Microbial isolates and HIV infection in couples attending fertility clinics in Sagamu, Nigeria.

This observational study was designed to determine the prevalence of HIV infection and the microbial isolates from the genital tracts of couples attending the fertility clinics of Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria between January 2001 and December 2002. A total of 110 women and 49 of their male partners were recruited into the study. The majority of the patients were between 25 and 34 years (women: 71.8%; partners: 65.3%), though the men were significantly older than the women (p < 0.001). The overall prevalence of HIV infection in those who consented to screening was 8.2%, which was over twice the reported prevalence among the general population in Ogun State, Nigeria during the study period. Candida albicans (32.5%) and Staphylococcus aureus (27.5%) were the most frequently isolated microorganisms from the endocervix while Trichomonas vaginalis (37.9%) and Staphylococcus aureus (24.1%) were the most common microbes isolated from the posterior vaginal fornix. Of all the seminal qualities, only the volume showed a significant difference between the infected and non-infected samples (p < 0.004). This study suggests a higher prevalence of HIV infection among the infertile couples in our environment and it may be advisable to have them screened for HIV in the face of the present HIV situation in sub-Saharan Africa.     

The rise in caesarean birth rate in Sagamu, Nigeria: reflection of changes in obstetric practice.

A retrospective and comparative study of women delivered by caesarean section over two different 3-year periods was conducted at Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. The caesarean section rate (CSR) increased from 10.3% in 1989-1991 to 23.1% in 2000-2003. The most frequent indication in both periods was different: prolonged/obstructed labour (20.0%) in 1989-1991 and antepartum haemorrhage (14.9%) in 2000-2003. Malpresentation, antepartum haemorrhage and pre-eclampsia/eclampsia were responsible for 51.7% of the difference in the CSR recorded between both periods. The CSR rose from 13.3% to 25.0% while the instrumental vaginal delivery (IVD) rate decreased significantly by 11.4% among the nulliparous women between the periods. Increase in CSR can be attributed mainly to reduction in IVD rate and alteration in the management of labour complications and induction policy. Strategies to reduce the CSR should cut across all indications and focus on encouraging instrumental vaginal deliveries, especially among nulliparous women.     

Insecticide poisoning in pregnancy. A case report.

A 25-year-old multigravida drank an organochlorine insecticide in an attempt to commit suicide at 16 weeks of pregnancy. This resulted in the death of twin fetuses and vaginal bleeding. The pregnancy was terminated using gemeprost, syntocinon and later surgical evacuation of the uterus. She developed respiratory arrest after the fetuses were aborted and also after surgical evacuation. On both occasions, she was intubated and mechanically ventilated. We believe that organochlorine insecticides may be fetocidal. In addition, surges in blood levels may occur during termination of pregnancy, delivery or evacuation of retained products of conception.     

Oral contraceptive marketing in Ibadan, Nigeria.

The demographic transition in Nigeria is gradually moving towards the second stage. There is clear evidence of a declining mortality but the fertility rate remains exceptionally high. A realistic approach towards reducing fertility rate is the use of oral contraceptive. This study assesses the distribution system of oral contraceptive in Ibadan, the second largest city in Nigeria. The findings revealed that the people are aware of modern oral contraceptives as they purchase them freely at chemist shops. But effective distribution is hampered by existing channels and high costs. A local source recommended is the proprietary medicine stores, often at convenient locations to the potential users of contraceptives. The current cost which is between $1.3 and $19.5 per couple-years of protection is exorbitant, consuming 0.5-7.8% of the gross annual income of the average individual. Therefore, the government should subsidize the prices of oral contraceptives, to facilitate freedom from the tyranny of excessive fertility.     

Ameloblastoma: analysis of 207 cases in a Nigerian teaching hospital.

OBJECTIVE: The aim of the study was to review all the cases of ameloblastoma seen at the Oral and Maxillofacial Surgery Clinic of the Lagos University Teaching Hospital, Nigeria, between 1980 and 2003. METHODS AND MATERIALS: In this retrospective study, case files and biopsy reports of new cases of ameloblastoma covering a 24-year period were retrieved and analyzed for sex, age on presentation, histologic type, and site distribution. RESULTS: A total of 207 cases of ameloblastoma were seen in the given period. One hundred and ninety-eight (95.7%) were benign, and 9 (4.3%) were malignant. A male-to-female ratio of 1.1:1 was found. The average ages on presentation for ameloblastoma and ameloblastic carcinoma were 31.67 and 46.44 years, respectively. The lesion was found to be more common in the premolar-molar region of the mandible. The most common histologic type was follicular ameloblastoma (25.1%). Nine (4.3%) cases of ameloblastic carcinoma were also reported. CONCLUSIONS: Ameloblastoma with a predilection for the posterior mandibular region is relatively common in our environment. Sex and site distributions are similar to previous reports in the literature.     

Health and economic consequences of septic induced abortion.

Over a period of 7 years, 230 cases of illegally induced abortions complicated by sepsis were treated at the University College Hospital, Ibadan, Nigeria. The number of terminations complicated by sepsis doubled from 25.4 (between 1981 and 1985) to 51.0 (between 1986 and 1987) cases per year. Peritonitis was the commonest associated complication while maternal mortality was 8.3%. The average cost of treatment was US$223.11, while the average monthly earnings was US$45.00. Legalization of abortion would have resulted in a saving of US$50,022.28. Provision of legal abortion would reduce the incidence of sepsis after termination while reproductive health education and information dissemination and provision of easily accessible family planning services would greatly reduce the number of unwanted pregnancies.     

Characterization of Aeromonas spp. isolated from humans with diarrhea, from healthy controls, and from surface water in Bangladesh.

Aeromonas isolates from patients with diarrhea in Bangladesh (n = 69), from healthy controls (n = 11), and from surface water (n = 40) were analyzed with respect to their hybridization groups (HGs) by the aid of fatty acid methyl ester (FAME) characterization and DNA fingerprinting by AFLP, biochemical phenotypes (Phe-nePlate [PhP] types), and the production of hemolysin and cytotoxin. The aim of the investigation was to find out whether certain strains carrying virulence factors predominated among patient isolates. According to FAME and/or AFLP analysis, most human isolates were allocated to DNA HGs 4 (Aeromonas caviae) and 1 (A. hydrophila). Most environmental strains were allocated to HG8 (A. veronii biogroup sobria) and HG4 (A. caviae), and only one was of HG1. According to PhP typing, the diversity among patient isolates was lower than that among other strains, and two dominating PhP types (types BD-1 and BD-2) were identified in 29 and 30% of the patient isolates, respectively. PhP type BD-1 was also common among the environmental isolates, whereas PhP type BD-2 was only identified in two of the other isolates. Twenty-five of 26 isolates belonging to HG1 were of the same PhP type (BD-2), whereas isolates of other common HGs were more diverse according to their PhP types. Hemolytic and cytotoxin-producing strains occurred more frequently among the environmental isolates than among patient isolates. However, the hemolytic and cytotoxic activities among human isolates was strongly correlated to the HG1/BD-2 type, which, in addition, showed high cytotoxin titers (median values, 1/512 compared to 1/128 for cytotoxin-positive isolates belonging to other types). Thus, the HG1/BD-2 type may represent a pathogenic A. hydrophila type that is able to produce diarrhea in humans.     

Components of the Gut Microbiome That Influence Bone Tissue-Level Strength

Modifications to the constituents of the gut microbiome influence bone density and tissue-level strength, but the specific microbial components that influence tissue-level strength in bone are not known. Here, we selectively modify constituents of the gut microbiota using narrow-spectrum antibiotics to identify components of the microbiome associated with changes in bone mechanical and material properties. Male C57BL/6J mice (4 weeks) were divided into seven groups (n = 7–10/group) and had taxa within the gut microbiome removed through dosing with: (i) ampicillin; (ii) neomycin; (iii) vancomycin; (iv) metronidazole; (v) a cocktail of all four antibiotics together (with zero-calorie sweetener to ensure intake); (vi) zero-calorie sweetener only; or (vii) no additive (untreated) for 12 weeks. Individual antibiotics remove only some taxa from the gut, while the cocktail of all four removes almost all microbes. After accounting for differences in geometry, whole bone strength was reduced in animals with gut microbiome modified by neomycin (−28%, p = 0.002) and was increased in the group in which the gut microbiome was altered by sweetener alone (+39%, p < 0.001). Analysis of the fecal microbiota detected seven lower-ranked taxa differentially abundant in animals with impaired tissue-level strength and 14 differentially abundant taxa associated with increased tissue-level strength. Histological and serum markers of bone turnover and trabecular bone volume per tissue volume (BV/TV) did not differ among groups. These findings demonstrate that modifications to the taxonomic components of the gut microbiome have the potential to decrease or increase tissue-level strength of bone independent of bone quantity and without noticeable changes in bone turnover. © 2021 American Society for Bone and Mineral Research (ASBMR).     

Elective abdominal hysterectomy in Nigerian Jehovah's Witnesses.

In a retrospective study at a university hospital, the perioperative morbidity associated with elective total abdominal hysterectomy in 23 Jehovah's Witnesses was compared with that of 46 non-Witness controls. The mean operative blood loss was significantly less, the procedure was lengthier and the average postoperative hospital stay was longer in the study than in the control group. Febrile morbidity was insignificantly more frequent among the study group (OR: 2.05, CI: 0.61-6.88) and there was no significant difference between the overall morbidity experienced by patients in both groups (study: 43.5% versus control: 39.1%; P = 0.73). The perioperative morbidity associated with elective abdominal hysterectomy in patients unwilling to accept blood transfusion does not justify the denial of this important gynaecological surgery when indicated. Gynaecologists in poor resource settings should consciously aim at providing 'bloodless' care for all their patients undergoing abdominal hysterectomy as this may translate to reduced blood loss and decreased need for blood transfusion.