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.     

Assessment of the compliance of Nigerian dentists with infection control: a preliminary study.

OBJECTIVE: To assess the compliance of a group of Nigerian dentists with standard infection control practices. METHOD: A confidential self-administered questionnaire survey was conducted among dentists engaged in active clinical practices in public hospitals in Lagos, Nigeria (n = 185). RESULTS: One hundred forty-six questionnaires were returned (response rate, 78.9%). Most (70.6%) of the dentists always wore gloves when treating patients, whereas 29.4% sometimes did. Regarding facemasks, 45.9% always wore them, 52.7% sometimes wore them, and 1.4% never wore them. Protective eye wear was always worn by 4.8% of the dentists, sometimes worn by 52.7%, and never worn by 42.5%. Approximately half (50.7%) of the respondents had received hepatitis B vaccination. Sterilization was performed using a combination of methods, including autoclaving (84.1%), boiling (19.3%), dry heat (17.5%), and chemicals (29.7%). Nonavailability of materials was the major reason for noncompliance with infection control practices. CONCLUSIONS: Nigerian dentists need continuous education regarding infection control. Also, Nigerian hospitals urgently need adequate funding for up-to-date and functional equipment and materials.     

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.     

Role of CaMKII in the regulation of fatty acids and lipid metabolism

Background & aimsPrevious studies have reported the beneficial roles of the activation of calmodulin-dependent protein kinase (CaMK)II to many cellular functions associated with human health. This review aims at discussing its activation by exercise as well as its roles in the regulation of unsaturated, saturated, omega 3 fatty acids, and lipid metabolism.MethodsA wide literature search was conducted using online database such as ‘PubMed’, ‘Google Scholar’, ‘Researcher’, ‘Scopus’ and the website of World Health Organization (WHO) as well as Control Disease and Prevention (CDC). The criteria for the search were mainly lipid and fatty acid metabolism, diabetes, and metabolic syndrome (MetS). A total of ninety-seven articles were included in the review.ResultsCalmodulin-dependent protein kinase activation by exercise is helpful in controlling membrane lipids related with type 2 diabetes and obesity. CaMKII regulates many health beneficial cellular functions in individuals who exercise compared with those who do not exercise. Regulation of lipid metabolism and fatty acids are crucial in the improvement of metabolic syndrome.ConclusionsApproaches that involve CaMKII could be a new avenue for designing novel and effective therapeutic modalities in the treatment or better management of metabolic diseases such as type 2 diabetes and obesity.     

Misoprostol for induction of labour: a survey of attitude and practice in southwestern Nigeria

BACKGROUND: Although supported by research evidence, misoprostol for induction of labour remains contentious. OBJECTIVE: To assess perception and practice of obstetricians regarding use of misoprostol for labour induction. METHODOLOGY: Cross-sectional questionnaire-based survey of Senior Registrars and Consultant Obstetricians in southwestern Nigeria. RESULTS: One hundred and six questionnaires were completed (52.8% Consultants; 47.2% Senior Registrars). Most respondents (96, 90.6%) employ misoprostol for induction in both live and dead fetuses with majority having personally prescribed misoprostol for cervical ripening or induction of labour (97.2 and 79.3%, respectively). Fetal tachycardia, hyperstimulation and ruptured uterus were the commonly reported complications. Twenty-six respondents (24.5%) reported being aware of maternal death in relation to misoprostol use. Only 52.9% of the respondents have protocols guiding misoprostol use in their hospitals. More than half of respondents administer misoprostol 50 mug or higher 6 hourly. Most (92, 87.6%) believe that research evidence backs use of misoprostol for the indication; 89.5% of respondents support use of misoprostol. Most respondents (90, 86.5%) disagree with the notion that misoprostol is too dangerous for induction; only 26 respondents (25.1%) considered oxytocin a better choice for induction; 93 respondents (88.6%) agreed that, given cautious use, misoprostol is safe for induction, while 86 respondents (81.9%) considered misoprostol a cost-effective intervention for labour induction in developing countries. Though senior registrars and younger consultants tended to report side effects more frequently than older consultants, they were more likely to support misoprostol for induction of labour than older consultants. This differences were however not statistically significant (P > 0.05). CONCLUSION: Misoprostol is widely utilized by obstetricians for induction of labour in southwestern Nigeria. Fetal and maternal side effects are commonly experienced. We recommend urgent adoption of evidence-based guidelines in every unit using the drug to prevent complications.     

Experience with unoperated cleft lip and palate patients in a Nigerian teaching hospital

A review of 31 cases of unoperated cleft lip and palate patients aged 10 years and above managed over a 6 years period at a suburban Nigeria teaching hospital is presented. There was an overall preponderance of the female gender and isolated cleft lip (58%) was the most predominant. Although clefts were very wide on presentation, there was adequate well-developed soft tissue in adults to achieve a cosmetically and functionally acceptable repair. This study also confirms the views that late primary repair of facial cleft is less likely to produce impaired growth of the maxillaas is commonly observed in early repair. However, the advantages of early repair cannot be over-emphasized.     

Assisted reproductive technologies in Africa: first results from the African Network and Registry for Assisted Reproductive Technology, 2013

Research question

What were utilization, outcomes and practices in assisted reproductive technology (ART) in Africa in 2013?