The Family Influence on the Gestational Age at Booking among Pregnant Women in Ogbomoso, Nigeria.

Introduction: Family plays an important role in health seeking behaviour and education of its members. Educating an individual especially a girl child usually results in improvements in the quality of life because women who attended school often have healthier families and if pregnant they often tend to book for antenatal care early. Objectives: This study is aimed to determine the influence of family type, educational level and occupation of women on the gestational age at booking among pregnant women in Ogbomoso, Nigeria. Methodology: The study was a cross-sectional prospective study. It was conducted among antenatal care seekers who presented for booking in the Baptist Medical Centre, Ogbomoso. The study involved consecutive recruitment of pregnant women at the antenatal booking clinic who came for antenatal care at Baptist Medical Centre, Ogbomoso. The pretested questionnaire was used to obtain the following information: Sociodemographic characteristics, family history and history of index pregnancy. Results: A total of 345 pregnant women at the antenatal booking clinic were recruited for the study. The age of the respondents ranged from 16 to 48 years with a mean age of 29.47±5.41 years. Not less than one-half of the subjects who were from monogamous and polygamous home booked at second trimester. A majority of the subjects who had no formal education (11, 73.3%) booked at the third trimester while the majority of the subjects who had post secondary education (56, 60.9%) booked at second trimester (P=0.01). More than one-half of the subjects who were artisans (25, 56.8%) booked at third trimester while most subjects who were civil servants (65, 61.3%) booked at second trimester (P=0.03). Conclusion: Many women in Ogbomoso still book late for antenatal care. Occupation and educational level have a significant influence on the gestational age at booking amongst pregnant women in Ogbomoso, Nigeria. There is need to increase public awareness on the importance of educating a girl child.

Female genital mutilation/cutting: Knowledge, practice and experiences of secondary schoolteachers in North Central Nigeria

Background. Despite global efforts at eradicating female genital mutilation/cutting (FGM/C), the act continues to be performed globally. Objective. To determine the experience of schoolteachers about FGM/C and their possible role in contributing to its eradication. Methods. A prospective cross-sectional survey involving secondary schoolteachers from 18 secondary schools in Ilorin, North Central Nigeria, was undertaken during October and November 2014. All consenting participants completed a self-administered questionnaire on FGM/C. Statistical analysis was with SPSS version 20.0 with χ2 and logistic regression; a p-value of <0.05 was considered significant. Results. There were 371 participants (113 males (30.5%) and 258 females (69.5%)). More females than males were aware of FGM/C (205 v. 94; χ2 41.2; p=0.001); 180 women (69.8%) and 81 men (71.7%) wanted awareness and the implications of FGM/C to be taught in schools, while 46 women (17.8%) and 23 men (20.4%) had previously educated students about FGM/C. Also, 109 (42.3%) of the female teachers had been mutilated (mean (standard deviation) age 4.76 (4.86) years), and 49 mutilations (45.0%) had been performed by traditional circumcisers. Of the teachers, 44.0% of men and 24.5% of women had subjected their daughters to FGM/C (p=0.029), mostly for religious reasons. The men initiated the majority of their daughters' mutilations, while the mothers-in-law were the main initiators among the women; 44 (17.0%) women and 23 (20.4%) men held the opinion that females should be circumcised, while the majority considered education and legislation to be the most important interventions to encourage its eradication. Predictors of the likelihood to support discontinuation of FGM/C include awareness of government policy about FGM/C and having a mutilated daughter. Conclusion. Education, reorientation and motivation of teachers will position them as agents for eradicating FGM/C

Prevalence of Pain in Family Medicine Clinic of Bowen University Teaching Hospital, Ogbomoso, Nigeria.

Introduction: Pain is the most common reason for physician consultation in most advanced countries such as the United States. It is a major symptom in many medical conditions, and can significantly interfere with a person's quality of life and general functioning. Objectives: This study aimed to determine the prevalence of pain among adult patients and to describe the localization, duration and severity of pain in this population. Methodology: A cross-sectional descriptive survey was used. Consenting participants aged 18 years or older were recruited for the study. Descriptive and pain-specific data were collected using a predesigned interviewer administered questionnaire and the Brief Pain Inventory (BPI). The initial questionnaire elicited information on demographic variables, pain prevalence, and pain characteristics, and the BPI was used to characterize pain further. Results: A total of 100 subjects participated in the study and the mean age was 44.94±14.92 years. The prevalence of pain (defined as any subject who reported pain as a top or secondary reason for the visit) was 84.0% (95% CI 76.7% – 91.3%). More than one-half (52.4%) of the subjects complained of pains in the lower limbs and back and the duration of pain was less than 6 months in 58.3% of the subjects. More than one-half (54.8%) of the subjects who presented with pain claimed that pain interfere with their walking ability. No significant association was found between socio-demographic characteristic and prevalence of pain. Conclusion: The prevalence of pain in Family Medicine Clinic of the Bowen University Teaching Hospital, Ogbomoso is very high. It affects mainly the lower limbs and the back and interferes with their walking ability. Majority of them presented with severe pain that is usually less than 6 months.

Comparative micromorphological study of wild and micropropagated Dioscorea bulbifera Linn

Objective:To study the leaf epidermis of wild and micropropagated Dioscorea bulbifera Linn. (D. bulbifera) in order to document useful diagnostic features that may be employed for correct crude drug identification and to clear any taxonomic uncertainties in the micropropagated medicinal plant. Methods:Growth responses of micropropagated D. bulbifera were observed on Murashige Skoog medium supplemented with 6-benzylamino purine (1.0 mg/L)+α-naphthaleneacetic acid (0.2 mg/L)+cysteine (20 mg/L) using nodal segments as explants. Leaves of the wild and micropropagated plants were studied microscopically. Results: More than 80%shoot regeneration and formation of 10%-30%whitish-brown callus were observed within 3 weeks. The highest root proliferation was obtained from Murashige Skoog medium of 6-benzylamino purine (0.05 mg/L) and α-naphthaleneacetic acid (0.01 mg/L) with mean root length of (27.00±1.25) mm and elongated single shoot of mean length (38.00±11.09) mm. Leaf epidermal features that revealed similarities between the wild and micropropagated plants included amphistomatic condition, presence of mucilage, glandular unicellular trichome with multicellular head, polygonal cells with smooth walls, stomata type and shape. Slight variations included thick cuticular wall with closed stomata in wild plant compared to thin walled opened stomata in the in vitro plant. Opening of stomata accounted for larger average stomata sizes of (7.68±0.38) μm and (6.14±0.46) μm on the adaxial and abaxial surfaces, respectively of the micropropagated plant compared to the wild. Conclusions: The diagnostic features obtained in the study could serve as a basis for proper identification for quality control for standardization of the medicinal plant.

Umbilical cord parameters in Ilorin: correlates and foetal outcome

Background: The anthropometric parameters of the umbilical cord have clinical significance. Current parameters of the cord, its correlates and related foetal outcome are lacking in our parturients. Objectives: To describe the anthropometric parameters and abnormalities of the umbilical cord; and determine their maternal correlates and foetal outcome. Design: A cross sectional analytical study. Setting: The Obstetric and Gynaecology Department of the University of Ilorin Teaching Hospital, between September 2012 and June 2013. Subjects: Healthy pregnant women with singleton pregnancies. Results: Four hundred and twenty- eight (428) singleton deliveries were studied. The respective mean values of the cord length and width were 526.87±115.5mm and 19.56±11.12mm. Short cord (< 40cm) occurred in 7.2% while long cord (> 69cm) was found in 9.3% of the parturient. The incidences of single umbilical artery, cord round the body and knots were 7%, 8.4% and 14.5% respectively. Nuchal cord was the most common (91.4%). Only gestational age had significant statistical relationship with cord length abnormalities (P = 0.0093). The cord length was an important correlate of cord helices, knots and vessels (P< 0.05).Parity had correlations with the number of vessels(R= 0.099, P=0.042). The cord coiling index was statistically related to the presence of congenital abnormalities (P=0.011). Other perinatal events were not related to umbilical cord parameters. Perinatal asphyxia was the most common indication for NICU admission (3.5%) but there was no significant statistical difference between NICU admission and cord parameters. Conclusion: The umbilical cord parameters in apparently healthy parturients in Ilorin were comparable with others elsewhere. The cord length and helix are important correlates of gestational age and congenital abnormalities. Parity may be related to abnormal umbilical vessels. Cord length, coils, coil index and umbilical vessels should be examined post-natally

Vesicovaginal Fistula: a Review of Nigerian Experience

BACKGROUND: Vesicovaginal fistula is a preventable calamity; which has been an age-long menace in developing countries. OBJECTIVE: To review the causes; complications; and outcome of vesicovaginal fistula in Nigeria. METHODS: Studies on vesicovaginal fistula were searched on the internet. Information was obtained on Pubmed (medline); WHO website; Bioline Innternational; African Journal on Line; Google scholar; Yahoo; Medscape and e Medicine. RESULTS: Many Nigerian women are living with vesicovaginal fistula. The annual obstetric fistula incidence is estimated at 2.11 per 1000 births. It is more prevalent in northern Nigeria than southern Nigeria. Obstetric fistula accounts for 84.1-100of the vesicovaginal fistula and prolonged obstructed labour is consistently the most common cause (65.9-96.5) in all the series. Other common causes include caesarean section; advanced cervical cancer; uterine rupture; and Gishiri cut. The identified predisposing factors were early marriage and pregnancy; which were rampant in northern Nigeria; while unskilled birth attendance and late presentation to the health facilities was common nationwide. Among the significant contributory factors to high rate of unskilled birth attendance were poverty; illiteracy; ignorance; restriction of women's movement; non-permission from husband; and transportation. All but one Nigerian studies revealed that primiparous women were the most vulnerable group. Pregnancy outcome was dismal in most cases related to delivery with still birth rate of 87-91.7. Stigmatization; divorce and social exclusion were common complications. Overall fistula repair success rate was between 75and 92in a few centres that offer such services. CONCLUSION: Vesicovaginal fistula is prevalent in Nigeria and obstetric factors are mostly implicated. It is a public health issue of concern