Attitude and knowledge of women between 45 and 65 years on menopause syndrome at the university college hospital, Ibadan, Nigeria

This research was designed to find out the attitude and knowledge of women between 45 and 65 years on menopause syndrome and its management. The study was conducted in University College Hospital located in Ibadan North Local Government of Oyo state. A self-designed forced-choice questionnaire was distributed to 100 women using random sampling technique. Furthermore, our study showed that most women view the onset of menopause positively and that few seek treatment. They report relatively low prevalence of menopausal symptoms, with the most significant being irregular menstrual cycles and increased blood pressure and urinary tract infections. Furthermore, our study revealed that 41% of the participants had no idea why their menstrual period stopped, while why 60% of the women had no idea what could be done to reduce menopausal symptoms. This study reveals a low level of awareness about menopausal syndrome and more should be done. (Afr J Reprod Health 2022; 26[5]: 57-62).

Ultrasonic evaluation of median nerve before and after carpal tunnel decompression

Background: Carpal tunnel syndrome (CTS) is the most frequent peripheral compression neuropathy of the median nerve in the wrist. High-definition ultrasonography can detect and follow up any postoperative complications causing persistent complaint or poor result like hematoma, scarring, nerve damage or incomplete cutting of retinaculum. The aim of the study was to evaluate effect of surgical decompression on cross sectional area (CSA) of median nerve in patients with carpal tunnel syndrome and examine the role of ultrasound as a follow up tool. Methods: The prospective observational study was done on 20 patients with CTS referred for peripheral neurosurgery. All patients were subjected to full history taking, complete general medical examination, electromyelography (EMG), high-definition ultrasonography including cross-sectional area before and after surgical decompression (open fashion or endoscopically). Results: Using EMG, there is statistically significant decrease in distal motor latency (DML) while there is significant improvement in amplitude following surgical decompression (p<0.001). On using US, there is statistically significant increase in anteroposterior diameter (APD) wrist and decrease in CSA at wrist. There is significant negative correlation between preoperative DML and APD at wrist. There is significantly negative correlated with postoperative DML and pre and postoperative APD at wrist. On the other hand, there is significantly positive correlation with postoperative DML and pre CSA. Conclusions: There is a decrease in size of the median nerve after surgical decompression denoting that the preoperative increase in median nerve CSA at the carpal tunnel is partially reversible. Ultrasonographic parameters correlated with EMG ones so it can be used as an alternative tool for postoperative follow up

Aspects cliniques et évolutifs de la thrombopénie au service de Réani- mation Chirurgicale du Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo

Introduction : La découverte d'une thrombopénie en réanimation est une situation fréquente et la prise en charge est lourde. L'objectif de cette étude était d'évaluer les aspects cliniques et évolutifs de la thrombopénie dans un service de Réanimation Chirurgicale d'Antananarivo. Matériels et Méthodes : C'est une étude rétrospective, descriptive sur une période de 36 mois, réalisée au service de Réanimation Chirurgicale du Centre Hospi¬talier Universitaire Joseph Ravoahangy Andrianavalona Antananarivo, Madagascar, incluant les patients ayant présenté une thrombopénie à l'ad-mission. Nous avons analysé les caractères démographiques, les motifs d'admission, le taux de plaquettes à l'entrée et 72h après l'admission, le mécanisme et l'évolution des patients. Les données ont été saisies et analysées avec le logiciel Epi-Info 7.0. Résultats : Durant cette période, 386 patients sur 7021 admis ont présenté une thrombopénie soit 5,5% des patients. L'âge moyen était de 47,6±17,3 ans avec une prédominance mascu¬line (sex ratio de 2,1). Le taux moyen de plaquettes à l'admission était à 95,1±36,9 G/L. Le motif d'admission était dominé par le syndrome hémor¬ragique (46,1%) dont la majorité était une hémorragie digestive (88% des cas). Concernant le mécanisme, 84,1% ont été d'origine périphérique suite à un syndrome hémorragique et un hypersplénisme ; 5,2% étaient considérées comme d'origine centrale secondaire à des toxiques et une hémopa¬thie maligne et dans 10,7% des cas, l'origine était non identifiée. Le taux de mortalité était de 34,5% suite à un syndrome hémorragique et des dé¬faillances d'organes. La prise en charge est surtout faite de transfusion par du sang total frais ou du plasma riche en plaquettes à défaut de concentré de plaquettes, et de corticothérapie. Conclusion : La présence d'une thrombopénie en réanimation témoigne toujours la gravité d'une maladie. L'origine de la thrombopénie n'est pas toujours évidente mais sa connaissance détermine la suite de la prise en charge

The demographic and clinical profiles of women presenting with vaginal discharge syndrome at primary care facilities in South Africa: Associations with age and implications for management

Background. Current South African guidelines for the management of vaginal discharge syndrome (VDS) do not recommend treatment for sexually transmitted infection (STI) pathogens for women aged ≥35 years whose partners do not have male urethritis syndrome. The guideline assumes that older women are unlikely to have an STI and that their partners do not have asymptomatic infections.Objectives. To describe the demographic, behavioural and clinical characteristics of women with VDS, comparing older women (≥35 years) with younger women, and to determine the performance of age alone as a criterion for predicting the presence of STI.Methods. This was a cross-sectional study at seven primary healthcare centres taking part in the aetiological surveillance of STIs between January 2015 and December 2016. Eligible women presenting with VDS were enrolled and completed a nurse-administered questionnaire. Genital swabs and blood specimens were collected for laboratory testing. Data were entered into surveillance-specific databases and exported into Stata 14 for analysis. Descriptive statistics were used to compare demographic and clinical profiles of older with younger women. A receiver operator curve (ROC) was used to determine the age cut-off that would best differentiate between women who had infection with STI pathogens and those without.Results. Of 757 women enrolled, 157 (20.7%) were aged ≥35 years. HIV positivity was 46.6%, and higher in older than younger women (54.9% v. 44.5%; p=0.02). Of those enrolled, 283 (37.4%) had bacterial vaginosis (BV) and/or Candida infection only, 232 (30.7%) had BV or Candida with STI pathogens detected, 98 (13%) were infected with STI pathogens only, and 144 (19.0%) did not have any detectable STI or non-STI causes. Although older women were less likely than younger women to have Neisseria gonorrhoeae, Chlamydia trachomatis or Mycoplasma genitalium infection (23.6% v. 38.2%; p<0.01), the burden in older women was not negligible. The area under the ROC for age was 57.5% (95% confidence interval 53.2 - 61.8%), which implies suboptimal performance.Conclusions. Although older women with VDS were less likely than younger women to have STIs, a significant proportion of them did have an infection with STI pathogens. Age alone was not a good criterion for discriminating between women with and without infection with STI pathogens. Other ways of improving the VDS algorithm performance are needed, as is better integration of HIV and STI prevention and treatment

Indications d'amygdalectomie à Lubumbashi : profil clinique

A l'ère où les indications d'amygdalectomie sont constamment discutées et face à l'absence des données dans notre milieu, nous avons mené cette première étude descriptive transversale multicentrique à Lubumbashi du 1er juillet 2013 au 31 décembre 2014, afin déterminer le profil clinique de l'amygdalectomie dans notre milieu. L'analyse statistique et le traitement des données ont été effectués à l'aide des logiciels Excel version 2010 et Epi info 7 version 7.1.1.14 de 2013.Sur 84 patients opérés durant la période de la présente étude, 68 cas d'amygdalectomie ou tonsillectomie ont été colligés, ce qui a représenté 81% des activités chirurgicales oto-rhino-laryngologiques (ORL). Le sexe féminin était plus représenté (53%) avec un sex-ratio H/F de 1:1,1 (0,9). L'âge médian était de 5 [1-37] ans (âge moyen 8,5 ans) et la majorité des opérés avait un âge ≤ 5 ans. Les principaux symptômes étaient dominés par la respiration bouche ouverte pendant le sommeil, la dysphagie et le ronflement pendant le sommeil. L'hypertrophie amygdalienne dans le cadre du syndrome d'apnée obstructive du sommeil et l'amygdalite récurrente étaient les indications les plus représentées avec respectivement 53% (n = 36) et 37% (n = 25). L'amygdalectomie a été couplée à l'adénoïdectomie dans 65% des cas (n = 44). L'hémorragie primaire a été la seule complication objectivée, chez un patient (1,5%). L'amygdalectomie a été réalisée en ambulatoire dans 49% des cas.L'hypertrophie amygdalienne dans le cadre du SOAS et l'amygdalite récurrente ont constitué les indications les plus fréquentes. La maîtrise de ces indications nous éviterait les interventions superfétatoires

Aetiology of Sexually Transmitted Infections in Maputo; Mozambique

Introduction: The study sought to ascertain the prevalence of the aetiological agents of genital discharge and genital ulcer diseases in Maputo; Mozambique. Methodology: Consecutive consenting patients presenting to the Centro de Saude do Porto in Maputo between March and April 2005 with genital discharge syndrome and/or genital ulcer diseases were recruited. Specimens were collected for the identification of STI pathogens. Results: Of 346 recruited patients; 164 were male and 182 female. The prevalence of confirmed single aetiological agents for male urethritis was as follows: N. gonorrhoeae; 35; C. trachomatis; 10; and M. genitalium 4. For vaginal discharge; N. gonorrhoeae was found in11of the women tested; followed by C. trachomatis (6.5); bacterial vaginosis (34); and T. vaginalis (2). The prevalence of genital ulcers was as follows: Herpes simplex virus type 2; 62; H. ducreyi 4; and C. trachomatis biovar LGV; 4. Five percent of patients with genital ulcers had a positive syphilis serology (RPR = 1:8 and confirmed by TPHA) and 35of all tested patients were HIV-1/2 infected. Cases of mixed infections were present in 5; 11and 3of patients with male urethritis; vaginal discharge; and genital ulcers respectively. Conclusion: The classic sexually transmitted infection aetiologies are still prevalent in Maputo. The study highlights the need for a periodic surveillance to inform syndromic management protocols

Treatment Outcomes in Patients Receiving Combination Antiretroviral Therapy in Central Hospital; Benin City; Nigeria

Purpose: This study investigated mortality rate; early CD4 responses; pattern of ARVs substitutions and medication adherence of HIV-infected patients on first-line triple combination antiretroviral therapy (ART) in Central Hospital; Benin City; Nigeria. Methods: A retrospective assessment of 196 HIV-infected patients on first-line combination ART regimens was performed following 18 months of therapy. Medication adherence assessment of a 69-patient follow-up target group was based on a study-specific questionnaire. Paired sample t-test and simple linear correlation were used to test the association of the CD4-cell counts at different time intervals. Kaplan-Meier model was used to assess survival functions while log-rank test was applied to assess statistical difference at 95confidence interval (CI). Mean age of participants was 33.6 years (95CI; 32.1 - 35.2; 67.9were females. Results: At ART initiation; 27.0were at WHO clinical stage II; 47.0at stage III. Mortality rate (N = 196) was 20.3 deaths per 100 patient-months; 31.6occurred in 30 days while 52.6occurred post-120 days of treatment. The mean CD4-cell count (cells/mm3) at ART initiation was 179.2 which increased to 328.5 at 3 months; 325.6 at 6 months; 357.4 at 12 months; and 366.7 at 18 months; (p 0.01). Patients started on stavudine-based or efavirenz-based regimens were considerably more likely to have that drug substituted; compared to patients started on zidovudine-based or nevirapine-based regimens. The level of adherence reported after 18 months on ART was 73.8. Conclusion: In this setting; patients receiving ART showed significant improvements in CD4-cell status but adherence level was relatively poor. Patients were more stable on zidovudine-based or nevirapine-based regimens than on stavudine-based or efavirenz-based regimens. Early mortality rate was high; indicating a need for early interventions

The Impact of HIV Syndromes on the Treatment of TB Cases in Gombe State; Nigeria

Tuberculosis (TB) is the leading cause of death among people living with HIV/AIDS worldwide. HIV fuels the TB epidemic in populations such as in Nigeria where there is overlap between those infected with HIV and those infected with Mycobacterium tuberculosis. To address the enormous challenges posed by the dual TB/HIV infection; the Nigerian National Tuberculosis and Leprosy Control Programme (NTBLCP) began collaborative TB/HIV services in Gombe State with some other selected states in 2006. The study looked at 300 new sputum smear-positive acetate-free biofiltration (AFB) patients that had tested positive to HIV screening between diagnosis and second month of follow-up; and were treated between January and December 2006 in the Gombe State TB control programme. The control for the study came from the same cohort of January to December 2006 of new sputum smear-positive AFB patients (595) who had tested negative to HIV screening. The cohort analysis looked at the HIV sero-prevalence and the treatment outcomes: cure rate; failure rate; death rate; default rate; and transfer out rate among new smear pulmonary tuberculosis (PTB) patients that are dually infected with HIV and TB as compared to those not dually infected. The majority of HIV-positive and HIV-negative PTB patients studied were aged 39 years and below. There was no statistically significant difference between the mean age of patients with co-infection and those without co-infection. The majority of the co-infected patients were aged up to 30 years. There was a statistically significant difference in the mean age of males and females. Of the 300 HIV co-infected patients in the study population that were HIV positive; males accounted for 58.3compared with 41.7females. This was not statistically significance. TB patients that were HIV positive had a cure rate of 12.7; while those that were HIV negative had a cure rate of 31.8. The death rate among dually infected patients was higher compared with the HIV-negative patients. The treatment completion and default rates were higher in the HIV co-infected patient

The Clinical Features of HIV/AIDS at Presentation at the Jos University Teaching Hospital

Background: The clinical characteristics and consequences of HIV-1 infection observed in studies from developed countries cannot be generalized across the multiple virus subtypes that circulate in sub-Saharan Africa in general and Nigeria in particular. This study was therefore conducted to determine the commonest symptoms and signs at presentation in HIV-infected individuals at the Jos University Teaching Hospital.Method: This descriptive study was conducted at the antiretroviral clinic of the Jos University Teaching Hospital, Jos, between May and October 2004. Two hundred (200) newly diagnosed and laboratory confirmed adult cases of HIV infection without prior antiretroviral drug use were recruited after obtaining informed consent. Each qualified patient had a comprehensive history taken with emphasis on the clinical symptoms and detailed physical examination performed by the researchers. The data collected were analyzed using a multipurpose computer programme, Epi-info 2000 version 1.1.3 (Atlanta GA, USA). Results: There were 86(43.0%) males and 114(57.0%) females whose mean ages were 39.0±7.8 and 32.0±8.1 years, respectively. The major symptoms in the study population were: weight loss (65.5%), fever (41.5%), chronic cough (38.5%), diarrhea (32.0%), pruritus (13.0%) and body rash (12.5%). The major signs were pallor (25.0%), oral thrush (20.5%), wasting (20.0%), lymphadenopathy (18.0%), dermatitis (16.0%), hyperpigmented nails (13.5%) and finger clubbing (8.5%).Conclusion: The symptoms and signs of HIV/AIDS obtained were similar to those obtained by other workers from different parts of the world; however, the findings of hyperpigmented nails and finger clubbing have not been frequently reported for other populations