeding women in Sagamu, Nigeria, were observed prospectively in order to describe their infant feeding practices and to determine whether any predictors of the return of menses could be identified. The women remained amenorrheic for seven months. Compared with similarly selected women in other countries, they regularly fed their infants with supplements from a very early age, yet breastfeeding frequency and duration did not decline dramatically. Semi-solid food was introduced at about four months and such supplementation, as well as earlier supplementation with milk/milk-based feedings, was associated with the return of menses. The median duration of abstinence was about four months but the mean may have been much longer. No woman became pregnant until her infant was weaned. (Afr J Reprod Health 2002; 6[2]: 3950) Résumé Lallaitement et laménorrhée qui se rapporte à la lactation à Sagamu, au Nigéria. Cinq cent vingt femmes instruites et allaitant à Sagamu ont été observées prospectivement afin de décrire leurs pratiques dallaitement et pour déterminer sil était possible didentifier quelques indices du retour des règles. Les femmes sont restées aménorrhéiques pendant sept mois. Comparées aux femmes qui ont été selectionnées de la même manière dans dautres pays, elles nourrissaient régulierement leurs enfants du supplément dès leur très jeune âge; pourtant la fréquence de lallaitement et la durée nont pas baissé de façon dramatique. A lâge de presque quatre mois, on a initié les enfants à la nourriture semi-solides. Une telle administration dun supplément aussi bien quune administration antérieure dun supplément du lait et dautres nourritures à base du lait, ont été associées au retour des règles. La durée médiane de labstinence était à peu près quatre mois, mais la moyenne a probablement duré plus longtemps. Aucune femme nest devenue enceinte quaprès avoir sevré lenfant. (Rev Afr Santé Reprod 2002; 6[2]: 3950) Key Words: Breastfeeding, fertility, Nigeria, infant feeding, amenorrhea, Afric

Postpartum Sexual Abstinence and Breastfeeding Pattern in Sagamu, Nigeria

This was a prospective study involving 371 mothers. The mean age of the mothers was 27.5 (.3.6) years with a mean years at school (Educational years) of 11.3 (2.9) years. All the mothers had previously breastfed at one of their infants for at least 6 months, while the mothers also breastfed their last child for an average (mean) of 10.3 (4.0) months. The overall mean of previous live births was 1.9 (0.8). In the first month postpartum, 84.6% of the mothers abstained from sexual intercourse, but by the 4th-5th month the proportion had dropped to 18.1%, with just 2.1% of the study population abstaining from sexual intercourse at 11-15 months post-partum. Forty seven (13.5%), 30 (8.6% ) and 3 (0.9 % ) mothers in social classes 2,3 and 1 respectively have resumed sexual intercourse at 4-5 months, while only 12(3.4%) and 4(1.1%) in social classes 2 and 3 respectively continued with sexual intercourse at 11-15 months. More mothers resumed sexual intercourse from 1 to 15 months post-partum when they breast fed for 6-10 minutes and 11-15 minutes than those who breast fed for 1-5 minutes, 16-20 minutes and 21-25 minutes. Also more mothers within the 25-29 years age group resumed sexual intercourse from the first month to the fifteenth month post-partum than mothers in the other age groupsKeywords: Postpartum, Sexual, Abstinence, Breastfeeding, Sexually Transmitted InfectionsAfrican Journal of Reproductive Health Vol. 12 (1) 2008: pp. 96-10

Male sexual dysfunction and HIV--a clinical perspective.

Sexual dysfunction in men with HIV is often overlooked by clinicians owing to many factors, including the taboo of sexuality. The improved life expectancy of patients with HIV requires physicians to consider their general wellbeing and sexual health with a renewed interest. However, data on sexual dysfunction in those with HIV are scarce. Erectile dysfunction (ED) is the most common sexual dysfunction in men, with a prevalence of ∼30-50% and is frequent even in men <40 years of age. HIV infection itself is the strongest predictor of ED, and many factors related to the infection-fear of virus transmission, changes in body image, HIV-related comorbidities, infection stigma, obligatory condom use-all impair erectile function. The diagnosis and treatment of sexual dysfunction is based on a multidisciplinary approach, which involves specialists in both infectious diseases and sexual medicine. Particular attention should be paid to the promotion of safer sex in these patients. This Review, describes the issues surrounding sexual dysfunction in men with HIV and aims to provide clinical advice for the physician treating these patients