FACULTY OF CLINICAL SCIENCES
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Item WHO Recommendations for the Prevention of Postpartum Haemorrhage(The WHO Reproductive Health Library, 2010) Fawole, B.; Awolude, O. A.; Adeniji, A. O.; Onafowokan, O.Item Endometriotic Ascites; a very rare presentation of pelvic endometriosis(Association of Resident Doctors, University College Hospital (UCH), Ibadan., 2019) Obajimi, G.; Awolude, O.A 30 year-old P0+1 lady who was referred to the gynaecology clinic on account of inability to conceive for 8 years duration and progressive abdominal distension of 2 years duration. She had a history of severe cyclical dysmenorrhoea warranting occasional hospitalization. An abdomino-pelvic ultrasound revealed marked intra-abdominal collection. The uterus and ovaries appeared normal. She subsequently had laparoscopy and drainage of 6 litres of endometriotic ascites. Both fallopian tubes were diseased. She was followed up on an out-patient basis with sub-cutaneous goserelin injections and referred for assisted reproduction.Item Perceived Barriers to Uptake of Cervical Cancer Screening Among Women of Childbearing Age in a Gynaecological Clinic(The International Institute for Science, Technology and Education, 2019) Amos, A. T.; Awolude, O. A.Introduction: Cervical cancer is an important reproductive health problem Tor women in the developing countries where it constitutes 13% of all female malignancies. It is the second most common cancer in women worldwide and 83 percent of the world’s 500,000 new cases and 85 percent of the 288,000 cervical cancer deaths occur in developing countries. Evidences show that women attending various health facilities were not routinely screened for cervical cancer. Gynaecological clinics present an important access to target group for cervical cancer screening. This study assessed the barriers to uptake of cervical cancer screening services among women attending a gynaecological clinic of a tertiary health i a tertiary health facility in South West region of Nigeria, the most populous black country of the world. Methodology Adopting a descriptive cross-sectional approach and Health Belief Model (HBM), women aged 15 49 years attending gynaecological clinic at the health institution were interviewed. The respondents were selected using systematic random sampling technique and interviewed using a specially designed structured questionnaire. Barrier to uptake of cervical cancer screening services was defined as significant when the number of the respondents in' the “agree” and “strongly agree” domains to the selected reasons for not screening for cervical cancer are at least 50%. Results Of the 100 respondents interviewed, 85 responses were found suitable for analysis. The mean age of the respondents was 33.3 (SD±8.6) years. Although a large proportion of the respondents (77.1%) were aware of cervical cancer, 95.2% with at least secondary education and 51.9% earning at least N50,000/month, only 23 (27.1%) had undergone the screening for cervical cancer. Age > 44 years and earning > N100,000/month were positively and significantly associated with uptake of cervical cancer screening. The significant reasons for not screening for cervical cancer by the respondents were Lack of information/counselling (77.4%), Lack of convenient clinic time (62.9%), Fear of having a positive result (61.3%), Lack of support from partners and significant others is a barrier (56.5%) and Attitude of health workers discourage women from assessing cervical cancer screening (51.6%) Conclusion It can be concluded from this this study that there is need for need for regular information on cervical screening at every opportunity for the populations that will benefit from this preventive service like women of reproductive age group attending our obstetric services. There is an urgent need for provision of more screening opportunities especially the type that will have population coverage and to leverage on other programmes like family planning services, post-natal clinic services and HIV/AIDS programmes. Screening services should be available in all secondary facilities and primary health care centres. Reminder/Recall services should be in place to ensure compliance with appointments in order to increase utilizationItem Acquired Clitoromegaly Cyst: Consequence of Persistent Unorthodox Practice in the 21st Century(Fortune Journals, 2019) Awolude, O. A.; Akinyotu, O.Objective: To present case report a patient with clitoral cyst, following type II female genital cutting performed in childhood, management and literature review. Design: Report of cases managed and review of available current literatures. Setting: University College Hospital Ibadan. Patients: The case was a 30 year old Para 2+0 , 2 alive, known hypertensive, with perineal swelling since childhood. She presented 30 years later with increasing size of the clitoral swelling associated with pain. Management: Surgical excision of the cyst following thorough evaluation of the patients. Results: Better cosmetic outcome, vulvar discomfort subsided and improved sexual satisfaction post-operatively. Conclusion: While a good cosmetic and stoppage of vulvar discomfort can be managed with acceptable outcomes, these case, again, brings to attention of persistence of unacceptable female genital cutting with attendant effects even in the 21st century. Also, to let us know that there is need for more and continuous awareness creation of the need to stop this dehumanizing practice, of female genital cutting, which is of no health importance, rather numerous adverse sequelae.Item Assessment of Infrastructural and Human Resource for Health Status and Readiness for HPV Vaccination in Rural Communities in Nigeria(Fortune Journals, 2019) Awolude, O. A.; Oyerinde, S. O.Introduction: Human papillomavirus vaccination remains an important primary preventive measure for cervical cancer. Its inclusion in preventive messages and service provision by first-line health care workers in low- and middle-income countries needs to be routine. However, there is paucity of data on willingness by health care workers (HCWs) working in rural communities, to counsel and/or provide service to beneficiaries of HPV vaccination programs. This study evaluated available facilities for cervical cancer prevention and willingness to vaccinate daughters for HPV by these HCWs. Materials and Methods: This was a descriptive, cross-sectional study among HCWs in all the primary and secondary health care facilities in the three local government areas of Ibarapa health zone of Oyo state, Nigeria. Descriptive statistics such as mean ± SD, frequency and proportion were used for socio-demographic data, awareness and willingness to vaccinate daughters by the study population. Results: We observed that despite good awareness about cervical cancer (79.1%), awareness about HPV vaccine (41.9%) and their availability in Nigeria (31.0%) were low. Also, the uptake of the vaccine was low (1.8%). However, the majority of the respondents (78.6%) were willing to vaccinate their daughters. This, we believe, can be leveraged on the opportunity of already existing structure for childhood immunization in 77.8% of the facilities where the respondents practise. Conclusion: It is important that narrowing of an existing gap between awareness of cervical cancer and practice of cervical cancer prevention should be initiated. Provision of more cervical cancer prevention educational programs and HPV vaccination opportunities will be key to achieving this.Item Convert Contraceptive use among women of reproductive age in Ibadan, Nigeria(Wolters Kluwer - Medknow, 2019) Awolude, O. A.; Olagunju, A. S.BACKGROUND: This study assessed the prevalence and determinants of covert contraceptive use among women of reproductive age in Ibadan, Nigeria. METHODS: A cross sectional study among women attending a family planning clinic in a maternity teaching hospital in Ibadan, Nigeria was conducted. Data was collected on sociodemographic characteristics, contraceptive use and partner awareness of use. The socio-demographic predictors of covert contraceptive use were explored using logistic regressions. RESULTS: Twenty-five (6.8%) of the 365 respondents were practicing covert contraception. Their mean age was 34.7+6.67 years, 98.6% were married and with modal parity of 3 (29.6%). A logistic regression analysis showed that participants' age (p = 0.555), occupation (p = 0.679), education (p = 0.642), parity (p = 0.385) and husbands' education (p = 0.926) were not statistically associated with covert contraceptive use while husbands' financial supports (p = 0.000) and approval for family planning use (p = 0.000) were associated with reduction in the likelihood covert contraceptive use. CONCLUSIONS: Covert contraceptive use exist among our women. Poor financial support and disapproval by the husbands were the strongest predictors of the practice. Greater male involvement in contraceptive service provision will help address these negative factors promoting covert contraceptive practices.Item Practice of Hot Abdominal Compression among Parturient Women at the University College Hospital, Ibadan, Nigeria(Association of Public Health Physicians of Nigeria (APHPN), 2019) Awolude, O. A.; Olagunju, A. S.; Agbana, R. D.Background: The postpartum period is an important period of excitement with the arrival of the newborn. The body then starts physiological adaptations to revert to the pregnancy states. These physiological adaptations can be associated with some cultural practices like hot abdominal compress (HAC) which may have harmful effects such as hot water burns, abdominal wrinkling and darkening. This study assessed the practice of HAC among mothers seen at the postnatal clinic of the University College Hospital (UCH), Ibadan, Nigeria. Methods: This was a cross-sectional study among 290 postpartum women recruited consecutively at the postnatal clinic in UCH between 1st December 2015 and 29th February 2016. Data collection was by pretested self-administered questionnaire and was analyzed using SPSS version 22.0. p value was set at < 0.05. Results: The participants’ mean age was 31.88 (SD+ 5.1 years), 97.2% of the women had ANC in formal setting and 53.8% had vaginal delivery. Of the 290 participants, 264 (91.0%) were aware of HAC and 51.7% practiced HAC. The return of uterus to normal size (34.7%) and mothers’ encouragements (24.7%) were the commonest reason for practice of HAC. Mothers’ and mothers-in-law’ assisted with HAC in 46.2% and 36.6% of cases, respectively. More vaginally-delivered women practiced HAC (p < 0.001). Conclusion: This study showed that practice of postpartum HAC is high and the reasons for the practice are more of tradition and cultural beliefs. There is need for more studies to better understand this culturally deep-rooted practice.Item Oral Melanotic Hyperpigmentation (OMH) among HIV Seropositive Patients: A Clinical Study at the University College Hospital, Ibadan(Nigerian Association of Oral and Maxillofacial Pathology and Medicine, 2017) Abe, E. O.; Adeyemi, B. F.; Adisa, A. O.; Okoje-Adesomoju, V. N.; Awolude, O. A.BACKGROUND: Oral melanin hyperpigmentation (OMH) has been classified as a HIV associated condition which may present as a brown-black macule or patch of the oral mucosa in HIV seropositive patients. HIV-OMH may be idiopathic, drug- induced or due to adrenal insufficiency. This cross-sectional study was conducted to determine the prevalence of HIV- OMH among HIV seropositive patients attending the Infectious Disease Institute centre, UCH Ibadan. METHODOLOGY: Consecutive, consenting HIV seropositive patients attending PEPFAR clinic, UCH, Ibadan were enrolled. Data collected included age, gender, duration since diagnosis of HIV and commencement of HAART, history of smoking, any systemic disease, WHO staging of HIV, CD4 count, presence of OMH and site affected. Data analysis was done using SPSS version 15. RESULTS: The study group of 150 HIV sero-positive patients comprised 24 males (16%) and 126 females (84%). Out of all the patients seen, OMH was seen in 97 of them, majority reported not being aware of the condition, some noted it before being diagnosed of HIV, while only 14(14.4%) reported the presence of OMH after being diagnosed with HIV and commencement of HAART (p= 0.032). Concerning the OMH sites, gingiva was most noted followed by tongue, palate, buccal and labial mucosa. CONCLUSION: The prevalence of HIV-OMH in this study was 14.4%. Gingiva was the most common site affected.Item Effect of Hepatitis C virus infection on selected laboratory values in pregnant women with Human Immunodeficiency virus infection(Society for Gastroenterology and Hepatology in Nigeria (SOGHIN), 2016) Adesina, O. A.; Akinyemi, J. O.; Michael, O. S.; Fayemiwo, S. A.; Awolude, O. A.; Ogunbosi, B. O.; Kuti, M. A.; Adewole, I. F.Background and Objectives: Both hepatitis C and Human Immunodeficiency viruses affect laboratory indices. The objective of this study was to describe the impact of both viruses on laboratory indices among 1,821 HIV-positive pregnant women. Methods: This was a cross-sectional retrospective study at the University College Hospital, Ibadan Results: Twenty-six (1.7%) women were HCV positive, 139 (8.8%) were HBsAg positive and 1, 407 (89.3%) were negative for both viruses. Three patients (0.19%) were positive for both viruses. These patients, the HBsAg positive women and 246 with no result for either virus were excluded from analysis. The HCV positive women had lower hematocrit (27.3% + 4.5 vs. 28.4% + 4.6, p=0.29), lower WBC (5, 200 vs. 5, 500 cells/ml, p =0.766) but higher platelet count (209, 000 vs. 199, 000 cells / ml, p = 0.019). The coinfected group had higher CD4 (380 vs. 326 cells/ml, p = 0.319), higher urea (16.0vs.ll.0mg/ml, p =0.013) but comparable ALT (16.0 vs.15.0 iu/ml, p = 0.95), log viral load (4.08+1.22 vs. 4.08+1.11, p=0.97) and creatinine levels (0.6vs.0.6, p=0.329). Only the difference in urea level was statistically significant. Conclusion: While values were comparable between both groups, the synergistic effect of both viruses makes it necessary for health-care providers to closely monitor patients.Item Integration of VIA Into Staff Medical Exercise as Prevention Strategy(Society of Gynaecology& Obstetrics of Nigeria (SOGON), 2011) Akinwunmi, B. O.; Awolude, O. A.; Adesina, O. A.; Akingbola, O. O.; Adewole, I. F.