Obstetrics. & Gynecology

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    Prevalence and associated risk factors of chlamydia trachomatis among gynecology clinic attendees in a tertiary institution in Ogun State, Nigeria.
    (2019) Ajani, T. A.; Elikwu, C. J.; Anaedobe, C. G.; Oluwasola, T. A. O.; Ajani, M. A.
    Chlamydia trachomatis is one of the most prevalent bacterial causing urogenital infections in men and women worldwide. There have been increasing reports of the prevalence of C. trachomatis in Nigeria. Aims: This study aimed to detect the prevalence of C. trachomatis seromarkers immunoglobulin G (IgG) and immunoglobulin A (IgA) and also to determine their associated risk factors among gynecology clinic attendees in the Babcock University Teaching Hospital, Ilishan Remo, Ogun State of Nigeria. Materials and Methods: This was a cross sectional study involving 145 consenting attendees of gynecology clinic of the hospital. Blood samples were collected and tested for =C. trachomatis IgG and IgA using the enzyme linked immunosorbent assay technique. Sociodemographic and sex behavioral factors were obtained by the interviewer based questionnaires, whereas statistical analysis was done using SPSS version 23. Results: Overall prevalence of combined IgG and IgA was 46 (31.7%). Among the infected, 30 (65.2%) were young women aged 15–25 years and majority, 109 (75%), had never used condom while 83 (57.2%) had only one sex partner in the preceding 3 months. Twenty three (15.9%) had a positive history of sexually transmitted infection (STIs), whereas 75 (51.7%) had ≥2 lifetime sex partners. Factors associated with the occurrence of both seromarkers on bivariate analysis included the previous history of STI and number of lifetime sex partners (P < 0.05), but with further analysis, only lifetime sex partners remained statistically significant (odds ratio = 5.63, confidence interval = 1.09–29.05, P = 0.007). Conclusion: There was a high prevalence of active, chronic, and persistent C. trachomatis infection with number of lifetime sex partner being a significant risk factor among our clinic attendees in Ogun State. Appropriate sex education should be encouraged among young people to reduce the burden of the infection and its attendant sequelae in our community.
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    Bayesian semi-parametric modeling of infertility in Nigeria.
    (2019) Onatunji, A. P.; Folorunsho, S. A.; Oluwasola, T. A. O.; Bamanga, M. A.; Folorunsho, M. A.
    Infertility in Nigeria is a neglected reproductive health issue despite its negative impact. Majority of infertility-related research has focused on treating the consequences of infertility rather than investigating the determinants to explain the spatial and spline effect of infertility in the country. This work is aimed at investigating spatial variation of determinants of infertility among female in Nigeria. The finding reveals that women at reproductive age have a high probability of infertility in some southern part of Nigeria as their ages are steadily increasing. Also, change in the characteristics of place of residence and source of water increase the chance of woman being infertile. Policy makers on health sectors should make effort to address problems of climatic and atmospheric change in the identified social and demographic risk factors.
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    Pattern of infertility at LAUTECH teaching hospital, Ogbomoso, Nigeria.
    (2019) Suleiman, B. K.; Bello, O. O.; Tijani, A. M.; Oluwasola, T. A. O.
    Background and Objectiver Infertility is a socially destabilising health problem, which remains a cause of stigma and threat to couples desirous of conception in Nigeria. This sludy aimed to ecxamine the pattern of presentation and management outcome of infertility at LAUTECH Teaching Hospital (LTH), Ogbomoso. Methods A descriptive retrospective study of infertile couples attending the gynaecological clinicovera 3-yearpe-riod was conducted. Intonation on sociodemographic and gynaccological characteristics, medical history and management outcome was obtained from the medical reconls of the patients using a stctured proforma Data was analysed using SPSS version 20.0. Results The incidence of infertility was 34.30ol The mean age of the infertile women was 6.44 4.7 ycars. Secondary infertility/ accounted for the majority of the cases (73.0") with the_ mean duration of infertility being3,92 1 years. Male factor was identified in 10.4 of cases while female factor wasscen in 4L6"ot cases Both partners contributed to infertility in 34% while there was no identifiable cause in 14%. The commonest causes of infertility in the women were inadequate coital exposure, previous abnormal vaginal discharge and previous induced abortion representing 39.5%, 37.1%, and 33.7% respectively. Pregnancy was achieved in 3.0% of the women following treatment Conclusion The institutional incidence of infertility was high with a preponderance of secondary infertility. Pregnancy rate following conventional treatment was poor
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    Awareness and attitude of female undergraduates of University of Ibadan towards human papilloma virus (HPV) and its vaccine.
    (2019) Oluwasola, T.A.O.
    Background: Struma ovarii—an uncommon type of benign germ-cell tumor of the ovary—is mainly composed of thyroid tissue. The presence of ascites has been reported in*20% of all cases, while a combination of struma ovarii and elevated serum levels of cancer antigen (CA)–125 has been rarely reported. Case: A 57-year-old postmenopausal woman presented with a complex pelvic mass associated with ascites and marked elevation of serum CA-125. The clinical impression was ovarian malignancy and she was worked up for staging laparotomy. During surgery, she had total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy following significant intraoperative findings of 7600mL of straw-colored ascitic fluid and a right ovarian mass (with both cystic and solid components) measuring 10 cm • 12 cm • 12 cm. A final diagnosis of struma ovarii was made histologically. Results: There was an immediate resolution of the ascites and associated normalization of the patient’s serum CA-125 level following surgical excision of the pelvic mass. At a 6-month follow-up, she remained free of ascites or tumor recurrence while her laboratory and clinical parameters have also remained normal. Conclusions: Clinically, struma ovarii can mimic ovarian malignancy, especially when presented as a complex mass with associated ascites and a high serum CA-125 level. This should be considered when evaluating ovarian masses. ( J GYNECOL SURG 35:38)
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    Ensuring health security for Nigerians by 2050: Closing equity gaps in reproductive health.
    (2019) Adebayo A. M.; Oluwasola T. A. O.; Oluwasanu, M. M.; Fawole, A. O.
    Background: Reproductive health is a key foundation for strategies to address health security. It constitutes a vital element in the vision to achieve improved health, quality of life and well-being of individuals and families and the realisation of national economic goals. Developing a blue print for health security in reproductive health matters may contribute to closing the equity gaps in Nigeria by the year 2050. Methods: Gaps in reproductive health were identified through situation analysis of selected reproductive health indices. SWOT analysis was also conducted to outline areas of strengths and opportunities, in addition to weaknesses and threats. Key reproductive health indicators were forecasted for 2050. Results: Despite all efforts, gaps still exist in the country’s reproductive health indices including maternal, perinatal, contraceptive, abortion and gynaecological. Most pregnancy-related deaths are linked largely to preventable causes. If unaddressed, these challenges would undermine gains from previous interventions and responses from governmental and non-governmental organizations and pose serious threats to the nation’s health security. Conclusions: The country must be committed to reproductive health agenda that is focused on the International Conference on Population and Development goal in its bid to achieve health security by the year 2050. Due considerations must be accorded to emerging reproductive health issues like men’s reproductive health and their involvement in their partners’ reproductive health, and the reproductive health needs of the aged, people with disabilities and those in humanitarian settings. Further in achieving health security for Nigerians by the year 2050, the principles underlying the reproductive health policy of the country must be upheld. These include equity, right based approach, gender and age responsiveness, cultural sensitivity and continuum of care amongst others.
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    Polymerase chain reaction versus enzyme-linked immunosorbent assay in detection of Chlamydia trachomatis infection among gynaecological patients in southwestern Nigeria.
    (2018) Ajani, T. A. O.; Anaedobe, C. G.; Ajani, M. A.; Fayemiwo, S. A.; Bakare, R. A.
    Background: Chlamydia trachomatis (C. trachomatis), is the most common bacterial Sexually Transmitted Infection, a major cause of Pelvic Inflammatory Disease and female infertility. Since C. trachomatis infections are frequently asymptomatic with higher prevalence in developing countries, highly sensitive and affordable methods are desirable for routine screening and diagnosis. This study aimed to evaluate the performance of C. trachomatis-specific IgG antibody by ELISA as a screening tool for C. trachomatis infection, by comparing the performance of ELISA with the gold standard Polymerase Chain Reaction( PCR). Method: In this cross sectional study, we enrolled 150 women attending infertility clinic at Ibadan between January and November, 2015. ELISA for detection of IgG antibodies specific to C. trachomatis major outer membrane protein (MOMP) was performed on the blood samples using third generation indirect Enzyme Linked Immunosorbent Assay (ELISA) and endocervical samples were analyzed for presence of C. trachomatis nucleic acid using PCR. Socio demographic bio-data and gynaecological history were obtained with questionnaire; data was analyzed using SPSS version 20.0. Results: Overall, 58 (38.7%) were positive for C. trachomatis specific IgG antibody by ELISA and 11 (7.3%) for C. trachomatis nucleic acid by PCR. Using PCR as the gold standard, ELISA had a sensitivity of 81.8% specificity of 64.8%, positive predictive value of 15.5% negative predictive value of 97.8% and accuracy of 66%. Conclusion: The high sensitivity of the ELISA indicates that over 80% of patients identified as being positive in the screened population are truly infected. Also, the negative predictive value approaches 100% amongst those screened out as being negative. Thus its use as a screening tool for C. trachomatis infection is warranted particularly in developing countries where cheaper and easier to use alternatives to PCR are in dire need.
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    Soil transmitted helminthes infection among pregnant women in peri-urban areas of Ibadan, Nigeria: A cross-sectional study
    (2018) Umezurike, C. E.; Adeoye, I. A.; Oluwatoba, O. A.; Oluwasola, T. A. O.
    "Background: Soil Transmitted Helminthes (STH) infection is an important public health problem in developing countries which adversely affects pregnant women and their newborn infants. The epidemiology of STH among pregnant women has not been fully explored in Nigeria. We examined the prevalence, intensity and risk factors of STH among antenatal care attendees in Ibadan. Methods: A cross sectional facility-based study was conducted among the 326 pregnant women attending antenatal care clinics in six selected Primary Health Care centers, in the peri-urban areas of Ibadan Oyo State. An interviewer administered questionnaire was used to obtain information on the socio-demographic, maternal, environmental characteristics and hygiene practices. Kato-Katz method was used to identify the presence of STH from stool samples. Data were analysed using chi-square and bivariate logistic analysis. Results: The overall prevalence of STH was 13.8%, 95% CI (10.0–17.7). Ascaris lumbricoides 12.8%, 95% CI (9.5–16.9) was the most prevalent followed by hookworm infection 0.6%, 95% CI (−0.2–0.15) and Trichuris trichiura 0.3%, 95% CI (−0.2–0.9). Majority of the infection were of light intensity (44 out of 45). Walking bare footed in the home environment increased the likelihood of being infected with STH [OR 1.93 95% CI (1.01–3.72) p=0.048] compared with women who wore shoes. Conclusion: STH infection is prevalent among pregnant women in the peri-urban region of Ibadan. Therefore public health interventions like active surveillance of STH and the prescription of deworming drugs will be beneficial for pregnant women. "
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    Knowledge of ovarian cancer in Ibadan: community-based assessment women aged 15 years and above
    (2014) Odukogbe, A.A.; Oluwasola, T.A.O.; Onebunne, C.; Lawal, A.H.|; Adebiyi, A.O.; Group E2014
    "Background: Non communicable diseases are increasing in proportion in developing countries. Ovarian cancer has the highest case fatality rate among gynecological cancers but forms only 3%. Its etiology is unknown, and no cost‑effective screening program exists due to the absence of well‑defined precursor lesions. Early symptoms are vague but can be used to detect Stages I and II diseases. Documented knowledge or awareness of ovarian cancer varies between 4.4% and 15%. However, this is the first community‑based survey in Africa to determine knowledge of ovarian cancer by females. Materials and Methods: The questionnaire was semi‑structured and interviewer administered. Females aged 15 years and above were selected through a four‑stage process involving urban/semi‑urban settings, local government areas, wards, and units. We randomly selected 424 participants, equally distributed between urban and semi‑urban areas. Bivariate and linear regression analyses were done. Results: Most (83.5%) of the respondents were <40 years, married (56.1%), had secondary education (52.4%), Yoruba (92.5%), and Christian (56.1%). With good knowledge score taken as having at least 70% of required information, about 2.8% of respondents had good knowledge of ovarian cancer. Only level of education and occupation significantly affected knowledge of ovarian cancer. Conclusion: There is very poor knowledge about ovarian cancer, its risk factors, symptoms, treatment, and prognosis among females in Ibadan, strongly affected by education and occupation."
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    Challenges of gynaecological cancer care in Nigeria – A review article.
    (2018) Oluwasola, T. A. O.; Oladewa, A. C.
    "Background: Gynaecological cancers and their management in the tropics constitute a big challenge to the gynaecological oncologist considering the overwhelming economic burden of care on patients and their relatives. These challenges arc numerous and present at different levels vis-a-vis of prevention, diagnosis, treatment of the disease and patients’ follow up. The main thrust of this review was to illustrate the challenges affecting gynaecological cancer care in Nigeria and proffer potential opportunities for their early identification while making recommendations that may be beneficial in ameliorating their effects and impacts. Methodology: Electronic search of local and international literatures was conducted in major databases including PubMed, Web of Science, Science direct, EMBASE, SpringerLink, Scopus, JSTOR, JaypccDigital, and Google Scholar using appropriate MESH terms either individually or in combination. All relevant peer-reviewed article and publications were identified, retrieved and reviewed. Results: Challenges of management of gynaecological cancers are enormous and diverse. They vary at different levels of care and included poverty, lack of access to health care inadequate or absence of basic infrastructure for cancer care and lack of political will. Delay at different levels of care leading to late presentation remains a leading factor that negatively contributes to survival. Conclusion: Gynaecological cancer care in the tropics is a big challenge to health care providers. Efforts should be intensified in prompt identification of these challenges and offering solutions that will help in improving the health of our women. "
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    Bilateral ovarian serous cystadenocarcinoma in a teenager: a case report.
    (2019) Ajani, T. A.; Oluwasola, T. A. O.; Anaedobe, C. G.; Ajani, M. A.; Fayemiwo, S. A.; Bakare, R. A.
    Epithelial ovarian cancers are uncommon among young girls and teenagers compared to germ cell tumors. We report a case of bilateral ovarian serous cystadenocarcinoma in a teenage girl with the attendant challenges of diagnosis, management and follow up. HT, 19 year old had presented at a secondary care level with features suggestive of benign ovarian tumor and had ovariectomy done. However, histology report revealed a malignant epithelial cancer, necessitating a repeat exploration. She was found to have surgical stage 3c disease and subsequently has total abdominal hysterectomy with bilateral salpingectomies, right oophorectomy and omentectomy. She was further managed with paclitaxel-carboplatin combination chemotherapy but defaulted after the 3rd cycle on account of financial constraints. She succumbed to the disease 11 months post diagnosis. Though uncommon, detailed evaluation of teenage patients for malignant ovarian cancer is expedient. The financial burden of cancer care in our environment is also highlighted.