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Item Menstrual health of in-school adolescents in Ibadan: knowledge, attitudes and consequences(2009) Owonikoko, K. M.; Okunlola, M. A.; Ogunbode, O. O.|; Enabor, O. O.; Oluwasola, T. A. O.; Arowojolu, A. O."We evaluated the knowledge, attitudes to and consequences of menstrual morbidities among in –school Adolescents in Ibadan and determined their effect on school attendance. The pattern of drug use for menstrual symptoms was also assessed. Self-administered questionnaires were given to 1194 respondents in secondary schools chosen by randomization. The mean age of respondents was 15.7+ years while 86.1% were aged between 10-17 years. The most prevalent menstrual disorder was dysmenorrhea (87.3%). The commonest source of information about the menstrual cycle was from mothers (71%) while 0.5% of adolescents obtained information from health care givers. Menstrual symptoms were treated with non-pharmacological means in 53.1%. Of girls using pharmacologic agents 44% of them obtaining over the counter medications (OTC). Forty four percent of respondents missed school for 6-7 weeks per session following dysmenorrhea while 19% of them required hospital admission. It was concluded that there is insufficient knowledge of the menstrual cycle and its abnormalities among adolescents. Menstrual health should be introduced as part of reproductive health programs in school curricula in Nigeria. "Item Health risks of obesity(Association of Resident Doctors (ARD), University College Hospital (UCH), Ibadan, Nigeria, 2009-12) Ogunbode, A. M.; Fatiregun, A. A.; Ogunbode, O. O.Obesity is becoming of interest as a non-communicable disease. There is however a dearth of information on obesity in this environment, as literature in developing countries is limited. Review of health risks of obesity is useful in order to increase the pool of available information in Nigeria and to draw attention to obesity and its attendant health risks.Item Plasma C-reactive protein and selected nutritional indices in elective caesarean section(Journalgurus, 2009-04) Adedapo, K. S.; Nwobi, L. N.; Olayemi, O.; Aimakhu, C. O.; Ogunbode, O. O.; Akinboade, A. F.; Adeniyi, F. A. A.Context: Caesarean Section (CS) is a major surgical procedure, often performed when a vaginal delivery is considered unsafe. Objective: This study was carried out to understand the interaction between acute phase proteins and nutritional factors consequent to caesarean section. The knowledge of this interaction is important for successful management of these patients. Methods: Plasma samples from fifty (50) pregnant women booked for elective caesarean section in Ibadan, Nigeria were collected on the day preceding surgery, one day and four days post-surgery to determine the levels of CRP, vitamin C, PCV, Total protein, albumin and globulin (Glb) levels. Results: The mean age of the patients studied was 32.29 + 3.66 years, range; 24 39 years. Significant elevations were observed in the levels of TP, Glb and CRP one day post-surgery (1DPS) compared with baseline (BS) (7.36 + 1.46) vs 6.56±1.30, (4.68 + 1.33) vs 2.70±1.51, (111.43 + 68.89) vs 6.00 ± 13.27 respectively, while albumin reduced significantly (2.68 + 1.08) vs 3.87±0 .63. Similar changes were observed on day 4. There was no significant change in the levels of Vitamin C. Conclusion: One of the positive predictive indicators of good outcome after caesarean delivery is adequate nutrition.Item Perception and practice of emergency contraception among female Undergraduates of the University of Ibadan, Nigeria(Elsevier, 2009) Bello, F. A.; Olayemi, O.; Fawole, A. O.; Ogunbode, O. O.; Sobukunola, T.; Adesina, O. A.; Aimakhu, C.; Okunola, A.Objective To assess perception and level of proper utilization of emergency contraception (EC) among female undergraduates. Methods Cross-sectional questionnaire study was performed on 383 female undergraduates in Nigeria in June 2006. Data analysis was with χ-square test and logistic regressions (P<0.05). Results One hundred and five (48.2%) had been sexually exposed. Only 32 (30.5%) used regular contraception. Seventy-three (24.3%) female undergraduates were aware of EC. Only 29 (7.6%) had used EC before. Most would not use emergency contraceptive drugs in future due to lack of awareness (64.8%), and fear for future fertility and of drugs being injurious to health. Use of EC was associated with awareness of correct interval for use (OR=9.1; 95%CI: 2.1-39.9). Conclusion There is poor knowledge about EC and poor use, while significant need remains. Most knowledge was acquired from peers and inaccurate. Peer educators are important and professionals’ knowledge needs improvement.Item Menstrual health of in-school adolescents in Ibadan: knowledge, attitudes and consequences(Lagos Society for Advancement of Medical Education (SAME) Ventures, 2009) Owonikoko, K. M.; Okunlola, M. A.; Ogunbode, O. O.; Enabor, O. O.; Oluwasola, T. A. O.; Arowojolu, A. O.We evaluated the knowledge, attitudes to and consequences of menstrual morbidities among in –school adolescents in Ibadan and determined their effect on school attendance. The pattern of drug use for menstrual symptoms was also assessed. Self-administered questionnaires were given to 1194 respondents in secondary schools chosen by randomization. The mean age of respondents was 15.7+ years while 86.1% were aged between 10-17 years. The most prevalent menstrual disorder was dysmenorrhea (87.3%). The commonest source of information about the menstrual cycle was from mothers (71%) while 0.5% of adolescents obtained information from health care givers. Menstrual symptoms were treated with non-pharmacological means in 53.1%. Of girls using pharmacologic agents 44% of them obtaining over the counter medications (OTC). Forty four percent of respondents missed school for 6-7 weeks per session following dysmenorrhea while 19% of them required hospital admission. It was concluded that there is insufficient knowledge of the menstrual cycle and its abnormalities among adolescents. Menstrual health should be introduced as part of reproductive health programs in school curricula in Nigeria.Item Awareness of cervical cancer and screening in a Nigerian female market population(Wolters Kluwer Medknow Publications, 2005) Ogunbode, O. O.; Ayinde, O. A.Background: Cervical cancer, although largely preventable, remains a leading cause of cancer death among females in the developing world. The study was aimed at providing useful information on awareness of market women, who are from diverse social backgrounds, about cervical cancer and evaluate U1e extent of utilisation of Papanicolaou's smear by them, It was also aimed at determining the prevalence of risk factors for development of cervical cancer among the population. Methods: TI1is cross-sectional descriptive survey was carried out among market women at Aleshinloye market in November 2003, among 483 randomly selected respondents. A questionnaire probing into their sexual history, awareness about cervical cancer and the extent of utilisation of Pap smear was the survey instrument. Results: The majority (79.5%) of the women were sexually active. One hundred and eighty-six (38.5%) had early sexual debut and 163 (33.7%) had multiple sexual partners. Only 197 respondents (40.8%) were aware of cervical cancer. Of these, 95 (19.7%) were aware of Pap smear as a screening test. The common media of awareness were radio and television (46.6%), public lecture (27.8%) and friends/ relatives (19.9%). However, only 25 respondents (5.2%) have had previous Pap smear done. Conclusion: Though the market women are at considerable risk of developing cancer of the cervix, they are poorly informed about the disease and its prevention. Therefore, there is need for continuous awareness campaign and well-organized screening programmes among this unique category of women.Item Pre-induction cervical ripening: transcervical foley catheter versus intravaginal misoprostol(Taylor & Francis Group, 2005) Adeniji, R. A.; Oladokun, A.; Olayemi, O.; Adeniji, O. I.; Odukogbe, A.; Ogunbode, O. O.; Omigbodun, A. O.; Ilesanmi, A. O.The object of this study was to compare the effectiveness of the intravaginal Misoprostol and transcervical Foley catheters as pre-induction cervical ripening agents, to estimate the proportion of patients achieving vaginal delivery and to compare the complications of labour and foetal outcome between the two groups. The study was a prospective, randomised study of pregnant women, with singleton pregnancies who presented for antenatal care and delivery at the University College Hospital (UCH), Ibadan, Nigeria. Ninety-nine patients were invited to participate and ninety-six (96) agreed. No patient withdrew from the study. The patients were assigned by means of computer-generated random numbers to receive transcervical Foley catheters (Size 16F, with 30 ml balloon capacity) or 50 mg intravaginal Misoprostol (Cytotec 1tablet, Searle & Co., Chicago). Fifty (50) patients received intravaginal Misoprostol and Forty-six (46) received Transcervical Foley catheters. The proportions of nulliparous, primiparous and multiparous patients were 52, 20 and 28% in the misoprostol group and 43.5, 26.1 and 30.4%, respectively, in the Foley catheter group. The time to achieve a favourable cervical status was significantly shorter in the Misoprostol group, with 98.0% of the subjects attaining Bishop score 56 within 6 – 12 hours of insertion of the study agent, in contrast to 69.0% of the subjects in the Foley catheters group (P50.001). Thirteen (26.6%) and three (6.5%) patients in the Misoprostol and Foley catheters groups, respectively, went into labour while undergoing cervical ripening and all had uneventful vaginal deliveries (P50.05). The induction-delivery interval did not differ significantly between the groups. The incidence of caesarean delivery was 6.0% in the Misoprostol group compared with 2.2% in the Foley catheter group (P =0.62). Instrumental vaginal delivery rates were similar in both groups. Overall, the mode of delivery did not differ significantly between the groups. The number of neonates with 1-minute Apgar score 57 did not differ significantly in both groups and no neonate had 5- minute Apgar score 57. Meconium stained liquor was noticed in 5 (Misoprostol) vs 2 (Foley catheters) patients in labour. None of the neonates had any features suggestive of meconium aspiration. Labour complications were mainly precipitate labour {2 (Misoprostol) vs 1 (Foley catheters) } and 1 patient with transient tachysystole (56 contractions in 10 minutes for two consecutive 10-minute periods) in the Misoprostol group. Hyperstimulation was not noticed in any of the patients in either arm of the study groups. Intravaginal Misoprostol is as effective a pre-induction cervical ripening agent as transcervical Foley catheters, with added advantages of shorter duration of cervical ripening, reduced oxytocin requirement for induction of labour and greater acceptability to patients. The incidence of caesarean sections, other labour complications and the foetal outcome were similar with both methods.Item Emergency obstetric patients in a developing country and prevalence of HIV infection(2009) Awolude, O. A.; Oladokun, A.; Adesina, O. A.; Mutiu, W. B.; Adewole, I. F.The availability of VCT for HIV for booked antenatal patients offers a unique opportunity for best obstetrics practice but not for patients presenting with emergencies and unknown HIV status. Health workers who attend to such patients are at higher risk of acquiring HIV infections. Between 1st March 2005 and 30th September 2007, unbooked emergency obstetric patients in the labour ward of a teaching hospital who consented were tested using double rapid immunodiagnostic technique and confirmed by Western Blot. HTV positive patients were post-test counselled and offered single dose nevirapine tablet (200mg) in labour with syrup given to the baby at birth at 2mg/kg followed by syrup zidovudine for 6 weeks: The results showed that 275 (89.0%) of the 309 women pre-test counselled agreed to testing. The mean age of clients was 27.7 years (± 4.4 SD). The mean gestational age at presentation was 36.4 weeks (± 4.2 weeks). Primigravidae constituted 37.5% of the patients. Twenty-one (7.6%) of these consenting patients were H3V positive. In conclusion, the HIV prevalence of 7.6% among these unbooked obstetric patients is higher than the 4,7% among our booked antenatal patients and National prevalence of 4.4%. This poses substantial risk of transmission of HIV to attending health workers considering the readiness with which needle prick accident can occur in emergency situations.Item Pregnancy outcome in diabetic patients at University College Hospital, Ibadan(2003-04) Oladokun, A.; Aimakhu, C. O.; Aimakhu, C. O.; Awolude, O. A.; Olayemi, O.; Adeleye, J.Context: Diabetes mellitus is one of the common medical complications in pregnancy, which if not properly controlled, can lead to significant perinatal and maternal morbidity and mortality. Objective: To determine the incidence of diabetes mellitus in pregnancy in this centre, and to assess the effect of maternal glucose control on the obstetric performance as well as perinatal outcome of pregnant diabetics managed at the University Collage Hospital, Ibadan. Study Design: A review of the obstetric outcome for 49 diabetic women who delivered at the University College Hospital, U.C.H, Ibadan, Nigeria during a 1 0-year period (January, 1991 t o D ecember 2 000) i s presented. Results: The incidence rate of diabetes in pregnancy was 0.74 per 1000 deliveries per year. Most patients (89.8%) booked for antenatal care and delivery in this centre. Good control was achieved in 77.6% of patients and the mean birth weight was 3.37 ± 1.52kg. There was no significant difference in the birth weight and fetal outcome if a patient had pre-existing or gestational diabetes. However, the outcome was significantly related to the level of control. With good control there was a better Apgar score at 5 minutes, which was prognostic for fetal outcome. The perinatal mortality rate was 98/1000 births and this was significantly associated with poor control when compared with good control (p < 0.05). There was no maternal death. Conclusion: Further improvement in the management is needed. Preconception control, early antenatal booking and good control in pregnancy are strongly advocated as means of achieving good pregnancy outcome.Item The challenges of single-short spinal anaesthesia for caesarean section in a morbidly obese patient: a case report(2005-10) Danladi, K. Y.; Sotunmbi, P. T.; Awolude, O. A.; Obisesan, K. A.An unusual case of morbid obesity, severe hypertension and twin gestation at 36weeks in an unbooked multigravid patient was presented for cesarean section. She was referred from a private clinic to the obstetric emergency unit of the University College Hospital, Ibadan with history of hypertension in pregnancy. She was a known hypertensive for ten years and her blood pressure was poorly controlled due to non-compliance with medications and medical check-up. She had been having progressive visual loss over the ten year period and had lost three, previous pregnancies. Following comprehensive clinical and radiological evaluation, she had a carefully planned single-shot spinal anaesthesia for cesarean delivery of a set of twin which was performed on a double operation table. She remained stable throughout the procedure and post operative period.