A mixed method assessment of research productivity on microplastics in various compartments in the environment.

Microplastic distribution and pollution as emerging contaminants have become a leading environmental issue globally, owing to their ecological and health implications on biota and humans. Although several bibliometric studies have been reported on microplastics, they are mostly restricted to selected environmental media. As a result, the present study aimed at assessing the literature growth trend of microplastics-related research and their distribution in the environment using a bibliometric approach. The Web of Science Core Collection was explored to retrieve published articles on microplastics from 2006 to 2021, and the data were analysed using the Biblioshiny package of RStudio. This study also highlighted filtration, separation, coagulation, membrane technology, flotation, bionanomaterials, bubble barrier devices, and sedimentation as MP remediation techniques. In the present study, a total of 1118 documents were collected from the literature search; the documents/author and authors/document were 0.308 and 3.25, respectively. A significant growth rate of 65.36% was recorded with notable progress between 2018 and 2021. China, the USA, Germany, the UK, and Italy recorded the highest number of publications within the period under consideration. A collaboration index of 3.32 was also relatively high, with the Netherlands, Malaysia, Iran, France, and Mexico having the highest MCP ratios, respectively. It is anticipated that findings from this study will help the policymakers in addressing issues concerning microplastic pollution assist the researchers in identifying areas to concentrate their studies, and where to seek collaboration in their future research plans. Supplementary Information: The online version contains supplementary material available at 10.1007/s13762-023-04916-7.

Distribution and Chemical Analysis of Pharmaceuticals and Personal Care Products (PPCPs) in the Environmental Systems: A Review.

PPCPs are found almost everywhere in the environment especially at an alarming rate and at very low concentration in the aquatic systems. Many methods-including pressurized hot water extraction (PHWE), pressurized liquid extraction (PLE), ultrasound-assisted extraction (UAE), and micro-assisted extraction (MAE)-have been employed for their extraction from both surface waters and biota. Solid-phase extraction (SPE) proved to be the best extraction method for these polar, non-volatile, and thermally unstable compounds in water. However, ultrasonic extraction works better for their isolation from sediment because it is cheap and consumes less solvent, even though SPE is preferred as a clean-up method for sediment samples. PPCPs are in groups of-acidic (e.g., diclofenac, ibuprofen, naproxen), neutral (e.g., caffeine, carbamazepine, fluoxetine), and basic pharmaceuticals, as well as antibiotics and estrogens amongst others. PPCPs which are present in trace levels (ng/L) are more often determined by liquid chromatography-mass spectrometry (LC-MS), gas chromatography-mass spectrometry (GC-MS), and high-performance liquid chromatography-ultraviolent (HPLC-UV). Of these, LC-MS and LC-MS-MS are mostly employed for the analysis of this class of compounds, though not without a draw-back of matrix effect. GC-MS and GC-MS-MS are considered as alternative cost-effective methods that can also give better results after derivatization.

Levels of Polycyclic Aromatic Hydrocarbons in the Water and Sediment of Buffalo River Estuary, South Africa and Their Health Risk Assessment.

The incidence and spatial distribution of polycyclic aromatic hydrocarbons (PAHs) in the Buffalo River Estuary in the Eastern Cape Province of South Africa were assessed in this study. A total of 60 surface water and 19 sediment samples were collected from 5 sites of the estuary over a period of 6 months (December 2015 to May 2016). Extraction of PAHs from the water and sediment samples was achieved by using liquid-liquid and soxhlet extraction methods respectively, followed by column clean up with silica gel and quantification by gas chromatography-flame ionization detection. Individual PAH levels in the water and sediment samples ranged from not detected (ND) to 24.91 µg/L and ND to 7792 µg/kg, respectively. Total concentrations of the PAHs in the water and sediment samples varied as 14.91-206 µg/L and 1107-22,310 µg/kg in that order. Total levels of the contaminants were above the target values in the two matrices and were higher in summer than autumn. Although the noncarcinogenic risk of PAHs estimated in the water column through dermal absorption was very low compared with the target value, the carcinogenic risk determined was high for both adults and children. Similarly, benzo(a)pyrene and dibenzo(a,h)anthracene were found to be of higher carcinogenic and mutagenic risks in the sediments collected from the study area. Diagnostic ratios suggest that the target hydrocarbons are predominantly from pyrolytic sources. It therefore could be inferred that the water body is conspicuously polluted; hence, efforts should be made to control all the activities contributing to such magnitude of pollution at the sites.

Distribution pattern and health risk assessment of polycyclic aromatic hydrocarbons in the water and sediment of Algoa Bay, South Africa.

Polycyclic aromatic hydrocarbons are amongst the pollutants of major concern in the terrestrial and aquatic habitats. They are mostly characterised by carcinogenic and non-carcinogenic effects. Distribution and potential health risks of sixteen priority PAHs in the water and sediment samples collected between December 2015 and June 2016 from Algoa Bay, South Africa, were evaluated. Water and sediment samples collected were extracted with liquid-liquid and soxhlet extraction methods, respectively, and then cleaned up using glass column loaded with silica gel. Final concentrations of the target PAHs were determined by gas chromatography interfaced with flame ionization detector. Results indicated that individual PAH concentrations in surface water, bottom water and sediment samples ranged from not detected (ND) to 24.66 µg/L, ND to 22.81 µg/L and ND to 5.23 mg/kg correspondingly. Total PAHs concentrations varied as 12.78-78.94 µg/L, 1.20-90.51 µg/L and 1.17-10.47 mg/kg in the three environmental matrices in that order. The non-carcinogenic risk was generally below 1, whereas risk indices (dermal contact) were above the acceptable limit of 1 × 10-4 in the water column, suggesting possible carcinogenic effects to humans, with adults being the most vulnerable. Similarly, highest contributions to TEQs and MEQs in the sediments were made by benzo(a)pyrene and dibenzo(a,h)anthracene, the two most toxic congeners, signifying the possibility of carcinogenicity and mutagenicity in humans. Diagnostic ratios of PAHs reflect a prevailing pyrogenic input all through. The pollution was albeit moderate, yet regular check is recommended to ensure safe and healthy environment for human and aquatic lives.

Behavior modifying myths practices and effect on health seeking behavior among pregnant Yoruba women, south western Nigeria ­ a cross-sectional study

INTRODUCTION: Cultural practices and beliefs influence and underpin the behavior of women during pregnancy and childbirth; this behavioral change could influence the health-seeking behavior as well as the outcome of pregnancy. OBJECTIVES: The objective of this study was to determine the behavior modifying myths among pregnant Yoruba women and their sources. METHODS: This descriptive cross-sectional study was carried out among 250 pregnant Yoruba women attending the antenatal clinics of Bowen University Teaching Hospital, Ogbomoso and Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso. A structured, interviewer-administered questionnaire was undertaken. Consent was sought verbally. RESULTS: The age of the respondents ranged from 15-45 years with a mean age of 27 years (±3.5). Most of the women were married n=239 (95.6%) and primarily Christian n=184 (73.6%). 127 (50.8%) of the women had a tertiary education while only 13 (5.2%) had no formal education. 41 (16.3%) of the respondents being primigravida. Six myths were identified with food taboos being the most common. These were being practiced by 61.2% of the respondents. The reasons given for modifying their behavior varied from warding off ghosts to the delivery of a well-formed child. The most frequent source of information were their relatives (42.4%). CONCLUSION: The practice of the myths was neither influenced by educational status nor religion. The majority of these practices do not have a deleterious effect and did not influence health-seeking behavior or outcome of pregnancy based on the reasons adduced for the practice

Petroleum Hydrocarbon Fingerprints of Water and Sediment Samples of Buffalo River Estuary in the Eastern Cape Province, South Africa.

Petroleum hydrocarbon status of the Buffalo River Estuary in East London, South Africa, was evaluated from January to May, 2016. Surface water and sediment samples were collected from five points in the estuary and extracted using standard methods. The extracts were subsequently analyzed by gas chromatography-flame ionization detection. Results showed that total petroleum hydrocarbon (TPH) varied from 7.65 to 477 µg/L in the water and 12.59 to 1,100 mg/kg in the sediments, with mean values of 146.50 ± 27.96 µg/L and 209.81 ± 63.82 mg/kg, respectively. Concentrations of TPH in the sediments correlated significantly with organic carbon (OC) in both seasons. TPH and OC levels were slightly lower in summer than in autumn in the two environmental matrices, and the average amount of TPH in the water samples collected from all the sampling stations was generally lower than the EU standard limit of 300 µg/L. However, the levels in the sediments exceeded the EGASPIN target value (50 mg/kg) for mineral oil but were below the intervention value (5,000 mg/kg), indicating a serious impact of industrial growth and urbanization on the area, although the n-alkane ratios and indexes used for source tracking revealed excessive flow from both natural and anthropogenic sources.

Randomization of two dosing regimens of vaginal misoprostol for cervical ripening and labor induction in a low resource setting.

OBJECTIVES: To compare the effectiveness of two dosing regimens of vaginal misoprostol for cervical ripening and induction of labour. MATERIALS AND METHODS: Pregnant women with singleton low risk pregnancy at term scheduled for elective induction of labour were randomized to receive either 25 µg or 50 µg of vaginal misoprostol for pre-labour cervical ripening. All the patients received antenatal care and delivered at the University College Hospital (UCH) from January 1 st to May 31 st 2006. A total of 128 patients were randomized; 65 patients received 25 µg and 63 patients received 50 µg of vaginal misoprostol. RESULTS: Significantly higher number of patients in the 50 µg group progressed to active labour as compared with the 25 µg group (95.2% versus 84.6%, P < 0.05). The need for oxytocin augmentation of labour was higher among the 25 µg as compared with 50 µg (39.7% versus 16.4%, P = 0.007). There was higher proportion of patients in the 50 µg group delivering vaginally within 24 hours as compared with the 25 µg group (98.2% versus 90.0%, P = 0.063). However, the mean interval between the first dose of misoprostol and vaginal delivery was not statistically different in the two groups (754 ± 362 minutes and 885 ± 582 minutes, P = 0.152). The incidence of caesarean section was similar in the two groups (7.7% versus 11%, P = 0.580). Labour complications, such as precipitate labour, tachysystole and abnormal fetal heart rate patterns were greater in the 50 µg group. CONCLUSION: Twenty-five microgram of misoprostol appears to be as effective as 50 µg for pre-induction cervical ripening and labour induction. Though 50 µg of vaginal misoprostol resulted in relatively faster delivery and less need for oxytocin augmentation, it was associated with more labour complications as compared with 25 µg of misoprostol.

Syntheses and in-vitro evaluation of novel adamantane based γ-secretase inhibitors.

Abnormal processing of amyloid precursor protein (APP) by ß - and γ -secretases to produce excess amyloid-ß-peptide is believed to contribute to the pathophysiological cascade that results in Alzheimer's disease. γ -Secretase inhibition or modulation therefore represents a rational approach to the prevention and/or management of AD. Here, we present the discovery and SAR of a class of novel adamantanyl sulfonamide based γ -secretase inhibitors. Activity evaluation was conducted on cell lines overexpressing APP (wild type and Swedish mutation). Our results suggest size threshold and hydrogen bond formation are necessary for inhibitory activity. There was no correlation between compound activity, Log P, and the electronic effect of substituents on the aromatic ring. These compounds possess desirable drug like properties and results of the study can guide a pharmacophore based design of γ -secretase inhibitors.

A comparison of orally administered misoprostol and membrane sweeping for labour induction in uncomplicated singleton post-term pregnancies

Objectives. This study assessed the efficacy of the two outpatient processes of single-dose 50 µg oral misoprostol (OM) and membrane sweeping (MS) on the outcome of labour induction and the possibility of reducing the need for hospital admission for cervical ripening/labour induction in uncomplicated post-term singleton pregnancies at a tertiary health institution in south-western Nigeria. Methods. A total of 100 patients were equally randomised into the two groups between April 2007 and March 2010. Primary outcome measures were delivery within 48 hours after the start of induction and route of delivery. Secondary outcome measures were time interval from induction to onset of labour (latency period), time interval from start of induction to delivery (duration of labour), need for oxytocin augmentation, labour complications, Apgar scores at 1 and 5 minutes, and need for neonatal intensive care unit (NICU) admission. Results. Both groups were similar at the baseline with regard to age, parity and days beyond 40 weeks' gestation. There was a significantly shorter induction to onset of labour (latency) interval in the OM group, with a mean of 17.0 hours compared with 31.9 hours in the MS group (p=0.005), with 82.0% of the patients in the OM group in spontaneous labour within the latency period of 18 hours as opposed to 32.6% of the MS group (p<0.005). Forty-two patients in the OM group and 40 in the MS group had a vaginal delivery (84.0% v. 87.0%, p=0.361), with 12 and 20 patients in the OM and MS groups, respectively, requiring oxytocin augmentation (p=0.023). The duration of labour was significantly shorter in the OM group, in which 78.6% of those who had a vaginal delivery achieved it within 9 hours, compared with 57.5% in the MS group (p=0.036). Overall, neonatal outcomes and need for NICU admission were similar and comparable in the two groups. On a preference scale, 43% of the women in the MS group felt positive about the intervention, compared with 92% of the women in the OM group. Conclusion. The study demonstrated a shorter latency period, less need for oxytocin augmentation and shorter duration of labour in patients who received OM. The two induction agents were similar with regard to neonatal outcomes and need for NICU admission. Both showed good safety profiles for outpatient care, although further assessment of the safety profile with larger studies will be needed. More patients felt positive about the intervention in the OM group than in the MS group

Visual morbidities among elderly patients presenting at a primary care clinic in Nigeria.

BACKGROUND: Visual challenges compromise mobility, increase dependency on family members and constitute a major health problem mainly seen by the primary care physicians among the elderly. However, there is little information on the pattern of visual problems of elderly patients attending the primary care clinics in Nigeria. OBJECTIVE: To describe the visual problems among elderly subjects in a hospital setting. METHODS: Five hundred consecutive patients (311 females and 189 males) aged 60 years and above were interviewed using a structured questionnaire based on the World Organization of Family Doctors (Wonca) format between September 2004 and April 2005. The main outcome measurements were sociodemographic characteristics, visual acuity and ocular problems. RESULTS: The main visual problems reported by the elderly were impaired vision 224 (44.8%) and abnormal sensations in the eyes 64 (12.8%). Cataract 198 (39.7%) was the commonest eye disorder diagnosed by the Family Physician, followed by pterygium 32 (6.4%). Assessment of binocular acuity revealed blindness in 109 (21.8%) and low-vision in 68 (13.6%). The prevalence of visual impairment increased significantly with age. CONCLUSION: Visual impairment is a common problem of the elderly people in the hospital setting, with cataract being the main cause. Efforts should be made to detect these conditions early and institute treatment promptly.

Cardiovascular and electrocardiographic changes in Nigerians with a normal pregnancy.

INTRODUCTION: Pregnancy is associated with major haemodynamic and cardiac changes, which can mimic or precipitate cardiac diseases. There is a paucity of this kind of data among pregnant Nigerian women. This study was aimed at describing the cardiovascular and electrocardiographic changes found among healthy pregnant Nigerian women. METHODS: This was an age-matched control study of 69 consecutive normal pregnant and 70 healthy non-pregnant controls. The study protocol included history, physical examination and 12-lead electrocardiography. RESULTS: Diastolic blood pressure < 60 mmHg was significantly commoner among pregnant subjects than controls (64.7 vs 24.3%, respectively, p < 0.005). Mean heart rate was higher among pregnant women (88.34 ± 11.46 bpm) than the controls (75.16 ± 12.22 bpm, p = 0.020). Pregnant subjects also had a higher proportion of left ventricular hypertrophy (LVH) (10.2 vs 0%, p < 0.05) than non-pregnant controls. Abnormal cardiac findings included a loud second heart sound (P(2)), missed beats and systolic murmurs (41.2% in pregnant subjects vs 12.9% in non-pregnant controls, p < 0.05). Negroid-pattern ST-segment elevation was commoner among controls (24.3%) than pregnant subjects (2.9%, p < 0.005). Arrhythmias were rare among the study participants. CONCLUSION: Significant findings on examination were low diastolic blood pressure and a systolic ejection murmur. However, ECG changes showed a normal frontal-plane QRS axis, normal PR interval, significantly rare normal Negroidpattern ST elevation, significant LVH based on Araoye RI > 12 mm and a rarity of all forms of arrhythmias. These data may help resolve some cardiac diagnostic difficulties during pregnancy.

Review of skull base surgery in a Nigerian teaching hospital.

BACKGROUND AND OBJECTIVES: There is dearth of information on skull base surgery in Nigerians. This study was conducted to determine types of skull base lesions describe surgical approaches to the lesions and determine outcome of surgical management of the lesions over the study period. METHODS: We retrospectively reviewed the case notes of the patients who underwent skull base neurosurgical procedures between January 2001 and June 2007 in our centre. We obtained information on demography, clinical presentation, diagnosis, cranial computerised tomography findings, type of surgery, intraoperative findings and outcome of surgical management at the time of discharge from the hospital. RESULTS: Brain tumours were diagnosed in 28 patients, head injuries in 9 patients and one patient each had anterior encephalocele and frontal sinus mucocele. Eighteen patients had frontal craniotomy, three patients had temporal craniotomy and two patients had lateral rhinotomy in addition to bifrontal craniotomy. Two patients had frontoorbitotomy while retrosigmoid craniectomy was performed in one patient. Thirty three patients showed significant postoperative improvement at discharge. CONCLUSION: Brain tumour was the most common indication for skull base surgery in our centre. These tumours were mainly located in the anterior cranial fossa. Frontal craniotomy was the most common surgical approach. Non-availability of modern neurosurgical facilities confined us to the use of mainly traditional approaches. The availability of these facilities will assist in improving our management outcome in the future.

Feto - maternal haemorrhage in parturients: Incidence and its determinants.

This prospective study of parturients at a tertiary health institution in south-western Nigeria aims to identify the incidence, severity and obstetric factors predisposing to feto - maternal haemorrhage (FMH) in our population. The exclusion criteria were haemoglobinopathy and patient's refusal of consent to participate in the study. The prepared slide was processed as in the acid elution test described by Kleihauer - Betke. The FMH was calculated using Mollison formula (Mollison 1972). Baseline data included maternal biodata, blood group, RhD and haemoglobin electrophoresis, route/mode of delivery, duration of labour, obstetric interventions, fetal blood group and birth weight. Data generated were analysed with Statistical Package for Social Scientists (SPSS) version 11 software. Frequency tables, cross-tabulations and correlations were performed. Pearson's correlation was applied to continuous variables, while Spearman's correlation was utilised for discrete variables. Level of statistical significance was set at p < 0.05. A total of 163 parturients were studied, of which eight were multifetal gestations. There were no significant differences in maternal age, parity, estimated gestational age at delivery and birth weight, in both groups of parturients with and without FMH. A total of 17 parturients (10.43%), four of which were multifetal gestations (2.45%), had demonstrable FMH. Large FMH (>15 ml fetal cells) were noted in 10 (6.14%) parturients, of which, four were RhD-negative mothers. A total of 9.8% and 11.5% parturients in the vaginal and caesarean delivery groups, respectively, had significant FMH (p = 0.736). Incidence of large FMH was similar with each of the routes of delivery. Antepartum complications of pregnancy, delivery manoeuvres and episiotomy were not significant determinants of FMH. Multiple gestations, fetal birth weight and complications in labour were significantly associated with risk of FMH. Risk-based approach to management, in RhD negative pregnant women, might lead to under-treatment, with attendant increased incidence of isoimmunisation. At least in all RhD-negative women, the cord blood should be tested to determine the baby's blood group and if RhD-positive, Kleihauer - Betke test should be done to determine the degree of FMH and anti-D immunoglobulin dose administered appropriately. Further studies are necessary to establish the determinants/risk factors for FMH.

Blood loss at fibroids surgery: myomectomy versus total abdominal hysterectomy.

Two hundred and fifty patients with uterine fibroids were reviewed to compare operative outcomes and blood loss.

HIV as an additional risk factors for anaemia in pregnancy: evidence from primary care level in Ibadan, Southwestern Nigeria.

Anaemia in pregnancy has serious consequences including maternal morbidity and impairment of infant cognitive development. Several authors have however reported inconsistent findings on risk factors for anaemia in pregnancy. This study was carried out to determine risk factors for anaemia in pregnancy among women at primary care level and document the contribution of HIV/AIDS to anaemia in pregnancy in low risk pregnant women at primary care level. A prospective study carried out among pregnant women attending the booking clinics of primary health care centres in Ibadan, Nigeria. HIV positive and HIV negative mothers were followed throughout pregnancy till delivery of their babies. History of use of iron, folate, Vitamin B complex and daraprim were obtained. Haemoglobin, malaria parasitaemia, and HIV serostatus were determined. Use of iron (P < 0.006), folate (P = 0.032), vitamin B complex (P = 0.001) and treatment for malaria (P = 0.05) significantly reduced the risk for anaemia in pregnancy. Malaria parasitaemia (P = 0.0001) significantly increased the risk of anaemia. However, use of daraprim and HIV seropositivity increased the risk of anaemia in pregnancy but not significantly. In a logistic regression analysis, iron (P = 0.001) and folate supplementation (P = 0.015) significantly protected against anaemia in pregnancy while malaria parasitaemia (P = 0.006) and HIV seropositivity (P = 0.015) were significant adverse risk factors. HIV is an additional risk factor for anaemia in pregnancy. Voluntary counseling and testing of pregnant women for HIV is therefore also indicated at primary care level to detect asymptomatic anaemia in pregnancy that may be due to HIV.

Total ovulating period: any contribution to ovarian carcinogenesis?

The etiology of ovarian cancer has many postulates including that of incessant ovulation. Women of high parity especially those that breastfeed in addition are supposed to be protected. Ovarian cancer patients in the developing world are of higher parity than their Caucasian counterparts. Our study compared the length of reproductive career (LRC), the physiological ovulation free period (PFP) and the total ovulating period (TOP) amongst histologically proven ovarian cancer patients and age - matched controls. This is a questionnaire survey of 21 ovarian cancer patients managed by us between 1st December 1998 and 31st July 2002 and 42 gynaecological patients not known to have ovarian cancer. The mean age among the patients was 45.7+16.9 years while among the controls it was 45.4 +/- 16.1 years. The mean parity of the patients was 3.6 +/- 2.2 compared to 3.4 +/- 2.9 in the controls. The patients had a mean LRC of 23.8 +/- 11.2 years while in the controls it was 25.7+10.8 years. The mean PFP of the patients was 7.4 +/- 5.6 years and for the controls 7.1 +/- 6.5 years. The patients had a mean TOP of 15.8 +/- 8.8 years while this was 18.6 +/- 8.1 years for the controls. None of these differences was statistically significant. Our study revealed no statistically significant differences in the total ovulating periods between ovarian cancer patients and age-matched controls. Further studies will be necessary.

Comparison of changes in pre-induction cervical factors' scores following ripening with transcervical foley catheter and intravaginal misoprostol.

The study compares the changes in the cervical factors in pre-induction cervical ripening with both transcervical Foley catheter and Intravaginal Misoprostol. This was a randomised prospective study of pregnant women, with singleton gestations who presented for antenatal care and delivery at a tertiary health institution in the South-western Nigeria between 1st March 2003 and 31st March 2004. One hundred and two (102) patients received 50microg intravaginal Misoprostol and Ninety-six (96) received size 16F Transcervical Foley catheters. Both groups were similar at the baseline. Misoprostol group showed greater improvement in the final cervical length score, with 38.4% and 58.6% scoring 2 and 3 respectively, in contrast with the Foley catheter group where 77.7% had final score of 1, with only 16% scoring 2 and none scored 3 (P = 0.00). Ninety-one percent of the patients in the misoprostol group achieved the maximum cervical consistency score of 2, contrasting with the 31.9% in the Foley Catheter group (P = 0.00). 64.9% of the patients in the Foley catheter group did not achieve appreciable change in cervical consistency. Our findings indicate that intravaginal misoprostol was more effective in improving the scores of cervical length and consistency, while transcervical Foley catheter was better at improving the cervical os dilatation score at pre-induction cervical ripening. The clinical implication is that, patients for pre-induction cervical ripening can be selected for either of these ripening agents based on which cervical factors require improvement in scores

Cervico-vaginal foetal fibronectin: a predictor of cervical response at pre-induction cervical ripening.

CONTEXT: Not all pregnant women with an "unripe" cervix can be successfully ripened by the cervical ripening agents; therefore tests with predictive information are justified. OBJECTIVES: To examine the effect of the presence of foetal fibronectin (FFN) in the cervico-vaginal secretions on pre-induction cervical ripening with either intravaginal Misoprostol or transcervical Foley catheter. METHODOLOGY: Twenty (20) patients managed at a tertiary health institution in South-western Nigeria between March and May 2003 were randomised for cervical ripening by either intravaginal Misoprostol or Transcervical Foley catheters. Cervico-vaginal secretions were assessed for presence of FFN with Foetal Fibronectin Enzyme Immunoassay Kit (Adeza Corp.) prior to commencement of cervical ripening. MAIN OUTCOME MEASURES: FFN status, Pre-ripening and Pre-induction modified Bishop scores and duration of cervical ripening. RESULTS: Ten of the fifteen patients with positive membrane immunoassay for FFN achieved ripened cervix (modified Bishop score > or = 6) within 6 - 12 hours of exposure to the agents of cervical ripening. In the FFN negative group, only 2 of the five patients achieved ripe cervix within the >12 - 18 hours period, the rest being in the >18 - 24 hours period. CONCLUSION: Foetal fibronectin test may offer useful predictive information prior to institution of processes of cervical ripening in patients with unfavourable cervices.

Anal complaints in Nigerians attending Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu.

The objective of this study was to determine prospectively the prevalence of anal complaints amongst Nigerians attending the General Out-patient Department (GOPD) of the hospital and review the records of those admitted to the surgical service with related complications. All the 272 patients attending the GOPD of OOUTH in November, 1999 were interviewed using a structured questionnaire. Information concerning age, sex, educational status, present or past history of at least one of the following symptoms viz recurrent bleeding per rectum, anal prolapse, anal/perianal pain, pruritus ani and anal discharge were obtained. Also obtained were reason(s) for current hospital attendance and any previous medical consultation. Those with at least one of the symptoms were classified as symptomatic. The symptomatic group had rectal examination including proctoscopy. The results showed that 82/272 (30.15% ) were symptomatic. Rectal examination on these 82 patients showed that 10(3.7% of 272) had haemorrhoids, 2(0.7% ) had rectal prolapse, 0.7% had peri-anal warts; 15(5.5% ) anal tags, 10(3.7% ) chronic anal fissure, 2 (0.7% ) perianal fistulae. In 29(10.4% ), the examination was normal and in 12 the rectum was too loaded with feaces to permit proctoscopy. However, only 5/272 (1.84% ) attended the clinic for the anal complaint, while 12(4.4% ) had previously consulted a physician for same. Fear of impotence following surgery in 24 males and belief in herbal remedies in 32 patients were the main reasons for not consulting a physician. During the year 1999, out of a total of 558 admissions into our surgical service, only 4(0.6% ) were for complications related to anal complaints. This study indicated the prevalence of anal complaints in the study population of Nigerians as 30.15% , haemorrhoids constitute 3.7% and anal fissure 3.7% , contrary to low rates reported for developing countries. While this result cannot be extended to represent prevalence amongst Nigerians, it may be a pointer to what is to be expected.