Pub Date : 2017-01-01DOI: 10.4103/archms.archms_32_17
Musa M Yusuf, E. Nwasor, R. Mohammed
Aim and Objectives: We sought to compare the hemodynamic effects of 5 international unit (IU) and 10 IU of intravenous (IV) boluses of oxytocin and their efficacy in reducing blood loss during cesarean section and also to determine the incidence of postoperative nausea and vomiting (PONV) and postdural puncture headache (PDPH). Patients and Methods: One hundred and ten parturients of American Society of Anesthesiologists' I and II scheduled for cesarean section under spinal anesthesia were randomized into two groups. Group A (n = 55) received 5 IU IV bolus of oxytocin and Group B (n = 55) received 10 IU IV bolus of oxytocin after delivery. Ten milliliters per kilogram of 0.9% saline was administered to both groups as volume preload. Subarachnoid block was performed with size 24G spinal needles at L2/L3 or L3/L4 intervertebral space with the patients in sitting position. Two milliliters of 0.5% heavy bupivacaine was administered slowly intrathecally. Following delivery of the baby, IV boluses of 5 IU (Group A) or 10 IU (Group B) of oxytocin were administered slowly, and recording of heart rate, systolic, diastolic, and mean arterial blood pressure was done every minute for 5 min after bolus injection. IV infusion of 30 IU of oxytocin in 500 ml of 0.9% saline (60 mU/ml) at a rate of 125 ml/h was continued in both groups till the end of surgery. Estimated blood loss (EBL) was assessed by visual estimation. Patients were monitored continuously until 24 h after surgery to evaluate PDPH and PONV. Results: There were no statistically significant differences in the EBL between the two groups. There was no significant rise in heart rate and no significant decrease in mean arterial blood pressure in Group A compared to Group B. The incidence of PDPH and PONV was also comparable in both groups. Conclusion: Five IU of IV bolus of oxytocin is as effective as 10 IU of IV bolus in reducing blood loss during cesarean section.
目的和目的:我们试图比较5国际单位(IU)和10国际单位静脉注射(IV)后叶催产素的血流动力学效果及其减少剖宫产术中出血量的效果，并确定术后恶心呕吐(PONV)和硬脊膜穿刺后头痛(PDPH)的发生率。患者与方法:选取110例美国麻醉医师学会I、II期剖宫产麻下剖宫产术患者，随机分为两组。A组(n = 55)产后给予5 IU静脉注射催产素，B组(n = 55)产后给予10 IU静脉注射催产素。两组均给予每千克0.9%生理盐水10毫升作为体积预负荷。患者坐位，在L2/L3或L3/L4椎间隙用24G大小的脊髓针进行蛛网膜下腔阻滞。2毫升0.5%重布比卡因在鞘内缓慢注射。分娩后，缓慢静脉注射5 IU (A组)或10 IU (B组)的催产素，每分钟记录一次心率、收缩压、舒张压和平均动脉血压，持续5分钟。两组患者持续以125 ml/h的速度在0.9%生理盐水500 ml (60 mU/ml)中静脉滴注催产素30 IU，直至手术结束。估计失血量(EBL)采用目测法评估。持续监测患者至术后24小时，评估PDPH和PONV。结果:两组患者EBL差异无统计学意义。与b组相比，A组患者心率无明显升高，平均动脉血压无明显降低。两组患者PDPH和PONV的发生率也具有可比性。结论:5 IU静脉滴注催产素与10 IU静脉滴注减少剖宫产术出血量的效果相同。
{"title":"Is 5 IU bolus of oxytocin as effective as 10 IU bolus for control of bleeding during cesarean section under spinal anesthesia?","authors":"Musa M Yusuf, E. Nwasor, R. Mohammed","doi":"10.4103/archms.archms_32_17","DOIUrl":"https://doi.org/10.4103/archms.archms_32_17","url":null,"abstract":"Aim and Objectives: We sought to compare the hemodynamic effects of 5 international unit (IU) and 10 IU of intravenous (IV) boluses of oxytocin and their efficacy in reducing blood loss during cesarean section and also to determine the incidence of postoperative nausea and vomiting (PONV) and postdural puncture headache (PDPH). Patients and Methods: One hundred and ten parturients of American Society of Anesthesiologists' I and II scheduled for cesarean section under spinal anesthesia were randomized into two groups. Group A (n = 55) received 5 IU IV bolus of oxytocin and Group B (n = 55) received 10 IU IV bolus of oxytocin after delivery. Ten milliliters per kilogram of 0.9% saline was administered to both groups as volume preload. Subarachnoid block was performed with size 24G spinal needles at L2/L3 or L3/L4 intervertebral space with the patients in sitting position. Two milliliters of 0.5% heavy bupivacaine was administered slowly intrathecally. Following delivery of the baby, IV boluses of 5 IU (Group A) or 10 IU (Group B) of oxytocin were administered slowly, and recording of heart rate, systolic, diastolic, and mean arterial blood pressure was done every minute for 5 min after bolus injection. IV infusion of 30 IU of oxytocin in 500 ml of 0.9% saline (60 mU/ml) at a rate of 125 ml/h was continued in both groups till the end of surgery. Estimated blood loss (EBL) was assessed by visual estimation. Patients were monitored continuously until 24 h after surgery to evaluate PDPH and PONV. Results: There were no statistically significant differences in the EBL between the two groups. There was no significant rise in heart rate and no significant decrease in mean arterial blood pressure in Group A compared to Group B. The incidence of PDPH and PONV was also comparable in both groups. Conclusion: Five IU of IV bolus of oxytocin is as effective as 10 IU of IV bolus in reducing blood loss during cesarean section.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"82 1","pages":"7 - 11"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83766713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4103/archms.archms_10_17
S. Yakubu
Introduction: Preanesthesia assessment of patients is a major component of the perioperative care of surgical patients. The benefits of outpatient preoperative assessment clinics (PAC) were recognized over 67 years ago. However, these clinics are not used in Nigeria as part of surgical care. Search of the literature did not reveal any hospital in Nigeria that operates PAC, and therefore, its implementation in this country is still in process. This may not be unconnected with scarce financial, material, and human resources. Materials and Methods: This study was a questionnaire survey of the views of anesthetists, surgeons, and hospital administrators in some Nigerian Federal Teaching Hospitals on the usefulness and limitations of PAC. Structured questionnaires were sent to surgeons, anesthetists and Chairmen, Medical Advisory Committees in the selected Hospitalsand the results were analyzed. Results: Respondents indicated the benefits of preanesthesia assessment clinics as decrease in the incidence of surgery delays and cancelations, shorter lengths of hospital stay, improvement in the logistics of preoperative preparation, improved patient knowledge of anesthesia, and preoperative care as well as the role of the anesthetist in surgical care. Limiting factors to successful preanesthesia clinics were lack of cooperation from anesthetists and surgeons, other medical specialists, lack of supporting staff, finance, and appropriate office space. Conclusions: Preanesthesia assessment clinic increases the overall efficiency of the period of stay of the surgical patient in the hospital. Its benefits outweigh its disadvantages, and its successful implementation requires effort, time, money, and close collaboration with hospital administrators.
{"title":"Does implementation of preanesthesia assessment clinics improve surgical patients care in Nigeria?","authors":"S. Yakubu","doi":"10.4103/archms.archms_10_17","DOIUrl":"https://doi.org/10.4103/archms.archms_10_17","url":null,"abstract":"Introduction: Preanesthesia assessment of patients is a major component of the perioperative care of surgical patients. The benefits of outpatient preoperative assessment clinics (PAC) were recognized over 67 years ago. However, these clinics are not used in Nigeria as part of surgical care. Search of the literature did not reveal any hospital in Nigeria that operates PAC, and therefore, its implementation in this country is still in process. This may not be unconnected with scarce financial, material, and human resources. Materials and Methods: This study was a questionnaire survey of the views of anesthetists, surgeons, and hospital administrators in some Nigerian Federal Teaching Hospitals on the usefulness and limitations of PAC. Structured questionnaires were sent to surgeons, anesthetists and Chairmen, Medical Advisory Committees in the selected Hospitalsand the results were analyzed. Results: Respondents indicated the benefits of preanesthesia assessment clinics as decrease in the incidence of surgery delays and cancelations, shorter lengths of hospital stay, improvement in the logistics of preoperative preparation, improved patient knowledge of anesthesia, and preoperative care as well as the role of the anesthetist in surgical care. Limiting factors to successful preanesthesia clinics were lack of cooperation from anesthetists and surgeons, other medical specialists, lack of supporting staff, finance, and appropriate office space. Conclusions: Preanesthesia assessment clinic increases the overall efficiency of the period of stay of the surgical patient in the hospital. Its benefits outweigh its disadvantages, and its successful implementation requires effort, time, money, and close collaboration with hospital administrators.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"67 1","pages":"20 - 23"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89979079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4103/archms.archms_25_17
Y. Aliyu, A. Adesiyun, S. Avidime, A. Randawa
Objective: Obesity is rising in the developing countries because of changing life style, and this has its burden on fertility and its management. This study determined the prevalence of obesity and clinical correlation of obesity with menstrual abnormalities, as well as the rate of spontaneous conception among obese infertile women on nonsurgical weight loss therapy. Methodology: A cross-sectional longitudinal study was done among women that presented with infertility to the gynecology clinic. The main outcomes measured were percentage of infertile women that are obese, menstrual pattern of these women, and spontaneous conception among obese infertile women following weight loss therapy. Results: Of the 205 patients, 68 (33.2%) were found to be obese; there was a significant association between obesity and abnormal menstrual pattern (P = 0.0002). Oligomenorrhea and hypomenorrhea were also found to be significantly associated with obesity (P = 0.009 and P = 0.022, respectively). Following average of 12-month follow up, spontaneous conception among obese infertile women while on weight loss therapy was 21.1%. Conclusion: The prevalence of obesity was high with a significant association between obesity and menstrual abnormalities. Weight loss among obese infertile women led to improvement in spontaneous conception.
{"title":"Prevalence of obesity and outcome of weight loss on reproduction: A study among women attending infertility clinic in Zaria, Northern Nigeria","authors":"Y. Aliyu, A. Adesiyun, S. Avidime, A. Randawa","doi":"10.4103/archms.archms_25_17","DOIUrl":"https://doi.org/10.4103/archms.archms_25_17","url":null,"abstract":"Objective: Obesity is rising in the developing countries because of changing life style, and this has its burden on fertility and its management. This study determined the prevalence of obesity and clinical correlation of obesity with menstrual abnormalities, as well as the rate of spontaneous conception among obese infertile women on nonsurgical weight loss therapy. Methodology: A cross-sectional longitudinal study was done among women that presented with infertility to the gynecology clinic. The main outcomes measured were percentage of infertile women that are obese, menstrual pattern of these women, and spontaneous conception among obese infertile women following weight loss therapy. Results: Of the 205 patients, 68 (33.2%) were found to be obese; there was a significant association between obesity and abnormal menstrual pattern (P = 0.0002). Oligomenorrhea and hypomenorrhea were also found to be significantly associated with obesity (P = 0.009 and P = 0.022, respectively). Following average of 12-month follow up, spontaneous conception among obese infertile women while on weight loss therapy was 21.1%. Conclusion: The prevalence of obesity was high with a significant association between obesity and menstrual abnormalities. Weight loss among obese infertile women led to improvement in spontaneous conception.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"1 1","pages":"3 - 6"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90837406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4103/archms.archms_15_17
S. Bashir, M. Ibrahim, Matthias O Ekpenukpang, Saifuddin Ahmed
Background: Disclosure of human immunodeficiency virus (HIV)-positive status to sexual partner is crucial and helpful for treatment adherence, HIV transmission reduction, PMTCT interventions, partner testing and acceptance of referrals for HIV-related care, treatment and support. This study assessed the awareness, practices as well as factors associated with serostatus disclosure among HIV positive clients receiving anti-retroviral treatment in a tertiary health facility in northwest Nigeria. Methodology: A cross-sectional study was conducted among 129 HIV positive clients receiving anti-retroviral therapy selected using a systematic random sampling technique. Data were collected using a structured interviewer-administered questionnaire containing open- and close-ended questions, and analyzed using SPSS Statistics version 21.0. Result: The mean age of respondents was 38.0 ± 10.6 years and most (89.9%) of the respondents were on antiretroviral therapy for more than one year. Majority of the respondents have a positive attitude to serostatus disclosure (67.4%) and have disclosed their serostatus to their partner (79.8%), but only 57.3% did so within one month of knowing their serostatus. Their main reason for disclosure were concern for partner's health (74.6%) while partners' reactions were supportive in 35% and understanding in 21.4% of respondents. Disclosure was high among those currently married (odds ratio = 0.075 96% confidence interval: 0.0230-0.237, P = 0.001) but there was no statistically significant association between disclosure and age, gender, religion, educational status and average monthly income. Conclusion: This study found a good partner disclosure rate of HIV serostatus among PLWHA receiving treatment at Nasara Clinic, ABUTH, and client's marital status as currently married was a significant factor that influenced disclosure rate.
{"title":"Serostatus disclosure to sexual partner by human immunodeficiency virus-positive clients receiving antiretroviral therapy in a tertiary health facility in Northwest Nigeria","authors":"S. Bashir, M. Ibrahim, Matthias O Ekpenukpang, Saifuddin Ahmed","doi":"10.4103/archms.archms_15_17","DOIUrl":"https://doi.org/10.4103/archms.archms_15_17","url":null,"abstract":"Background: Disclosure of human immunodeficiency virus (HIV)-positive status to sexual partner is crucial and helpful for treatment adherence, HIV transmission reduction, PMTCT interventions, partner testing and acceptance of referrals for HIV-related care, treatment and support. This study assessed the awareness, practices as well as factors associated with serostatus disclosure among HIV positive clients receiving anti-retroviral treatment in a tertiary health facility in northwest Nigeria. Methodology: A cross-sectional study was conducted among 129 HIV positive clients receiving anti-retroviral therapy selected using a systematic random sampling technique. Data were collected using a structured interviewer-administered questionnaire containing open- and close-ended questions, and analyzed using SPSS Statistics version 21.0. Result: The mean age of respondents was 38.0 ± 10.6 years and most (89.9%) of the respondents were on antiretroviral therapy for more than one year. Majority of the respondents have a positive attitude to serostatus disclosure (67.4%) and have disclosed their serostatus to their partner (79.8%), but only 57.3% did so within one month of knowing their serostatus. Their main reason for disclosure were concern for partner's health (74.6%) while partners' reactions were supportive in 35% and understanding in 21.4% of respondents. Disclosure was high among those currently married (odds ratio = 0.075 96% confidence interval: 0.0230-0.237, P = 0.001) but there was no statistically significant association between disclosure and age, gender, religion, educational status and average monthly income. Conclusion: This study found a good partner disclosure rate of HIV serostatus among PLWHA receiving treatment at Nasara Clinic, ABUTH, and client's marital status as currently married was a significant factor that influenced disclosure rate.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"4 1","pages":"24 - 28"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90107022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4103/archms.archms_2_16
S. Kache, D. Sale, Nuhu Yusuf, J. Makama
Midgut volvulus due to intestinal malrotation is a rare occurrence in adult life. Malrotation is a congenital, developmental anomaly that results from an arrest of the physiological rotation of the gut through 270°. It is often thought that complications due to it, present themselves early during childhood and rarely occur among adults. However, a few cases have occurred and have been reported among adults. When it does occur in adults, it is often associated with catastrophic consequences. We present the case of a 45-year-old man with malrotation resulting in midgut volvulus. Our patient is a 45-year-old man, who presented with sudden onset of colicky abdominal pain and abdominal swelling of 24 h duration. He had been having recurrent abdominal pain since childhood. Physical examination revealed a patient in shock with markedly distended abdomen and anterior abdominal wall edema. Plain abdominal X-ray showed multiple air-fluid levels with thickened bowel outline. A diagnosis of intestinal obstruction was made. The patient was fully resuscitated and planned for emergency exploratory laparotomy under general anesthesia. Intraoperative findings revealed a 360° clockwise rotation of the small bowel around the mesenteric pedicle of the superior mesenteric artery and vein including about 350 cm of bowel gangrene. Resection and anastomosis were done. The early postoperative period was uneventful. However, he had anastomotic dehiscence on the 5th postoperative day and had to be reoperated but sadly he died 24 h later due to complications of anesthesia. Nonspecific recurrent abdominal complaints in adults of any age should raise suspicion of the possibility of a midgut malrotation or malfixation with or without intermittent volvulus. This case highlights the importance of early diagnosis and treatment.
{"title":"Malrotation with midgut volvulus and bowel gangrene in a 45-year-old man","authors":"S. Kache, D. Sale, Nuhu Yusuf, J. Makama","doi":"10.4103/archms.archms_2_16","DOIUrl":"https://doi.org/10.4103/archms.archms_2_16","url":null,"abstract":"Midgut volvulus due to intestinal malrotation is a rare occurrence in adult life. Malrotation is a congenital, developmental anomaly that results from an arrest of the physiological rotation of the gut through 270°. It is often thought that complications due to it, present themselves early during childhood and rarely occur among adults. However, a few cases have occurred and have been reported among adults. When it does occur in adults, it is often associated with catastrophic consequences. We present the case of a 45-year-old man with malrotation resulting in midgut volvulus. Our patient is a 45-year-old man, who presented with sudden onset of colicky abdominal pain and abdominal swelling of 24 h duration. He had been having recurrent abdominal pain since childhood. Physical examination revealed a patient in shock with markedly distended abdomen and anterior abdominal wall edema. Plain abdominal X-ray showed multiple air-fluid levels with thickened bowel outline. A diagnosis of intestinal obstruction was made. The patient was fully resuscitated and planned for emergency exploratory laparotomy under general anesthesia. Intraoperative findings revealed a 360° clockwise rotation of the small bowel around the mesenteric pedicle of the superior mesenteric artery and vein including about 350 cm of bowel gangrene. Resection and anastomosis were done. The early postoperative period was uneventful. However, he had anastomotic dehiscence on the 5th postoperative day and had to be reoperated but sadly he died 24 h later due to complications of anesthesia. Nonspecific recurrent abdominal complaints in adults of any age should raise suspicion of the possibility of a midgut malrotation or malfixation with or without intermittent volvulus. This case highlights the importance of early diagnosis and treatment.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"8 1","pages":"29 - 31"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89370772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4103/archms.archms_40_17
J. Makama
{"title":"Is acute appendicitis still the most common abdominal surgical emergency","authors":"J. Makama","doi":"10.4103/archms.archms_40_17","DOIUrl":"https://doi.org/10.4103/archms.archms_40_17","url":null,"abstract":"","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"35 7 1","pages":"1 - 2"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89600254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4103/archms.archms_22_17
M. Ibrahim, S. A. Adamu, M. Yakubu, S. Bashir
Introduction: Risky sexual behavior among adolescents is a major contributory factor to adolescent morbidity. This is mainly because during adolescence, cognitive, and psychological maturity coupled with increased need for autonomy translates into a greater desire for independent decision-making. The study assessed reproductive health decision-making and its sociodemographic determinants among adolescent senior secondary school students. Methods: This was a cross-sectional study involving 384 adolescent senior secondary school students selected through multi-stage sampling. Data were collected through a self-administered questionnaire and analyzed using IBM SPSS Statistics version 20 and results are presented in tables and charts. Results: Mean age of the respondents was 17.5 ± 1.3 years, and 170 (44.6%) were <18 years old. Reproductive health decision-making was good in 116 (30.1%). If they were sexually abused, 187 (48.4%) said that they would report first to their parents. Reproductive health decision-making showed statistically significant association with gender (P = 0.04), and class of the study (P < 0.0001), but not with age (P = 0.24), ethnicity (P = 0.86), religion (P = 0.16), and marital status (P = 0.99). Conclusion: Reproductive health decision was generally poor, and it was influenced by gender and class of the study. Therefore, Government should consider ways of improving reproductive health decision-making among the secondary school students, possibly by including it in their school curriculum. Future studies should identify locally applicable interventions to promote parent–child connectedness for improving reproductive health decision-making among adolescents.
{"title":"Reproductive health decision-making among adolescents in public secondary schools in Zaria, North-Western, Nigeria","authors":"M. Ibrahim, S. A. Adamu, M. Yakubu, S. Bashir","doi":"10.4103/archms.archms_22_17","DOIUrl":"https://doi.org/10.4103/archms.archms_22_17","url":null,"abstract":"Introduction: Risky sexual behavior among adolescents is a major contributory factor to adolescent morbidity. This is mainly because during adolescence, cognitive, and psychological maturity coupled with increased need for autonomy translates into a greater desire for independent decision-making. The study assessed reproductive health decision-making and its sociodemographic determinants among adolescent senior secondary school students. Methods: This was a cross-sectional study involving 384 adolescent senior secondary school students selected through multi-stage sampling. Data were collected through a self-administered questionnaire and analyzed using IBM SPSS Statistics version 20 and results are presented in tables and charts. Results: Mean age of the respondents was 17.5 ± 1.3 years, and 170 (44.6%) were <18 years old. Reproductive health decision-making was good in 116 (30.1%). If they were sexually abused, 187 (48.4%) said that they would report first to their parents. Reproductive health decision-making showed statistically significant association with gender (P = 0.04), and class of the study (P < 0.0001), but not with age (P = 0.24), ethnicity (P = 0.86), religion (P = 0.16), and marital status (P = 0.99). Conclusion: Reproductive health decision was generally poor, and it was influenced by gender and class of the study. Therefore, Government should consider ways of improving reproductive health decision-making among the secondary school students, possibly by including it in their school curriculum. Future studies should identify locally applicable interventions to promote parent–child connectedness for improving reproductive health decision-making among adolescents.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"40 1","pages":"16 - 19"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89971201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-01DOI: 10.4103/archms.archms_5_17
F. Bakari, Moroof Suleman Omobayowa, A. Adesiyun, H. Sulayman, N. Ameh, Hauwa Umar Shuaib
Gravitational pull and subtle uterine contractions on huge polypoidal submucous uterine fibroid may dilate the cervix and prolapse into the vagina. Such prolapsed fibroid can either be removed through the vaginal route if it is connected with a long stalk or through an abdominal route if it has a broad base or if it is coexisting with multiple uterine fibroids. We present two cases of grand multiparous women with huge prolapsed submucous fibroids where neglect led to presentation with life-threatening infection and bleeding.
{"title":"Infected huge prolapsed polypoidal fibroid: Issues of neglect and delayed access to surgical treatment","authors":"F. Bakari, Moroof Suleman Omobayowa, A. Adesiyun, H. Sulayman, N. Ameh, Hauwa Umar Shuaib","doi":"10.4103/archms.archms_5_17","DOIUrl":"https://doi.org/10.4103/archms.archms_5_17","url":null,"abstract":"Gravitational pull and subtle uterine contractions on huge polypoidal submucous uterine fibroid may dilate the cervix and prolapse into the vagina. Such prolapsed fibroid can either be removed through the vaginal route if it is connected with a long stalk or through an abdominal route if it has a broad base or if it is coexisting with multiple uterine fibroids. We present two cases of grand multiparous women with huge prolapsed submucous fibroids where neglect led to presentation with life-threatening infection and bleeding.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"93 1","pages":"56 - 59"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80453257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-01DOI: 10.4103/archms.archms_3_16
A. Lawan, L. Abdu, V. Pam
Background: The aim of the study is to determine the pattern, frequency, and types of anterior segment disorders in diabetic patients attending the outpatient specialist Diabetes Clinic of Aminu Kano Teaching Hospital (AKTH), Kano. Patients and Methods: This was a descriptive cross-sectional study of diabetic patients in AKTH over a 1-year period. Sample size was estimated using Fisher's formula, and systematic sampling was done to ensure proper randomization of patients that fulfilled the study criteria. Information obtained included patients' bio-data, height, weight, fasting blood sugar (FBS), type and duration of diabetes, associated comorbidities; visual acuity and anterior segment were examined using slit lamp biomicroscopy. Results: A total of 390 patients were examined during the study. There were 166 (42.6%) males and 224 (57.4%) females (M:F ratio = 1:1.35). Mean age was 54.81 ± 12.21 years. Seventy-four (18.97%) patients had type I disease, while 316 (81.03%) patients had type II disease. The mean presenting FBS was 9.52 mmol/L ± standard deviation 4.22, with a wide range of 3.4–24.8 mmol/L. Four patients were bilaterally blind, while ten were unilaterally blind from cataract and glaucoma. Myopia and myopic astigmatism were the most observed refractive errors though not statistically associated with high FBS (×2 = 1.00 P = 0.3165). Chronic blepharitis was the main lid finding and found to be related to high FBS (×2 = 38.68 P< 0.000001). Ocular surface findings included pterygia (3.85%), pinguecula (2.56%), dry eyes (2.31%), and combination of these. Bilateral rubeosis iridis and iris atrophy were found in 8 (2.1%) and 6 (1.5%) patients, respectively. Lens opacities varied in location and visual significance. Nuclear sclerosis was the most common lens disorder while posterior subcapsular cataract was the second predominant type observed and was associated with disease duration >10 years (×2 = 11.48, P = 0.0007039). Conclusion: Anterior segment eye disorders in diabetic patients could be clinically significant and yet unreported by the patient. These may cause low vision and blindness similar to nondiabetic population. The screening protocol in the study location should include routine eye examination.
背景:本研究的目的是确定在卡诺Aminu Kano教学医院(AKTH)糖尿病门诊专科诊所就诊的糖尿病患者前段疾病的模式、频率和类型。患者和方法:这是一项为期1年的糖尿病患者AKTH的描述性横断面研究。使用Fisher公式估计样本量，并进行系统抽样以确保符合研究标准的患者的适当随机化。获得的信息包括患者的生物数据、身高、体重、空腹血糖(FBS)、糖尿病类型和病程、相关合并症;采用裂隙灯生物显微镜观察视力及前段。结果:研究期间共检查了390例患者。男性166例(42.6%)，女性224例(57.4%)(男女比为1:1.35)。平均年龄54.81±12.21岁。I型74例(18.97%)，II型316例(81.03%)。FBS的平均值为9.52 mmol/L±标准差4.22，范围为3.4 ~ 24.8 mmol/L。4例为双侧失明，10例为单侧失明，原因为白内障和青光眼。屈光不正发生率最高的是近视和近视散光，但与高FBS无统计学相关性(×2 = 1.00 P = 0.3165)。慢性眼睑炎是主要的眼睑表现，与高FBS有关(×2 = 38.68 P< 0.000001)。眼表表现包括翼状胬肉(3.85%)、斑疹(2.56%)、眼睛干涩(2.31%)及以上症状的合并。双侧虹膜病变8例(2.1%)，虹膜萎缩6例(1.5%)。晶状体混浊的位置和视觉意义各不相同。核硬化是最常见的晶状体疾病，后囊下白内障是第二主要类型，并与病程bbb10年相关(×2 = 11.48, P = 0.0007039)。结论:糖尿病患者前段眼病可能具有临床意义，但未被患者报告。这些可能导致与非糖尿病人群相似的低视力和失明。研究地点的筛查方案应包括常规眼科检查。
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Pub Date : 2016-07-01DOI: 10.4103/ARCHMS.ARCHMS_12_17
A. Ajayi
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