FACULTY OF CLINICAL SCIENCES
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Item Human papillomavirus infection and related cancers in Sub-Saharan Africa: burden and tools for prevention(2013) Awolude, O. A.; Morhason-Bello, I. O.; Denny, L. A.; Adewole, I. F.Item Knowledge of the human papilloma virus vaccines, and opinions of gynaecologists on its implementation in Nigeria(2013-06) Morhason-Bello, I. O.; Adesina, O. A.; Adedokun, B. O.; Awolude, O.; Okolo, C. A.; Aimakhu, C. O.; Akinwunmi, B. O.; Oladokun, A.; Adewole, I. F.The objective of this study was to determine the knowledge and perception of Nigerian Obstetricians and Gynaecologists towards human papilloma virus vaccine use in Nigeria. A cross sectional study was conducted amongst participants that attended the 42nd Society of Gynaecology and Obstetrics of Nigeria. The findings revealed that 44.5% knew the correct HPV vaccine schedule. Regarding implementation in Nigeria, 87.4% suggested its incorporation into the national immunization program and about a third agreed that it should be a precondition for school enrolment. Regression analysis showed that senior residents were more likely to have adequate knowledge of the vaccine compared to junior residents (AOR 7.181 95% CI OR=1.792 – 28.782). We conclude that the knowledge of eligibility and schedule is poor. It is recommended that adequate information should be provided to this group of health workers because of their strategic position in its implementation in NigeriaItem The influence of health-seeking behavior on the incidence and perinatal outcome of umbilical cord prolapse in Nigeria(Dovepress, 2010-06-30) Enakpene, C. A.; Odukogbe, A. T.; Morhason-Bello, I. O.; Omigbodun, A.O.; Arowojolu, A. O.Objectives: To determine the influence of health-seeking behavior of urban women in South- West Nigeria on the incidence and perinatal outcome of umbilical cord prolapse (UCP). Methods: A retrospective study comparing two groups of urban women using information extracted from medical records of patients who had UCP, and were managed at the University College Hospital Ibadan, Nigeria from January1st 1995 to December 31st 2005. The data was analyzed using SPSS software (version 15). Analysis included simple tabulation, proportion and comparison of incidence, perinatal morbidity, and mortality of UCP between the two groups of women using Chi-square or Fisher’s exact test. Odds ratio (OR) and 95% confidence intervals (CI) were calculated whenever necessary. P-value of 0.05 or less was statistically significant. Results: Women without prenatal care were more likely to have fetuses with UCP (54, 75%), than in women who had prenatal care (18, 25%). The risk of perinatal death from UCP was higher in women without prenatal care, as compared with those who received prenatal care (OR 3.02, 95% CI: 0.879 to 10.356; P-value = 0.061). The risk of perinatal morbidity and neonatal intensive care admission was also higher among women without prenatal care as compared with women who received prenatal care (OR 4.09, 95% CI: 1.03 to 16.30; P-value = 0.041). The overall perinatal mortality rate in the study population was 403 per 1000 total births, and this was five times more than that of the hospital perinatal mortality rate of 80 per 1000 total births during the study period. The perinatal mortality rate was higher among women without prenatal care, 463 per 1000 total births, as compared with 222 per 1000 total births in women who received prenatal care. Perinatal death before arrival at the hospital is less likely to occur in women with prenatal care when compared with women without prenatal care (OR 0.0635; 95% CI: 0.0052 to 0.776; P-value = 0.03). Conclusion: A high index of suspicion and an identification of risk factors, with early diagnosis, prompt intervention, and provision of health care facilities can reduce the incidence and poor outcome of UCP in developing countriesItem Do women want disclosure of fetal gender during prenatal ultrasound scan?.(2010) Maaji, S. M.; Ekele, B. A.; Bello, S. O.; Morhason-Bello, I. O.Background/Objectives: It is possible that not all women would want the disclosure of fetal gender by the sinologist during a prenatal scan. The objectives of this study were to determine the proportion of women who do not want fetal gender disclosure at the time of prenatal ultrasonography and document their reasons. Method: A cross-sectional survey of women that were 20 weeks or more pregnant that had prenatal ultrasound at a private health facility in January 2006. The sonologist asked each of the women during the procedure whether they wanted to know fetal sex or not. Those that consented had disclosure of fetal sex while those that declined gave their reasons, which were documented. Results: Two hundred and one (201) women were studied within the study period. Most of the women (82%) were of the Hausa/Fulani ethnic group and were predominantly of the Islamic faith (90%). One hundred and ninety women (94.5%) consented to disclosure of fetal gender, while eleven (5.5%) declined. The main reason for not wanting to know fetal sex was: ‘Satisfied with any one that comes’. Conclusion: Most of the pregnant women (94%) would want disclosure of fetal gender at prenatal ultrasound scan. Only 5.5% of the women would not want fetal sex disclosure because they were satisfied with whichever that was there. It is advisable for the sonologist to be discrete on what to say during the procedure especially as it relates to fetal sex so as not to hurt those that do not want disclosureItem The role of ethnicity on pain perception in labour among parturients at the University College Hospital(2009-04) Olayemi, O.; Morhason-Bello, I. O.; Adedokun, B. O.; Ojengbede, O. A.Aims: In developing countries, the major mechanism by which parturients cope with labor pain is psychological. This study aims to assess the effect of ethnicity on the perception of pain by parturients in labor at the University College Hospital, Ibadan. Materials and Methods: The study was conducted between the 1 November 2006 and the 30 March 2007 at the University College Hospital Ibadan. The main outcome measure was pain perception assessed by the Box Numerical Scale (BNS). Univariate analysis was by t-test for continuous variables and c2 test for categorical variables. The multiple linear regression method was utilized for multivariate analysis. The level of statistical significance was set at P < 0.05. Results: The lowest adjusted mean BNS score was found in theYoruba ethnic group: they had scores lower than the mean scores for the other ethnic groups (-0.636 [95% confidence interval (CI) -0.959, -0.313]). The presence of a doula also reduced the mean BNS scores significantly (-0.533 [95% CI -0.844, -0.222]. Increasing parity also reduced pain scores (-0.182 [95% CI -0.342, -0.022]). Increasing educational attainment increased pain scores in labor (0.189 [95% CI 0.017, 0.361]). The influence of increasing age was not statistically significant in this model. In conclusion, ethnicity of the parturient relative to that of the predominant ethnicity in the place of birth has a significant effect on the perception of labor pain by the parturient. In our resource-challenged environment, trained doulas may help make labor less painful for the parturientItem Uncomplicated midvaginal vesico-vaginal fistula repair in Ibadan: a comparison of the abdominal and vaginal routes(2008-12) Morhason-Bello, I. O.; Ojengbede, O. A.; Adedokun, B. O.; Okunlola, M. A.; Oladokun, A.Background: Obstetric fistula is a resultant effect of prolonged obstructed labour. The best surgical management of simple uncomplicated fistula determines the outcome of care. Objective: To compare outcome of uncomplicated mid-vaginal fistula between vaginal and abdominal route of repair. Materials and Method: This was a hospital based retrospective study conducted at the University College Hospital, Ibadan from January, 2000 till December, 2006. Result: Of the 71 midvaginal fistulae managed, 40.8% had abdominal repair while the remainder were through vaginal approach. The overall repair success rate was 79.2% with comparable outcome in both groups-78.3% for the abdominal and 80% for the vaginal group (p=0.999). The duration of hospital stay did not differ significantly between the groups (p=0.972). Post operative complications were found in 41.4% of the abdominal group compared to none in the vaginal group (p<0.001). The complications were failed repair (20.7%) and urinary tract infection (20.7%). The mean estimated blood loss was 465.5ml in the abdominal group compared to 332.9ml for the vaginal group (p=0.303). Conclusion: Despite the comparable surgical repair outcome of the two methods, the vaginal approach is associated with lesser blood loss and lower risk of post-operative complications. It is recommended that the vaginal route should be employed in the repair of uncomplicated midvaginal fistula unless there are other compelling reasons to the contraryItem Contraceptive practice and commodity sources amongst female undergraduates in Ibadan, Southwest Nigeria(2008-09) Okunlola, M. A.; Morhason-Bello, I. O.; Adekunle, A O. .Objective: To determine the pattern of contraceptive use, and its sources among female undergraduates of the University of Ibadan. Methodology: A cross-sectional study design using self administered questionnaire. The study was conducted from November 2005 till March 2006. Results: The result of one thousand six hundred and thirty respondents were analysed out of 1800 interviewed. The commonest age group was 21-25years and about half were in their second and third undergraduate training year. They were mostly single, Christians and of the Yoruba ethnic group. Among those interviewed, 84% admitted to previous sexual activity. However, only a third had ever used any form of modern contraception. The commonest method of contraception ever used was male condom (82.0%) and the least was implantable contraception (1.4%). Other methods used included spermicides, oral contraceptive pills, and injectables. Of those that used contraception, 59.0% procured the service/commodity from pharmacy shops and patent medicine outlet. Other sources mentioned included; non-governmental organization private hospitals, and friends/relatives. Some did not indicate the source of procurement. Conclusion: The study revealed that students in Nigeria engage in risky sexual practices which may be detrimental to the future reproductive activities. Even those that claim to use contraceptives may not have been properly counseled prior to use. We recommend that safer sexual practices should be encouraged and some emphasis on abstinence. Advocacy on appropriate sources of contraceptives commodities should be pursuedItem Sexual behaviour of in-school adolescents in Ibadan, South-West Nigeria(2008) Morhason-Bello, I. O.; Oladokun, A.; Enakpene, C. A.; Fabamwo, A .O.; Obisesan, K.A.; Ojengbede, O. A.This study was a crossectional survey conducted among 716 senior secondary school adolescents in Ibadan from March to August 2005. The result of 695 that was analyzed revealed that the mean age of 15±2.6years. 28.3% of the respondents had previous sexual exposure with higher proportions being male (p=0.00043). Majorities’ first sexual exposure was unplanned. Family settings and educational level do not have significant influence on the previous sexual exposure. The methods of sexual activity were mainly through vagina route while some had also practiced oral and anal sex. Most of those that are sexually exposed had more than one partner. About half of the respondents learn about sex from their friends while others through their parents and media. We conclude that in-school adolescents practiced unsafe sexual activity and they are therefore predisposed to STI/HIV and other reproductive health risksItem Uterus bicornis unicollis; occurrence of consecutive viable pregnancies in separate horns(2007) Morhason-Bello, I. O.; Ojoko, I. E.; Owonikoko, K. M.; Olayemi, O.; Omigbodun, A.O.A case of two-consecutive viable pregnancies in separate horns of bicornuate unicollis uterus of a Nigerian is presented. The problem of misdiagnosis associated with the anomaly is noted. This case further demonstrates that women with such anomaly may not have unhindered reproductive carrier and antenatal care will improve their chanceItem Comparative evaluation of haemoglobin estimation amongst pregnant women in Ibadan: Hemocue – B Haemoglobin analyzer versus haemiglobincyanide (Standard) method as the gold standard(2008-08) Ojengbede, O.A.; Okonkwo, S. N.; Morhason-Bello, I. O.This was a comparative crossectional study that was conducted among 557 antenatal women at the University College Hospital, Ibadan, Nigeria between 1st April and 30th May 2006. The study compared the accuracy of haemoglobin estimation using an automated HemoCue B analyzer kit with a standard laboratory method (haemogloincyanide) as the gold standard. The result showed a positive correlation of HaemoCue haemoglobin results when compared with the standard methods (Pearson’s correlation coefficient = 0.892; p value = 0.000). We concluded that the use of the automated HemoCue kit for haemoglobin estimation gives an objective assessment which overcomes the challenge of extra skilled manpower or power outages in rural areas thereby enhancing access to quality of care in resource poor countries
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