ABSTRACT
Background: Management of complex genital fistulae is challenging due to the cost and technical skill required. This study reports our experience in the management of patients with complex genital fistulae and to highlight the crucial role of the reconstructive urologists.Methods: This was a retrospective review of female patients managed at a tertiary hospital in Nigeria from 2006 to 2017 for complex urinary fistulae. Data were extracted from patient case notes and the data analysed using the SPSS software.Results: Twenty-four female patients mean age 28.9±11.1 years. Fistulae resulted from prolonged obstructed labour 10 (41.6%), caesarean hysterectomy 7 (29.2%), caesarean section and abdominal hysterectomy 2 (8.4%) respectively. The fistulae were vesicovaginal 16 (66.7%), ureterovaginal 3 (12.5%). Others were vesicocutaneous, urethrovaginal and rectovaginal. Prior attempts at repair were done in 7 (29.2%) and the number of attempts ranged from 1 to 4. Surgical procedures included direct closure in 9 (37.5%), closure and uretero-neocystostomy 7 (29.2%), uretero-neocystostomy only 3 (12.5%) closure and abdominal hysterectomy 2 (8.3%), closure and continent catheterizable neo-bladder 2 (8.3%) and 1 (4.2%) closure, abdominal hysterectomy and uretero-neocystostomy. Post-operative complications were noted in 2 (8.3%) and consisted of gynaeatresia and recurrent RVF. Repair was successful in 70.8% of patients while failed repair was recorded in 16.7% and while stress incontinence was present in 12.5%.Conclusions: Complex genital fistulae in our practice are of obstetric origin involving the bladder, ureters and rectum. The reconstructive urologist has a crucial role the management for a favourable outcome.
ABSTRACT
Background and Aim: Different parts of Phyllanthus amarus are being used in the treatment of different diseases in several parts of Nigeria without considering its safety. This study was aimed at investigating the effect of ingestion of methanolic leaf extract of Phyllanthus amarus on the liver of Wistar rats. Materials and Methods: The acute oral toxicity of the leaf extract (LD50) was determined in 9 Wistar rats divided into 3 groups of 3 rats per group. Group 1 was the control and received distilled water. Different doses of 2000 mg/kg and 5000 mg/kg were administered orally once to the study groups 2 and 3 respectively. A sub-chronic toxicity study was carried out in 25 Wistar rats, divided into five groups of 5 rats per group. Group 1 served as control and received distilled water. The remaining 4 groups (2, 3, 4 and 5) served as the study groups and were administered different doses of 250 mg/kg, 500 mg/kg, 750 mg/kg and 1000 mg/kg of methanolic leaf extract of Phyllanthus amarus respectively on a daily basis for 28 days. Total protein (TP), albumin (ALB), total and conjugated bilirubin (TB and CB), aspartate and alanine transaminase (AST and ALT), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) were assayed using standard techniques. Results: In the acute oral toxicity study, no death or any sign of toxicities were recorded in the rats after 24 hours and up to 14 days post oral administration and there was no significant difference (P>0.05) in all the parameters analysed between the control and the study groups. In sub-chronic toxicity study, there was no significant difference (P>0.05) in all parameters analysed between the control and study groups. Histology of the liver of the rats in both the acute and sub-chronic study showed normocytic and normochromic cells. Conclusion: Methanolic leaf extract of Phyllanthus amarus is relatively non-toxic and is not likely to induce liver damage.
ABSTRACT
Objective: To determine the association of serum CTX-I levels with hormone replacement and interleukin inhibi tortherapi es
Study Design: Descriptive cross sectional study Place and Duration of Study: This study was conducted at the Hayatabad Medical Complex [HMC], Peshawar from June 2012 to August 2012
Materials and Methods: A total of 100 peri-men opausal women were included in the study to determine the association of serum of CTX-I levels with hormone replacement therapy [HRT] and interleukin inhibitors
These females were randomly selected and screened for osteoporosis. The age of study population was between 45-55 years. Informed consent was taken. Detailed history was obtained regarding occupation, income, family history, number of pregnancies and medications. Women with complaints of joint pains, history of osteoarthritis, rheumatoid arthritis and any other bone disease were excluded from the study. They were radiologically assessed for osteoporosis by using Singh index as I to VI. Ethical approval for the study was taken from the Institutional Ethical Research Committee [IERC] of HMC. Blood samples were taken for estimation of hemoglobin, ESR, calcium, alkaline phosphatase and CTX-I
Results: The levels of CTX-I were elevated in peri-menopausal women who were radiographically diagnosed as osteoporotic patients. However CTX-I levels were either normal or insignificantly raised in women taking either HRT or interleukin inhibitors. The data were subjected to statistical analysis using Chi-square test on computer software SPSS-17. Results were expressed in form of tables
Association and their significance were sorted out on the software. There was a significant association of CTX-I levels with both HRT and interleukin inhibitors [p = 0.000]
Conclusion: This study revealed a significant association of serum CTX-I levels with both hormone replacement and interleukin inhibitor therapies