Association of sociodemographic and maternal healthcare factors with birth registration in Angola.

OBJECTIVES: Angola has a high burden of unregistered children and efforts to increase birth-registration coverage have not yielded the desired progress. This study aimed to examine sociodemographic and healthcare-related factors associated with birth registration in Angola. STUDY DESIGN: Secondary data analysis of the Maternal and Child Health (MCH) Handbook randomised controlled trial conducted in Benguela province, Angola and involving 11,006 women. METHODS: For this analysis, we excluded women with missing data on birth registration (n = 1424), multiple gestation (n = 243), and those with infant death (n = 6). The final study population included 9333 women with infants under one year of age. We used multilevel mixed-effects logistic regression analysis to determine sociodemographic and healthcare-related factors associated with the registration of a child's birth. RESULTS: Of the 9333 live births, 25% (95% confidence interval [CI] = 13.4-41.8) were registered, while 21% (95%CI = 11.1-35.7) were registered with certificate. There were higher proportions of registered births among mothers who possessed the MCH Handbook across various demographic and healthcare indicators. Birth registration was most significantly associated with facility-based delivery (odds ratio [OR] = 2.97; 95%CI = 2.45-3.61), possession of MCH Handbook (OR = 2.04; 95%CI = 1.70-2.46), and complete scheduled vaccination visits (OR = 1.69; 95%CI = 1.44-1.97). Higher maternal age and education level, belonging to the highest wealth quintile, beginning antenatal care in the first trimester, attending at least four antenatal care visits, and using postnatal care services were positively associated with registration of birth. CONCLUSION: Maternal healthcare factors showed significant associations with birth registration and integrating birth-registration processes with certain maternal and child health services may further raise awareness and boost registration levels in Angola.

Diagnostic and Therapeutic Roles of Microdochectomy and Subareolar Ducts Excision for Pathological Nipple Discharge in Lagos.

BACKGROUND: Pathological nipple discharge (PND) comprises less than 10% of presentation in breast clinics. Data on the management of nipple discharge (ND) in our environment are scarce. AIM: To review management outcome in cohorts of patients with PND in our institution between December 2010 and October 2020. METHODOLOGY: This is a retrospective review of consecutive patients managed for PND between 2010 and 2020. Demographical characteristics, clinical features, investigation results and management outcome were retrieved from the clinical records for analysis. A cross-sectional survey via telephone conversation/clinic consultation was carried out to monitor patients for post-operative complications and recurrence. RESULTS: There were 25 patients (18 microdochectomies and 7 subareolar duct excisions) in the study with a median age of 44 (37.5-49.5) years. The median duration of symptoms before presentation was 3 (2.5-5.5) months. The major characteristics of ND in the study cohort were: single duct orifice in 18 patients (72%) spontaneous ND in 14 patients (56%); right ND in 15 patients (60%); and bloody ND in 21 patients (84 %). Only one patient had a family history of breast cancer. Intraductal papilloma diagnosed in 9 patients (36%) was the most common cause of PND. Breast cancer was an underlying aetiology in 28% of patients in the series. Six out of 7 patients with breast cancer diagnosis were <50years. CONCLUSION: Most women with PND in our practice were young with predominance of spontaneous bloody discharge. Intraductal papilloma was the most common cause of PND in this study. Breast cancer accounted for about a third of cases.

CONTEXTE: L'écoulement mamelonnaire pathologique (EMP) représente moins de 10 % des cas présentés dans les cliniques du sein. Les données sur la prise en charge de l'écoulement mamelonnaire (EM) dans notre environnement sont rares. OBJECTIF: Examiner les résultats de la prise en charge dans des cohortes de patientes présentant un écoulement mamelonnaire pathologique dans notre établissement entre décembre 2010 et octobre 2020. MÉTHODOLOGIE: Il s'agit d'une revue rétrospective des patientes consécutives prises en charge pour un DP entre 2010 et 2020. Les caractéristiques démographiques, les caractéristiques cliniques, les résultats des examens et les résultats de la prise en charge ont été extraits des dossiers cliniques pour analyse. Une enquête transversale par conversation téléphonique/consultation en clinique a été réalisée pour surveiller les complications post-opératoires et les récidives chez les patients. RÉSULTATS: L'étude a porté sur 25 patients (18 microdochectomies et 7 excisions du canal sous-aréolaire) dont l'âge médian était de 44 ans (37,5-49,5). La durée médiane des symptômes avant la consultation était de 3 (2,5-5,5) mois. Les principales caractéristiques de la MN dans la cohorte de l'étude étaient les suivantes : orifice unique dans 18 patients (72 %), MN spontanée chez 14 patients (56%), MN droite chez 15 patients (60 %) et MN sanglante chez 21 patients (84 %). Une seule patiente avait des antécédents familiaux de cancer du sein. Le papillome intraductal diagnostiqué chez 9 patientes (36 %) était la cause la plus fréquente de la MN. Le cancer du sein était une cause sous-jacente chez 28 % des patientes de la série. Six des sept patientes chez qui un cancer du sein a été diagnostiqué avaient moins de 50 ans. CONCLUSION: Dans notre pratique, la plupart des femmes souffrant de DPN étaient jeunes, avec une prédominance d'écoulements sanglants spontanés. Le papillome intraductal était la cause la plus fréquente de DPN dans cette étude. Le cancer du sein représentait environ un tiers des cas. Mots-clés: Cancer du sein, Écoulement, Mamelon, Pathologique.

Optimization of the mechanical properties of polyester/coconut shell ash (CSA) composite for light-weight engineering applications.

The mechanical properties of coconut shell ash (CSA) reinforced polyester composite have been optimized. Various test specimens were developed by dispersing 10, 20, 30 and 40 wt.%, of CSA in unsaturated polyester resin in decreasing particle sizes of 40, 30, and 20 µm in an open mould using hand lay-up technique. Tensile, flexural, and impact strengths, as well as tensile and flexural moduli and Shore D hardness of all test samples were determined. The results showed that 10-20 wt.% CSA increased tensile, flexural, impact strengths and flexural modulus for all particle sizes, but 30-40 wt. % CSA engendered depreciation in corresponding performance. For all particle sizes, 10-40 wt. percent CSA resulted in an increase in tensile strength, whereas 10-40 wt. percent resulted into a linear increase in Shore D hardness. Further observation portrayed that in each case, the finest CSA (20 µm) have the optimum result. Statistical analysis carried out on experimental outcomes confirmed the experimental variables (particle proportion and sizes) to be significant. From the surface plot, the strength responses revealed more dependence on the individual variables than their interactions. Regression models developed for individual responses are termed statistically fit in representing the experimental data.

Atherogenic and cardiovascular risks of women on combined oral contraceptives: A comparative study.

BACKGROUND: Although combined oral contraceptive (COC) is commonly used in sub-Saharan Africa, data on its cardiovascular disease risk remains scanty. The study aimed to determine serial serum lipid profiles and cardiovascular disease risks among COC-users. METHODS: This is a prospective, comparative multicentered study conducted at four health facilities in Nigeria. Participants were new users of contraceptives; 120 each of women initiating COCs (group I) and those initiating other forms of nonhormonal contraceptives (group II) were recruited and monitored over a 6-month period. Serial lipid profile, blood pressure, and atherogenic risk for cardiovascular diseases were measured at recruitment (start) and scheduled follow-up clinic visits at 3 months and 6 months for all participants. Statistical analysis was performed with SPSS (version 21.0) and P value < 0.05 was considered significant. RESULTS: In all, 225 participants (111 COC-users, 114 nonCOC-users) that completed the study were aged 18 to 49 years. There was a statistically significant increase in the diastolic blood pressure (P = 0.001), Low Density Lipoprotein- Cholesterol (P = 0.038) and higher atherogenic risk (P = 0.001) among COC-users compared to nonCOC-users. The serial total serum cholesterol, triglyceride, High Density Lipoprotein, systolic blood pressure, and body mass index were higher among COC-users but were not statistically significant compared to nonCOC-users. CONCLUSION: Alterations in lipid profile and increased short-term atherogenic risk for cardiovascular disease were reported among the COC-users in this study. Serial lipid profile and atherogenic risk assessment for cardiovascular diseases are recommended for monitoring of COC-users.

Development and practice of laparoscopic surgery in a Nigerian tertiary hospital.

BACKGROUND: For the benefits of less postoperative pain, early recovery and discharge, and better cosmesis, laparoscopic surgery is rapidly gaining acceptance amongst surgeons as a better alternative to traditional open procedures. In January 2015, bookings for laparoscopic surgery became a more regular feature on our operation list. AIMS: We reported the indications, management outcome, and challenges in patients who had laparoscopic surgery in our institution. This is to document the trends in our surgical practice. METHODOLOGY: This is a descriptive study of 137 patients who had laparoscopic surgery for general surgical indications in our institution over a period of 5 years. Patients data as collected from the records department were evaluated for demographic characteristics, medical comorbidities, type of procedures done, and perioperative outcome. Data analysis was performed using Statistical Package for Social Sciences (SPSS). RESULTS: A total of 137 Patients had laparoscopic general surgery between January 2015 and December 2019. There were 48 males and 89 females with a male-to-female ratio of 1:1.9. The mean age of the patients was 38.8 ± 3.4 years (range 16-87 years). Laparoscopic cholecystectomy (35%) and laparoscopic appendicectomy (29.9%) were the most common procedures performed. Five (3.7%) cases were converted to open surgery. Superficial surgical site infection (5.8%) following laparoscopic appendicectomy was the most common postoperative complication. There was no 30-day postoperative mortality. CONCLUSION: Laparoscopic surgery is safe and can be applied to wide variety of general surgical conditions in developing countries. Minimal postoperative morbidity of laparoscopy is a major benefit to the patients.

Influence of chemical treatment on the properties of cement-paper hybrid composites for ceiling board application.

This study evaluates the effect of treated and untreated jute fiber/eggshell particulate reinforced cement-paper matrix composites for ceiling board application. Treated jute fiber (TJF) was obtained by immersing untreated jute fiber (UJF) into 1.25 M sodium hydroxide (NaOH) solution in a shaker water bath maintained at 40 °C for 4 h. Eggshells (ESP) were pulverized and sieved to -75µm. Samples were prepared by varying the fiber volume fraction from 0.5 to 2.5 wt.% in the composites. While other constituents such as the binder (cement) and eggshell were kept constant. An hydraulic press cold compaction molder was utilized in the production of the hybrid composites in a predetermined mix ratio designed based on previous research. The samples produced were cured for 7 and 14 days, then sundried for 36 h. The physical, thermal, mechanical and wear behaviour of the produced composites were evaluated while the surface morphology of the fractured splitting tensile samples were analyzed. The result reveals that TJF/ESP hybrid composites had better performance than UJF/ESP hybrid composites in most of the tests carried out. Increase in the number of curing days was found to also enhance the properties of the composite produced in majority of the test evaluated. The 0.5 wt.% UJF/ESP gave the least performance of all the composites developed. While 2.5 wt. % TJF/ESP showed an optimum properties among the composites tested. When compared with standard, it is concluded that the hybrid composites developed can be suitable for ceiling boards and also find possible application in wall partitioning.

Physical and mechanical properties of Entada mannii particulates reinforced composites.

This paper reports the physical and mechanical properties of Entada mannii particulates reinforced composites. Polypropylene (PP) based composites filled with Entada mannii ash particulates was produced using the compression moulding. The thermal properties, structural characteristic and morphology of the composites and ash particulate were studied. Tensile properties, impact strength and flexural properties were used to evaluate the mechanical behaviour of composites. Tensile properties, elastic modulus and hardness properties of the fiber ash polymer composites were improved with aggregate fiber ash loading by 58 %, 41 % and 56 % relative to pure PP composites while there was a drop in impact strength by 56 % as compared with pure PP. Flexural strength of the fiber ash reinforced composites was enhanced significantly with increasing ash particulate loading by 45% and 32% respectively. The Fourier transform infrared spectroscopy (FTIR) revealed that changes occur due to stretching of hydrogen bond network and lignin was remove completely during carbonation process. Fracture surface morphology of fiber ash reinforced composites gave credence to the fact that good wetting between the particulate and the matrix was achieved.

Laparoscopic Transgastric Sutured Cystogastrostomy for Post-traumatic Pancreatic Pseudocyst in a Low Resource Setting: Case Report and Literature Review.

Pancreatic pseudocyst (PPC) complicating blunt and penetrating abdominal injury is well documented in paediatric age groups. In adults, PPC is often one of the sequelae of acute pancreatitis rather than trauma. Blunt abdominal trauma accounts for most documented cases of post-traumatic PPC. To the best of our knowledge, PPC following penetrating abdominal gunshot injury is a rare event. Laparoscopic drainage of PPC is fast gaining acceptance as the procedure of choice amongst experts as it offers many advantages and benefits of minimal access surgery to the patient. We report our experience and challenges with our first case of laparoscopic cystogastrostomy for a large post-traumatic PPC in a 24-yearold man who was diagnosed 8 months after laparotomy for a penetrating thoraco-abdominal gunshot wound. We also conduct a review of the literature on laparoscopic management of Pancreatic pseudocyst.

An Obstructing Small Bowel Phytobezoar in an Elderly Female Nigerian: A Case Report and Literature Review.

Small bowel obstruction secondary to phytobezoars is an unusual presentation in surgery. We present a case of an elderly female patient with an insidious onset of abdominal pain, abdominal distension, and bilious vomiting diagnosed radiologically to be small bowel obstruction. Exploratory laparotomy revealed a trapped mass of vegetable matter in the distal ileum. She had enterotomy with primary closure for removal of obstructing ileal phytobezoars. Her postoperative recovery was uneventful.

Basal Tumor Cell Isolation and Patient-Derived Xenograft Engraftment Identify High-Risk Clinical Bladder Cancers.

Strategies to identify tumors at highest risk for treatment failure are currently under investigation for patients with bladder cancer. We demonstrate that flow cytometric detection of poorly differentiated basal tumor cells (BTCs), as defined by the co-expression of CD90, CD44 and CD49f, directly from patients with early stage tumors (T1-T2 and N0) and patient-derived xenograft (PDX) engraftment in locally advanced tumors (T3-T4 or N+) predict poor prognosis in patients with bladder cancer. Comparative transcriptomic analysis of bladder tumor cells isolated from PDXs indicates unique patterns of gene expression during bladder tumor cell differentiation. We found cell division cycle 25C (CDC25C) overexpression in poorly differentiated BTCs and determined that CDC25C expression predicts adverse survival independent of standard clinical and pathologic features in bladder cancer patients. Taken together, our findings support the utility of BTCs and bladder cancer PDX models in the discovery of novel molecular targets and predictive biomarkers for personalizing oncology care for patients.

Coagulation profile in severe pre-eclampsia and eclampsia in Ilorin, Nigeria: implications for anaesthetic management in operative obstetrics.

BACKGROUND: Severe preeclampsia and eclampsia are associated with coagulopathy which may be a contraindication to central neural axial blockade for caesarean section. Many investigations of bleeding tendencies are not done in our environment because of logistic reasons and emergency presentations of these patients.The study was designed to determine the coagulation profile of severe preeclamptic and eclamptic women in labour and possibly arrive at affordable and readily available investigation(s) that can be used in excluding bleeding tendencies in these patients. STUDY DESIGN: In a prospective study, 50 severely preeclamptic/eclamptic patients in labour and, 50 parturients with normal pregnancies, and, in labour were recruited. Full blood count including platelet count, prothrombin time (PT) using the International Normalized Ratio (INR) and partial thromboplastin time with kaolin (PTTK) were done in all the patients. RESULTS: Mean platelet count was significantly lower in study patients than in controls, 158.1 × 10(9)/l versus 216.9 × 10(9)/l, p = 0.0001. Mean INR and PTTK were within the reference values for the reagents used but mean INR was significantly greater in cases than in controls, 1.06 ± 0.01 versus 0.92 ± 0.01 (p = 0.001) while PTTK was also significantly longer in cases than in controls, 38.4 ± 0.21 versus 34.3 ± 0.44 seconds (p = 0.002). CONCLUSION: As platelet count can be readily obtained and it is affordable in our environment, it can be used in assessing bleeding tendencies in these patients for their effective management.

Missed Diagnosed Bicornuate Unicollis Uterus Presenting As Acute Abdomen.

Uterus bicornuate unicollis is one of the various congenital abnormalities of the female genital tract caused by partial fusion of the mullerian ducts on both sides. A case of acute abdomen resulting from missed diagnosed bicornuate unicollis uterus in a 42-year infertile women was presented. The ultrasonographic diagnosis of twisted complex left adnexial cyst was made prior to exploratory laparotomy. However, findings at laparotomy revealed a non-communicating bicornuate unicollis uterus with damaged right tube (hyrosalpinx) and normal ovaries and left tube. A blind-ended rudimentary left sided uterine horn was excised with the ovary spared and the right sided hydrosalpinx disconnected using chromic 1. Patient was however counselled for in vitro fertilization.

Complications of unsafe abortion in South West Nigeria: a review of 96 cases.

BACKGROUND: Induced abortion is common and largely performed under clandestine and unsafe conditions in Nigeria. Complications from such procedures contribute significantly to maternal morbidity and mortality in the country. OBJECTIVE: To determine the sociodemographic characteristics and pattern of complications present in patients managed for unsafe abortion. SETTING: The patients studied were treated in Federal Medical Centre, Ido Ekiti, a tertiary health institution located in a rural town and a main referral hospital in Ekiti State, South West Nigeria. METHODOLOGY: The records of patients admitted for complications of unsafe abortion over a 5-year period were analyzed with regard to sociodemographic characteristics, gestational age at termination of pregnancy, the providers, methods used and the complications they develop. RESULTS: A total of 102 patients were treated for complications of unsafe abortion during the period under review constituting 7.4% of total gynaecological admission. Majority (60.4%) of the patients were less than 25 years old, 74.0% were students while 81.3% were unmarried. Only 9.4% of the women had ever used contraceptives. Of all the cases, 21 (21.9%) were performed within 8 weeks of gestation while 47.9% were performed in the second trimester. Surgical uterine evacuation was the method used in 67.7% of the patients and 65.6% of the abortions were performed by non physicians. Sepsis was the commonest complication in the patients (79.2%) while uterine perforation was present in 12.5% of the women. The case fatality rate was 16.6% and unsafe abortion accounted for 30.8% of all maternal mortality during the period. CONCLUSION: As young single nulliparous students are the principal sufferers of complications of unsafe abortion in this study, young persons, especially in-school adolescents, should be targeted for the provision of comprehensive reproductive health services.

Health status of birds fed diets containing three differently processed discarded vegetable-bovine blood-rumen content mixtures.

This study was conducted to determine the effect of feeding three differently processed mixtures on health status of broilers. A total of 1080 day-old Marshal broilers were fed; discarded vegetable-fresh bovine blood-fresh rumen digesta (P1), discarded vegetable-ensiled bovine blood-fresh rumen digesta (P2) and discarded vegetable-fresh bovine blood-ensiled rumen digesta (P3) at three levels of inclusion (0, 3 and 6%). Data on blood parameters was taken and were subjected to 3 x 3 factorial arrangements in a completely randomized design. Birds fed P1 had least values (p < 0.05) of serum glucose, total protein, globulin, uric acid and creatinine at starter phase. Birds fed diets containing 3 and 6% level of inclusion recorded the highest (p < 0.05) Packed cell volume, Haemoglobin, White blood cell and Red blood cell values. However, those fed at 0% level of inclusion recorded the highest albumin value. At finisher phase, birds fed P2 and P3 had the highest glucose, uric acid and creatinine values. 6% level of inclusion significantly (p < 0.05) increased the total protein and albumin values. Therefore, for enhanced performance and without comprising the health condition of birds; broiler chickens could be fed diets containing discarded vegetable-fresh bovine blood-ensiled rumen digesta (P3) up to 6% level of inclusion.

Ectopic pregnancy in Ilorin, Nigeria: a four year review.

AIMS AND OBJECTIVES: This is to study the incidence, predisposing factors, clinical presentation and management of ectopic pregnancy that presented over a four year period. PATIENTS, MATERIALS AND METHODS: This is a retrospective study of 98 ectopic pregnancies managed at the gynaecological unit of University of Ilorin Teaching Hospital, Ilorin from 1st January 2004 to 31st December 2007. Information was obtained from the case notes, theatre and labour ward registers. RESULTS: A total of 10,054 deliveries were recorded while 1,430 gynaecological patients were admitted. Ninety eight patients had ectopic gestation accounting for 1% of all deliveries and 6.9% of all gynaecological admissions. The peak age group was 25-29 years (33%); 70 (74.5%) were married and 16 (17%) were students mostly undergraduates. Previous pelvic inflammatory disease 78 (83%), previous pelvic surgery 7 (7.4%) and previous history of ectopic pregnancy 2 (2.1%) were the most common risk factors in the patients. Lower abdominal pain 90 (95.7%), missed period 82 (87.2%), dizziness/fainting attack 57( 60.6%) and vaginal bleeding 50 (53.2%) were the predominant symptoms at presentation. There were 2 (2.1%) bilateral ampullary tubal ectopic with one unruptured ec- topic which was treated with linear salpingostomy. Only one (1.1%) case of heterotrophic pregnancy. Open abdominal surgery was the treatment employed in all the patients. No Mortality was recorded. CONCLUSION: The incidence of ectopic pregnancy can be reduced by putting in place measures to reduce induced abortion and pelvic inflammatory disease. In addition, early presentation, prompt diagnosis and efficient blood transfusion services will decrease the morbidity and mortality associated with ectopic pregnancy.

Trends in the use of female sterilisation through minilaparotomy for contraception at a teaching hospital in north central Nigeria.

BACKGROUND: Female sterilisation is the most widely used method of contraception worldwide. However, only a small proportion of contraceptors are reported to rely on female sterilisation in Nigeria. Continuous reviews of trends in its use are necessary to develop policies that will improve uptake in the country. OBJECTIVE: To determine the volume and trends in the use of female sterilisation through minilaparotomy as a method of contraception in a Nigerian university teaching hospital. METHODS: The records of women who had sterilisation through minilaparotomy over a ten year period were reviewed for socialdemographic characteristics, reasons for undergoing sterilisation, timing of the procedure, surgical method used and complications recorded. This is too sketchy RESULTS: Female sterilisation through minilaparotomy accounted for 95 (0.8%) of the 12,035 total contraceptive use during the period. The rate decreased from 1.5% of total contraceptive use in 1995 to 0.22% in 2003. Eighty two (86.4%) of the female sterilisation acceptors were aged 35 years and above, 46 (48.4%) had no or only primary education and 42 (44.2%) were petty traders. Sixty six (69.5%) of the women were grandmultiparae and 70 (73.7%) had more children than they desired. Seventy three (76.8%) had used other contraceptive methods before sterilisation. The average cost of female sterilisation through minilaparotomy in our hospital was USD25 and this was significantly more than the cost of other contraceptives, and more than hospital charges for normal vaginal delivery. CONCLUSION: The proportion of contraceptive acceptors who rely on female sterilisation is low in our environment and has steadily declined over the years. The higher cost of the procedure as compared to other contraceptives appears to be the main barrier. Reduction or outright elimination of cost will probably act as incentive for women to choose female sterilisation as a method of contraception.

Factors hindering acceptance of HIV/AIDS voluntary counseling and testing (VCT) among youth in Kwara State, Nigeria.

HIV/AIDS has become a source of concern all over the world. The concern cannot be isolated from the devastating effects of HIV/AIDS on economic, social, political and technological development of any nation with a high prevalence rate Nigeria is one of the countries with HIV/AIDS prevalence rate of over 4%. Despite this challenge, the patronage of Voluntary Counseling and Testing (VCT) is still very low. This study therefore examined the factors hindering the acceptance of VCT as expressed by youths in Kwara State. A total of 600 youths from the three Senatorial districts in the State were involved in the study. A survey instrument designed by the researchers was used to collect relevant information from the respondents. Among others, the study identified ignorance, poverty, inadequate number of VCT centres, stigma and discrimination as major factors responsible for the low patronage of VCT centres in Kwara State. Gender and religion had no significant influence on the respondents' views while place of residence had significant influence. The implications of the findings to medical practice and counseling were identified and discussed.

Factors hindering acceptance of HIV/AIDS voluntary counseling and testing (VCT) among youth in Kwara State, Nigeria

HIV/AIDS has become a source of concern all over the world. The concern cannot be isolated from the devastating effects of HIV/AIDS on economic, social, political and technological development of any nation with a high prevalence rate Nigeria is one of the countries with HIV/AIDS prevalence rate of over 4%. Despite this challenge, the patronage of Voluntary Counseling and Testing (VCT) is still very low. This study therefore examined the factors hindering the acceptance of VCT as expressed by youths in Kwara State. A total of 600 youths from the three Senatorial districts in the State were involved in the study. A survey instrument designed by the researchers was used to collect relevant information from the respondents. Among others, the study identified ignorance, poverty, inadequate number of VCT centres, stigma and discrimination as major factors responsible for the low patronage of VCT centres in Kwara State. Gender and religion had no significant influence on the respondents' views while place of residence had significant influence. The implications of the findings to medical practice and counseling were identified and discussed. (Afr. J. Reprod. Health 2010; 14[3]: 159-164)

Clinical experience with injectable progestogen- only contraceptives at University of Ilorin teaching hospital: a five year review.

OBJECTIVES: This is a retrospective study of 1,042 new acceptors of injectable progestogen-only contraceptives at the family planning clinic of the University of Ilorin Teaching Hospital over a five year period from 1st January 2001 to 31st December 2004. The total number of new clients seen during this period was 4,752. 41.1% of these new clients chose condoms as a contraceptive method, 32.2% accepted IUCD, 21.9% accepted injectable progestogen-only contraceptive 08% accepted implants, 3.9% combined oral contraceptive pills and 0.1% bilateral tubal ligation. Of the acceptors of injectable progestogen, 59.5% used depo medroxyprogesterone acetate while 40.5% used norethisterone enanthate. 59.5% of the acceptors belonged to the 30 - 39 years age bracket and 36.2% were grandmultiparous women Injectable progestogen-only contraceptives are among the safest and most effective contraceptive methods available. The two commonly available types are Depot Medroxyprogesterone acetate and Norethisterone enanthate. This study looked at the clinical experience with this form of contraceptive at University of Ilorin Teaching Hospital (UITH). METHOD: The case notes of new clients that accepted injectable progestogen-only contraceptive at the family planning clinic of the UITH between June 2001 and December 2004 were analysed. RESULTS: Injectable progestogen-only contraceptive was the third most commonly accepted method of contraception at UITH during the study period. 59.5% of clients belonged to the 30-39 year age group, 63.5% of them were para 1-4 and 36.2% were grandmultiparous women. 59.8% of the clients were educated up to the secondary level or above. There was no pregnancy reported during the study period. 29.9% of clients experienced various forms of side effects, the commonest of which was menstrual irregularities. CONCLUSION: Injectable progestogen-only contraceptive is widely accepted by women in this centre. Its use cuts across women of all age groups, parities, religion and level of education.

A review of caesarean sections associated with perinatal mortality at the University of Ilorin Teaching Hospital, Ilorin, Nigeria.

OBJECTIVES: To determine the perinatal mortality rate among women who delivered through caesarean section in a tertiary health institution in Nigeria and evaluate how various social and obstetric factors influence the perinatal deaths. METHODS: A review of the clinical records of patients who had caesarean section associated with perinatal death over a 5-year period in the University of Ilorin Teaching Hospital was performed. Socio-demographic and obstetrics data were collected from the record of the patients and their infants for analysis. RESULTS: During the period under review, there were 122 perinatal deaths associated with 923 caesarean sections giving perinatal mortality rate of 132 per 1000 births. Majority (86.1%) of the patients were unbooked and 77.9% had no or low level of education. Nulliparae and grandmultiparae accounted for 88 (72.1%) of the perinatal deaths. Obstructed labour was the indication for caesarean sections in 64.8% of the cases. The stillbirth and early neonatal mortality rates were 80 and 52 per 1000 respectively. Seventy eight per cent of the stillbirths were identified prior to surgery. CONCLUSION: Perinatal mortality rate among patients who were delivered through caesarean section is still high in our center and the women were mostly unbooked, in the extremes of parity, and had no or low level of education. Preventive measures should aim at adequate female education and effective and efficient antenatal coverage.