ABSTRACT
Aim: To identify the prevalence, common symptoms, signs, partner contribution, common diagnosis and outcome of infertility in a resource poor setting. Study Design: Descriptive retrospective study. Place and Duration of Study: Ebonyi state University teaching Hospital, Abakaliki south-east, Nigeria, in two years (1st January 2009 to 31st December 2010). Method: Case notes of patients who attended the infertility clinic over the study period were retrieved from the health services department of the hospital and analysed. Results: Infertility patients were 295 out of 1,913 new gynaecological cases during the period under review, forming 15.4% of the study population. The number of folders with complete information was 266 which were 90.2%. Primary infertility patients were 94(35.3%) of all infertility cases) while 172(64.7%) were secondary infertility. The age range was 19 to 47 years, with a mean value of 30.9±2.3 of two standard deviations across the mean. The mean parity was 1.4±0.8 and ranged between 0 – 7 children. Among those with previous deliveries, 68.2% had no living child. The predominant symptoms in the females were insomnia, inadequate coital exposure, galactorrhoea and vaginal discharge. The commonest demonstrable signs were galactorrhoea in 92(34.6%) patients, cervical excitation tenderness in 54(20.3%) and uterine mass in 65(24.4%).Some 44(16.5%) persons had no remarkable findings. Partner contributions were: 93 (34.9%) for females; 60(22.6%) males; 64(24.1%) both partners. Pelvic infections (75.5%) and tubal occlusion (16.9%) were the commonest aetiologic factors. Others were: endocrine disorders including polycystic ovarian diseases, uterine myoma, uterine synaechiae and tubo ovarian masses. The outcome of treatment was: 40(15.0%) pregnancies; 112(42.1%) still on treatment and counseling; 75(28.2%) referrals and 39(14.6%) patients lost to follow up. Conclusion: Astute history taking and physical examination helped in elucidating the cause of infertility in many of our patients. Secondary infertility as in other parts of our country takes upper hand thereby reinforcing the need for prevention of pelvic infection in women of reproductive age. Total cares of infertility couples require the cooperation of men, laboratory scientists, radiologists, and even clinical psychologists (it is multidisciplinary). Treatment outcome is still poor and may be improved through increased priority in public funding, equipment supply, and manpower training as well as health education.
ABSTRACT
Background: The liver is affected by the various processes that occur during pregnancy. Ultrasound assessment of the intra abdominal organs during pregnancy is done on a daily basis. We want to determine the normal length of the liver by ultrasound scan in normal pregnant women in the University of Port Harcourt Teaching Hospital thus establishing normal and reference values and also to study the effect if any of the gestational age; parity and body mass index on the liver size. Materials And Methods: One hundred and fifty normal pregnant women were evaluated. The dimensions of the liver were measured in the midclavicular line. Other parameters such as the gestational age; parity and body mass index were obtained and a test of variance carried out. Results: The average longitudinal diameter of the liver (midclavicular line) was 14.21+1.82cm (median; 14.2 cm; range; 8.0-18.9 cm). Results of the multivariate analysis showed a positive correlation between the liver length and body mass index but not with the parity and gestational age. Conclusion: This study will be of importance in the daily practice in the radiology and other clinical department in the assessment of the liver in pregnant women