Open Access Short Research Article

Assessment of a Dazel-Kit (Fluconazole 150 mg, Azithromycin 1 gm, Secnidazole 1 g Two Tablets) for Syndromic Management of Abnormal Vaginal Discharge in Women of Kazakhstan

Saurav Deka, Siddhesh Sharma, Neelesh Katakwar, Umesh Kunte

International Journal of Research and Reports in Gynaecology, Page 1-7

Objective: Present study aimed to assess the effectiveness and safety of Dazel kit (fluconazole 150 mg, azithromycin 1 gm, secnidazole 1 g two tablets) among patients with vaginal infections.

Materials and Methods: In this observational study, 705 clinically diagnosed patients with abnormal vaginal discharge were enrolled in four different cities of Kazakhstan. Clinical features, treatment given, improvement in symptoms and adverse events were noted. Improvement in clinical features with Dazel kit was rated on a 4-point scale; 1=no effect; 2=somewhat effective; 3=effective; 4= highly effective.

Results: Abnormal vaginal discharge was the most common symptom (91.5%), followed by itching (88.2%) and lower abdominal pain (59.6%). For all patients, Dazel kit was recommended, whereas in 617 patients (87.5%), it was recommended for their partner(s) too. In 90 patients (12.8%) only Dazel kit was recommended alone whereas, in 615 patients (87.23%), vaginal treatment was recommended in addition to Dazel kit. In 99.2% patients with abnormal vaginal discharge and vaginal itching, treatment was effective or highly effective. For the control of dyspareunia, lower abdominal pain and burning sensation with urination, treatment was found to be effective or highly effective in 64.3%, 98.7% and 95.4% patients, respectively. No significant difference was observed in the “highly effective” and “effective” response for any of the symptoms between treatment only to the female patient and treatment to patient and her partner(s) [abnormal vaginal discharge (p= 0.755), vaginal itching (p= 0.512), dyspareunia (p0.791), lower abdominal pain (p= 0.964) or burning sensation (Pp= 0.804)].

Conclusion: Dazel kit was found to be effective in the treatment of vaginal symptoms in majority of the patients without significant adverse events.

Open Access Original Research Article

Predictors of Delivery at the Expected Date of Confinement among Women in Yenagoa, Southern Nigeria

Ikobho Ebenezer Howells, Addah Abednigo

International Journal of Research and Reports in Gynaecology, Page 1-8

Background: The expected date of confinement is calculated using Naegle’s rule that is 280 days or 40 weeks of gestation, but it is observed that most women tend to deliver between 38 and 42 weeks. Unfortunately, only a few women deliver exactly on the expected date of confinement, the reason remains mostly unknown.

Objective: The objective of this study is to determine the percentage of women in Yenagoa that can deliver on their expected date of confinement, using the Niger Delta University Teaching Hospital as a case study. It would also determine whether maternal age, parity, tribe, body mass index, birth weight and fetal sex have a significant influence on the date of delivery.

Materials and Methods: A retrospective observational study of 3,420 pregnant women who were admitted in labour, and delivered at term in the delivery suite of the department of obstetrics and gynaecology, Niger Delta University Teaching Hospital, in Southern Nigeria. The study was carried out from 1st January 2009 to 31st December 2012. A total of 2380 booked parturients living in Yenagoa, whose last regular menstrual period was documented in their case notes, including those who had an early first-trimester ultrasound scan, were selected. Data concerning their expected dates of confinement and the actual dates of delivery were retrieved. Also retrieved were maternal age, parity, tribe, birth weight, and fetal sex. Others include maternal height and weight at booking; these were used to calculate the body mass index. The data was analyzed after that.

Results: Majority of the women in Yenagoa 85.0% delivered at term, and only a handful 7.4% delivered on the expected date of confinement. Delivery on this date was associated with low body mass index, (BMI of 18.5 kg/m2) and male babies p = 0.006. Nulliparous women were twice more likely to deliver on the EDC than multiparas, Odds Ratio = 2.44, P = 0.002, and women with average maternal age of 25-29 years were 4 times more likely to deliver on the EDC than women ≥ 35 years, Odds Ratio = 4.93, p =0.0003.  Women from Yoruba living in Yenagoa delivered more on the EDC than any other tribe in Nigeria.

Conclusion: From our study, biological variables of the would-be mother and ethnicity stand out as some of the best predictors of delivery on the date of confinement among women living in Yenagoa, Southern Nigeria.

Open Access Original Research Article

Retracted: Morpho-functional Changes in Reproductive Status of Female Wistar Rats Fed with Cissus aralioides Aqueous Extract

A. A. Aigbiremolen, E. Y. Ihegihu, O. A. Udi

International Journal of Research and Reports in Gynaecology, Page 1-9

This paper was retracted.

Retraction Notice: This paper has been retracted from the journal after receipt of written complains. This journal is determined to promote integrity in research publication. This retraction is in spirit of the same. After formal procedures editor(s) and publisher have retracted this paper on 01st August 2019. Related policy is available here: http://goo.gl/lI77Nn

Open Access Original Research Article

Healthcare Workers Knowledge and Attitude towards Prevention of Obstetric Fistula

Oluwasomidoyin Olukemi Bello, Olatunji O. Lawal

International Journal of Research and Reports in Gynaecology, Page 1-9

Background: Obstetric fistula (OF) is a preventable devastating condition mostly caused by prolonged obstructed labour and the healthcare workers (HCWs) plays a key role in its prevention.

Objective: To determine the knowledge and attitude of HCWs towards OF prevention at all levels of health care facilities in Ibadan, Nigeria.

Methods: This was a facility based cross-sectional study among 171 HCWs providing obstetric care in the primary, secondary and tertiary health centres. A self-administered questionnaire was used to gather information on their knowledge and attitude towards prevention of OF. Data was analysed using SPSS 20.0 with a level of statistical significance set at p <0.05 and 95% confidence interval. The main outcome was the HCWs level of knowledge and attitude towards OF prevention. The association between HCWs knowledge and attitude and their socio-demographics and professional characteristics were also identified using logistic regression.

Results: Mean age of respondents' was 36.5 (SD= 9.3 years). Higher proportion (42.7%) of the HCWs are practising at tertiary health centre with more than one third (36.3%) of the HCWs' practising for more than 10 years. Very few 13.5% of the respondents had good knowledge of OF prevention while 91.2% of them had a positive attitude towards OF prevention. Sex, cadre, educational status and health facility of practice were found to be significantly associated with the HCWs knowledge of OF prevention (p<0.05). HCWs with MBBS/FWACS/FMCOG educational status were about four times more likely to have good knowledge of OF prevention compared to those with other educational status (OR=3.970, 95% CI=1.050-15.004).

Conclusion: Although, the HCWs studied have poor knowledge, they showed a positive attitude towards OF prevention with their educational status as an assessor of their good knowledge of the condition. Both good knowledge and positive attitude of HCWs are vital to OF prevention.

Open Access Original Research Article

Utilization and Factors Associated with Uptake of Prevention of Mother- To - Child Transmission (PMTCT) of HIV Services among Antenatal Clinic Attendees at a Tertiary Health Facility in Akure, Ondo State

Theresa Azonima Irinyenikan

International Journal of Research and Reports in Gynaecology, Page 1-9

Background: Prevention of mother-to-child transmission of HIV (PMTCT) programmes provide antiretroviral treatment to HIV-positive pregnant women to reduce the likelihood of their infants acquiring the HIV. However despite concerted efforts to scale-up PMTCT services in Nigeria, the coverage and uptake of the service by pregnant women remain low.  

Aim/Objective: This study was carried out to assess the utilization and factors associated with the uptake of PMTCT Services among pregnant women at a tertiary health facility in Akure, Ondo State.

Methodology: This research was an institutional based descriptive cross-sectional study conducted over a period of one month (May 2018). The study population included pregnant women accessing antenatal care at the University of Medical Sciences Teaching Hospital, Akure, Ondo State. Data was collected using interviewer administered questionnaire and analyzed using SPSS Windows 20.The main outcome measured was the utilization of PMTCT services. Factors associated with its utilization was assessed using binary logistic regression. Statistical significance was set at P<0.05.

Results: A total of 400 pregnant women were interviewed with 100% response rate. The mean age of the women was 32years ± 4.8.The majority of them with their spouses were educated up to the tertiary level. Their mean gestational age was 28weeks±2.2 standard deviation. Among the respondents, 252 (63.2%) had been tested for HIV in the index pregnancy while 148 (36.8%) were not yet tested, those not tested identified lack of counsellors as their main reason. The average time spent before the patients were seen at the clinic  was reported to be too long in 287 (71.7%), so 368 (92.5%) of the women were not satisfied with the service. Factors found to be positively associated with PMTCT utilization were the educational level of the women and their partners which could be in favour of their utilizing PMTCT services and inadequate counsellors which may not be in favour of utilization of the service.

Conclusion: All the respondents did not utilize the PMTCT services in the index pregnancy and the main reason being inadequate number of counsellors. There is the need to improve the quality of PMTCT services in the study setting.

Open Access Original Research Article

Endometriosis: A Clinicopathological Study

E. Innocent, A. Ochigbo, P. O. Akpa, D. Yakubu, Y. E. Nyam

International Journal of Research and Reports in Gynaecology, Page 1-7

Background: Endometriosis is defined by the presence of endometrial like glands and stroma without the endometrium and myometrium. It is an estrogen dependent condition and affects 6-10% of females commonly during their reproductive age. Theories have evolved to explain the mechanism of development of this disease whose etiology is largely unknown. It affects a wide range of organs and could present with symptoms.

Aims: The aim of this study is to document the pattern of endometriosis at the Jos University Teaching Hospital in relationship to patient’s age, anatomical distribution of lesion, and symptoms (especially infertility).

Study Design: This is a hospital based retrospective and descriptive study. The major grouping for data were age, site, and symptoms.

Place and Duration of Study: Department of Histopathology, Jos University Teaching Hospital, Jos, Plateau State in North-Central Nigeria between 1st August 2007, and 31st August 2017

Materials and Methods: We reviewed all consecutive cases of endometriosis histopathologically diagnosed at the Histopathology Department of the Jos University Teaching Hospital, Jos, between 1st August 2007, and 31st August 2017. Corresponding patient data such as age, sex, symptoms, and anatomical site of lesion were obtained from case files and surgical pathology records and analyzed. Archived slides and re-cut slides from tissue blocks were reviewed.

Results: Thirty-two (32) cases of endometriosis were diagnosed at the Jos University Teaching Hospital during the study period. The age range was 25-58 years and the mean was 38.0 +8.8 years. The ovary recorded 8 cases accounting for 25% of cases, being the commonest anatomical site involved. Thirteen (40.6%) affected women were infertile.

Conclusion: Endometriosis in our locality is more frequently located in the ovary and a relatively high percentage of this disease is associated with infertility. We recommend that endometriosis be considered in the management of patients with ovarian disease and infertility in our locality.

 

Open Access Case Report

Massive Collision Tumour of the Ovary: A Rare Case of Mature Teratoma and Serous Papillary Cystadenoma

Nkencho Osegi, Zakaa Zawua, Helen Toluhi, Kanayo Michael Mbah, Stephen Musa, Stanley Zikeyi Ogoinja

International Journal of Research and Reports in Gynaecology, Page 1-5

Aims: Collision tumours of the ovary are rare. A pre-surgery diagnosis is possible when there is a high index of suspicion during patient evaluation. This case report highlights the need for this clinical care, evaluation and treatment.

Presentation of Case: A 51 year old Para 7 lady presented at two years post-menopausal with a massively distended abdomen of 4 years duration. A diagnosis of ovarian tumour (likely benign) was made. She subsequently had exploratory laparotomy, total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological assessment revealed a benign collision tumour of the ovary.

Discussion and Conclusion: The case presented had a histological diagnosis of both a mature teratoma and a serous papillary cystadenoma. These are both benign ovarian tumours (germ cell tumour and epithelial cell ovarian tumour respectively). The occurrence of two primary neoplasms in the same organ is called a collision tumour. The clinical presentation and pre surgery investigations were not helpful in making a clinical diagnosis of an ovarian collision tumour. Making a clinical preliminary diagnosis of an ovarian tumour from history and examination is usually difficult. Medical imaging is therefore a valuable key, as it provides not only the origin of the tumour but also gives a probable picture of the histological type. Collision tumours are very rare, but having a high index of suspicion is important as making the right preliminary histologic diagnosis could affect the prognosis and management plan.