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2015| July-December | Volume 13 | Issue 2
Online since
November 21, 2015
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ORIGINAL ARTICLES
Polycystic ovarian syndrome: Analysis of management outcomes among infertile women at a public health institution in nigeria
LO Omokanye, OA Ibiwoye-Jaiyeola, A. W. O. Olatinwo, IF Abdul, KA Durowade, SA Biliaminu
July-December 2015, 13(2):44-48
DOI
:10.4103/1118-4647.170152
Background:
Infertility remains an issue of concern especially to the female partner who bears the brunt of the stigma attributed to the disease in this environment. Among the identified etiological factors for infertility, polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age that impact on ovulation and conception.
Aims and Objectives:
The objective of this study was to determine pregnancy outcome following the various modalities of management of PCOS at the University of Ilorin Teaching Hospital (UITH).
Materials and Methods:
This is a nonrandomized (nonblinded) clinical trial of five therapeutic options for infertile women with PCOS from the Assisted Reproductive Technology (ART) Clinic and Gynaecology Clinic of UITH between January 1, 2011 and December 31, 2013.
Results:
Of 624 infertile women who presented at ART and general gynecology clinic of UITH, 76 met the Rotterdam criteria for PCOS, giving a prevalence rate of 12.2%. The patients aged 20–44 years with a mean age of 31.5 years. Most 49 (64.5%) of the patients were nulliparous, and more than half (56.6%) belong to the middle social class. Thirty-four (44.8%) were obese while 22 (28.9%) were overweight. Of the various management options, 48.7% had laparoscopic ovarian drilling; other treatment options offered were the use of clomiphene citrate (CC) alone, CC with metformin, weight reduction, and gonadotropin. Patients were followed-up within 6–12 months (mean 5.5 ± 1.2 months) following the initial treatment for evidence of laboratory/clinical pregnancy. An overall pregnancy rate of 46.0% was recorded. However, a total of 13 (17.1%) were lost to follow-up. The highest pregnancy rate (75%) was reported in women managed with CC alone (
P
= 0.229).
Conclusion:
PCOS occurs commonly in reproductive age and management outcomes are promising in Nigeria. CC, metformin, and laparoscopic ovarian drilling are of great benefit. Further studies on PCOS in low resource countries are needed.
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Prevalence and risk factors of bacterial vaginosis in a cohort of women seeking child spacing services in nigeria
Nyengidiki Kennedy Tamunomie, Goddy Bassey
July-December 2015, 13(2):35-39
DOI
:10.4103/1118-4647.170150
Background:
The sustenance of reproductive potential of patients seeking contraceptive options is essential. The risk of bacterial vaginosis is increased by the choice of contraceptive options, which may affect postcontraception fertility.
Objective:
To determine the prevalence and risk factors of bacterial vaginosis in a cohort of women seeking child spacing services.
Materials and Methods:
A cross-sectional prospective study of women seeking fertility regulation services was conducted in a tertiary health facility in Nigeria between March and September 2014. Interviews were conducted to collect data on sociodemographic characteristics, characteristics of vaginal discharge, and sexual practices engaged by these women. Bacterial vaginosis was diagnosed using the Amsel criteria. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated to assess the predisposing factors.
Results:
One-hundred seventy-eight clients were recruited. Bacterial vaginosis was noted in 7.87% of these women. Patients had increased risk of bacterial vaginosis when they were of low socioeconomic class (OR 8.17; 95% CI 2.30–29.81), used vaginal drying agents (OR 9.70; 95% CI 2.35–46.15), had an early sexual debut (OR 9.56; 95% CI 2 54–38.92), a history of previous sexually transmitted infections (OR 21.39; 95% CI 4.99–105.30), and practiced vaginal douching (OR 19.23; 95% CI 3.82–130.43).
Conclusion:
The prevalence of bacterial vaginosis in this cohort raises the need for a high index of clinical suspicion in patients seeking fertility regulation services in the presence of notable risk factors. Avoidance of contraceptive methods that may increase the risk of bacterial vaginosis and the need for treatment to maintain reproductive potentials is advised.
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An evaluation of the characteristics of patients with gestational choriocarcinoma in south-south, nigeria
TK Nyengidiki, G Bassey
July-December 2015, 13(2):40-43
DOI
:10.4103/1118-4647.170149
Background:
Gestational trophoblastic diseases have been generally associated with the good outcome, especially in developed countries where early presentation and diagnosis is the norm.
Objective:
This study seeks to determine the characteristics of patients with gestational choriocarcinoma at the University of Port Harcourt Teaching Hospital(UPTH), Nigeria.
Methods:
This was a retrospective study of women who were treated for gestational choriocarcinoma at the UPTH over a 5-year period from January 1, 2008 to December 31, 2012.
Results:
Atotal of 13 cases of gestational choriocarcinoma were treated in UPTH during the study period, and there were 16,720 deliveries giving a prevalence of 0.8/1000 deliveries. The majority of patients (76.9%) were of low socioeconomic class. 92.3% of patients presented with amenorrhea for 28 weeks. Histological examination of tissues extracted from previous miscarriages was not performed in 100% of patients. Eighty percent of all mortalities were associated with antecedent pregnancies being miscarriages. All patients managed were lost to follow-up within 32 weeks.
Conclusion:
Gestational choriocarcinoma in Port Harcourt is associated with high mortality. Most patients with choriocarcinoma were of low socioeconomic class, presented late with lack of histological examination of previously extracted products of conception. Most of the patients were lost to follow-up within 32 weeks.
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CASE REPORT
That grossly enlarged abdomen is an unusual huge mesenteric cyst after all: case report and literature review
Thaddeus Chika Agu, Mary S Chukwu, Mary Philomena Ikeanusi
July-December 2015, 13(2):49-51
DOI
:10.4103/1118-4647.170151
We report a case of a married lady living with her husband for 8 years, who in the past 5 years developed an enlarging abdomen, which neighbors and in-laws thought was pregnancy but later turned out to be a huge mesenteric cyst. Arriving at a diagnosis by clinical methods and available tools with certainty failed and the inability to afford the state of the art diagnostic tools caused the surgeon to revert to exploratory laparotomy.
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Online since 20
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March, 2015