FACULTY OF CLINICAL SCIENCES
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Item 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 Discontinuation pattern of norplant among implant acceptors at the family planning clinic, University College Hospital, Ibadan, Nigeria(2006) Okunlola, M. A.; Owonikoko, K.M; Adekunle, A O. .; Morhason-Bello, I. O.This is a retrospective study of 136 Norplant acceptors. We assessed the reasons for the discontinuation during the prescribed 5-year period of use. The continuation rates for the first, second and third years were 94.1%, 83.8%, and 79.4% respectively. The commonest reason for discontinuation was menstrual irregularities (40.43%) of clients followed by the desire for pregnancy in 29.79%. Contraceptive failure as a reason for discontinuation of Norplant use was not recorded in any of the clients in this series. In conclusion, ii is our belief that to sustain high continuation rates of Norplant use the clients require proper and effective counselling and support on the side effects of irregular bleeding patterns, which when occurs will be better coped withItem Female condom awareness, use and concerns among Nigerian female undergraduates(Taylor & Francis, 2006) Okunlola, M. A.; Morhason-Bello, I.O.; Owonikoko, K. M.; Adekunle, A. O.A cross-sectional study of female condom awareness, usage and concerns among the female undergraduates of the University of Ibadan was conducted in September 2004. The results of 850 out of the 879 female students interviewed were used for analysis (96.6%). Over 80% had knowledge of the female condom as a form of modern contraception and the majority of them learnt about it through the mass media (39.9%) and health workers (34.4%). However, only 11.3% had ever used the female condom, with most (40%) using it to prevent both unwanted pregnancy and sexually transmitted infections including HIV (STI/HIV). The sexual partners’ approval was appreciable, accounting for about 42.7% among those that had experience of the female condom usage. Major concerns mentioned such as difficulty of inserting it into the vagina and lack of sexual satisfaction, were not different from those in earlier studies. The result of this study looks promising judging from a high awareness level of the female condom, even though its usage is low. The female condom may be an alternative strategy to combat unsafe sexual practises and its sequelae in a country like Nigeria that is male dominatedItem Assessment of tubal factor contribution to female infertility in a low resource setting (southwest Nigeria): hysterosalpingography vs laparoscopy(2005) Okunlola, M. A.; Adebayo, O. J.; Odukogbe, A. A.; Morhason-Bello, I. O.; Owonikoko, K. M.Item Repair of spontaneous perineal laceration at delivery, a cultural taboo: a case report(Association of Resident Doctors, University College Hospital, Ibadan, Nigeria, 2006-12) Morhason-Bello, I. O.; Adesina, O. A.; Okunlola, M. A.; Oladokun, A.; Onibokun, A. A.; Ojengbede, O. A.Although genital trauma is a recognized maternal complication of vaginal birth, the presence of skilled birth attendants at delivery and judicious use of episiotomy has been shown to reduce this risk to the barest minimum. Prompt repair of these traumas averts the resultant complications that may arise. A case of a booked 18-year-old nulliparous Guinea-Conakry woman with a second-degree perineal tear who declined repair due to a cultural reason is presented. The need for supervised delivery as well as immediate and long-term health implications of her decision is discussed.Item Repeat ipsilateral ectopic gestation: a series of 3 cases(College of Medicine, University of Ibadan, Ibadan, 2006) Okunlola, M. A.; Adesina, O. A.; Adekunle, A. O.Ectopic pregnancy remains an important cause of maternal mortality and morbidity as well as early foetal wastage in Nigeria and in other developing countries. We report 3 different cases of repeat ipsilateral ectopic pregnancy seen in the gynaecological emergency unit of the University College Hospital, Ibadan. Cases of repeat ectopic pregnancy often gives rise to diagnostic dilemma, and this becomes more difficult when it occurs at an ipsilateral location.Item Awareness and use of emergency contraceptive methods among Intern medical doctors at Ibadan(IJEJAS Ventures, Printers and Publishers, 2008) Morhason-Bello, I. O.; Adesina, O. A.; Ifemeje, A. A.; Okunlola, M. A.; Adedokun, B. O.; Abdu-Salam, R. A.; Adekunle, A. O.