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1.
F1000Res ; 11: 494, 2022.
Article in English | MEDLINE | ID: mdl-36212550

ABSTRACT

Introduction: This study investigates the impact of informative prior on Bayesian structural equation model (BSEM) with heteroscedastic error structure. A major drawback of homogeneous error structure is that, in most studies the underlying assumption of equal variance across observation is often unrealistic, hence the need to consider the non-homogenous error structure. Methods: Updating appropriate informative prior, four different forms of heteroscedastic error structures were considered at sample sizes 50, 100, 200 and 500. Results: The results show that both posterior predictive probability (PPP) and log likelihood are influenced by the sample size and the prior information, hence the model with the linear form of error structure is the best. Conclusions: The study has been able to address sufficiently the problem of heteroscedasticity of known form using four different heteroscedastic conditions, the linear form outperformed other forms of heteroscedastic error structure thus can accommodate any form of data that violates the homogenous variance assumption by updating appropriate informative prior. Thus, this approach provides an alternative approach to the existing classical method which depends solely on the sample information.


Subject(s)
Models, Theoretical , Research Design , Bayes Theorem , Latent Class Analysis , Sample Size
2.
Nat Commun ; 12(1): 6821, 2021 11 24.
Article in English | MEDLINE | ID: mdl-34819518

ABSTRACT

Understanding the molecular and phenotypic profile of colorectal cancer (CRC) in West Africa is vital to addressing the regions rising burden of disease. Tissue from unselected Nigerian patients was analyzed with a multigene, next-generation sequencing assay. The rate of microsatellite instability is significantly higher among Nigerian CRC patients (28.1%) than patients from The Cancer Genome Atlas (TCGA, 14.2%) and Memorial Sloan Kettering Cancer Center (MSKCC, 8.5%, P < 0.001). In microsatellite-stable cases, tumors from Nigerian patients are less likely to have APC mutations (39.1% vs. 76.0% MSKCC P < 0.001) and WNT pathway alterations (47.8% vs. 81.9% MSKCC, P < 0.001); whereas RAS pathway alteration is more prevalent (76.1% vs. 59.6%, P = 0.03). Nigerian CRC patients are also younger and more likely to present with rectal disease (50.8% vs. 33.7% MSKCC, P < 0.001). The findings suggest a unique biology of CRC in Nigeria, which emphasizes the need for regional data to guide diagnostic and treatment approaches for patients in West Africa.


Subject(s)
Biomarkers, Tumor/genetics , Colorectal Neoplasms/genetics , Liver Neoplasms/epidemiology , Lung Neoplasms/epidemiology , Peritoneal Neoplasms/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Case-Control Studies , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/epidemiology , Colorectal Neoplasms/pathology , Female , High-Throughput Nucleotide Sequencing , Humans , Liver Neoplasms/genetics , Liver Neoplasms/secondary , Lung Neoplasms/genetics , Lung Neoplasms/secondary , Male , Microsatellite Instability , Middle Aged , Mutation , Nigeria/epidemiology , Peritoneal Neoplasms/genetics , Peritoneal Neoplasms/secondary , Risk Factors , Young Adult
3.
Niger Med J ; 60(3): 99-105, 2019.
Article in English | MEDLINE | ID: mdl-31543559

ABSTRACT

Breast cancer (BC), a malignant tumor characterized mainly by a lump in the breast and a change in breast shape, has plagued many women of childbearing age in Nigeria today. This has thus propelled many to find both prophylactic and curative agents to combat BC in affected persons. This article extensively reviews a method of preventing BC in the offspring of affected parents, known as preimplantation genetic testing (PGT) - an assisted reproductive technique that selects genetically unaffected embryo(s) to be transferred to the uterus of a mother upon in vitro fertilization and standard genetic analysis. The present study also seeks to present the techniques involved in PGT that have been reported to prevent the inheritance of BC, its benefits and risks, related case studies in Africa and other continents, and ethical issues surrounding the application of assisted reproduction for BC testing. To achieve these, a thorough search was conducted in reputable scientific journals of reproduction and cancer, and expert knowledge was consulted with regard to these aspects of health and reproduction. Upon reviewing this very important subject, it was confirmed that the beneficial role of assisted reproduction in the field of science and the homes of many cannot be overestimated. This review of the role of PGT in BC prevention will enlighten the understanding of many - creating awareness that with PGT, BC-affected women can have not only children, but also healthy and genetically unaffected children.

4.
Afr J Reprod Health ; 23(4): 63-74, 2019 Dec.
Article in English | MEDLINE | ID: mdl-32227741

ABSTRACT

In spite of the improvements in knowledge about family planning (FP), the contraceptive prevalence rate and unmet need for FP remain poor in most parts of Northern Nigeria. This study sought to explore specific factors that influence contraceptive uptake and demand in North-West Nigeria. Key Informant and In-depth Interviews were conducted using guides among stakeholders in two selected states in North-West Nigeria, Kebbi and Sokoto States. Interviewees were selected purposively to include Reproductive Health Focal Persons at the local government level, service providers, Women of Reproductive Age (WRA) and FP coordinators. Factors inhibiting contraceptive uptake included lack of health education, religion, fear of spousal rejection and side effects. Poor government funding and inadequate number of health workers were also identified as systemic factors. Suggested methods of overcoming identified challenges include; task-shifting, increased stakeholder participation and political will.


Subject(s)
Contraception Behavior/psychology , Contraception/psychology , Contraceptive Agents/supply & distribution , Family Planning Services/organization & administration , Health Knowledge, Attitudes, Practice , Health Services Accessibility/statistics & numerical data , Adolescent , Adult , Contraception/statistics & numerical data , Contraception Behavior/ethnology , Contraception Behavior/statistics & numerical data , Contraceptive Agents/administration & dosage , Cross-Sectional Studies , Cultural Characteristics , Family Planning Services/methods , Female , Health Services Needs and Demand , Humans , Interviews as Topic , Islam , Middle Aged , Nigeria , Qualitative Research , Reproductive Health , Sexual Partners , Young Adult
5.
Int Med Case Rep J ; 11: 307-312, 2018.
Article in English | MEDLINE | ID: mdl-30464652

ABSTRACT

BACKGROUND: Mixed connective tissue disease (MCTD; also known as Sharp's syndrome) is a rare autoimmune inflammatory disorder characterized by high titer of U1 ribonucleoprotein (U1RNP) antibody and clinical and serological overlap of systemic lupus erythematosus, systemic sclerosis, and polymyositis. The diagnosis is based on clinical and serological factors in criteria such as Alarcon-Segovia, Khan, Kusakawa, and Sharps. Cardiac disease can be a complication of connective tissue disease (CTD). There are few reports in Africa. AIMS: To present MCTD as underlying cause of heart failure with reduced ejection fraction and highlight challenges of investigations and treatment. OBJECTIVES: To highlight the first case in our center and discuss the cardiac, respiratory, and rheumatologic management. PATIENT AND METHODS: We present a 52-year-old woman with 3 weeks history of productive cough with whitish sputum, severe dyspnea, orthopnea, paroxysmal nocturnal dyspnea, right sided abdominal pain, leg swellings, a one year history of recurrent fever, Raynaud's phenomenon, small joint swellings and deformities with pain in both hands. RESULTS: On examination there was microstomia, tethered forehead and lower eyelid skin, tender swelling of the interphalangeal joints and arthritis mutilans. Laboratory findings showed estimated glomerular filtration rate <60 mL/kg/min/1.73 m2, U1RNP antibody levels were eight times upper limit of normal, elevated rheumatoid factor, speckled antinuclear antibody pattern, negative anticentromere antibody, anti Scl-70 and anticyclic citrullinated peptide. Chest X-ray/CT revealed pulmonary fibrosis. Echocardiography findings showed reduced ejection fraction of 40%, elevated pulmonary arterial pressure at rest of 60.16 mmHg. The patient showed improvement on antifailure drugs, but prednisolone was stopped for sudden reversal of previously controlled stage 2 hypertension (HTN), and the patient was discharged in a stable condition. Difficulties ensued in obtaining prompt definite results due to the unavailability of serologic tests in the hospital, and the tests were done outside the state and country. CONCLUSION: Identifying MCTD is critical, especially in patients requiring steroids that may worsen systemic HTN and heart failure. There is a need to have definitive investigative facilities for such patients in hospitals.

6.
Haemophilia ; 23(5): e394-e402, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28641362

ABSTRACT

INTRODUCTION: The International Immune Tolerance Study (I-ITI) demonstrated comparable success rates between low (FVIII 50 IU/kg/TIW) and high dose (FVIII 200 IU/kg/day) regimens. While costlier, the high dose ITI regimen achieved shorter time-to-treatment success with fewer bleeding episodes compared to the low dose ITI regimen. Adding bypassing agent prophylaxis (BAP) to a low dose ITI regimen may reduce bleeding while still being less costly than high dose ITI. AIM AND METHODS: An economic model was developed to compare high dose ITI to low dose ITI with BAP. All model inputs were derived from clinical trials. The I-ITI study indicated a median time to negative inhibitor titre of 4.6 and 9.2 months and average number of bleeds/patient of 4.2 and 9.9 for the high and low dose regimens respectively. Based on the BAP trials, aPCC (85 U/kg/TIW) and rFVIIa (90 µg/kg/day) achieved a 62% and 45% reduction in bleeding frequency respectively. Cost analysis was from a US third party payer perspective and limited to drug costs. One-way, two-way and probabilistic sensitivity analyses were performed. RESULTS: Costs of low dose ITI with aPCC prophylaxis until negative inhibitor titre is achieved was 24.0% less compared to high dose ITI. Low dose ITI with rFVIIa prophylaxis cost 46.5% more compared to high dose ITI. Model results were robust in the majority of the sensitivity analyses. CONCLUSION: A low dose ITI regimen with aPCC prophylaxis may be cost saving compared to a high dose ITI regimen with the potential to reduce morbidity by lowering the risk for breakthrough bleeds.


Subject(s)
Cost-Benefit Analysis , Drug Costs , Factor VIII/administration & dosage , Hemophilia A/drug therapy , Hemorrhage/prevention & control , Immune Tolerance , Blood Coagulation Factor Inhibitors/immunology , Clinical Decision-Making , Disease Management , Factor VIII/adverse effects , Factor VIII/immunology , Hemophilia A/complications , Hemophilia A/immunology , Humans , Isoantibodies/immunology , Models, Economic , Recombinant Proteins/administration & dosage , Recombinant Proteins/adverse effects , Recombinant Proteins/immunology
7.
Ann Surg Oncol ; 24(3): 627-631, 2017 Mar.
Article in English | MEDLINE | ID: mdl-27743225

ABSTRACT

PURPOSE: There is an increasing effort in the global public health community to strengthen research capacity in low- and middle-income countries, but there is no consensus on how best to approach such endeavors. Successful consortia that perform research on HIV/AIDS and other infectious diseases exist, but few papers have been published detailing the challenges faced and lessons learned in setting up and running a successful research consortium. METHODS: Members of the African Research Group for Oncology (ARGO) participated in generating lessons learned regarding the foundation and maintenance of a cancer research consortium in Nigeria. RESULTS: Drawing on our experience of founding ARGO, we describe steps and key factors needed to establish a successful collaborative consortium between researchers from both high- and low-income countries. In addition, we present challenges we encountered in building our consortium, and how we managed those challenges. Although our research group is focused primarily on cancer, many of our lessons learned can be applied more widely in biomedical or public health research in low-income countries. CONCLUSIONS: As the need for cancer care in LMICs continues to grow, the ability to create sustainable, innovative, collaborative research groups will become vital. Assessing the successes and failures that occur in creating and sustaining research consortia in LMICs is important for expansion of research and training capacity in LMICs.


Subject(s)
Biomedical Research/organization & administration , Developing Countries , Neoplasms , Organizations/organization & administration , Capacity Building , Cooperative Behavior , Humans , International Cooperation , Nigeria , Organizations/economics , Program Development , Workforce
8.
Acta Pol Pharm ; 72(2): 357-65, 2015.
Article in English | MEDLINE | ID: mdl-26642687

ABSTRACT

A 2(4) full factorial analysis was used to study the individual and interactive effects of binder type, X1; binder concentration, X2; relative density, X3 and tabletting technique, X4, on disintegration time (DT), brittle fracture index (BFI), tensile strength (TS) and mucoadhesion time (MT) of ibuprofen tablets formulated by direct compression (DC) and wet granulation (WG), and containing Entandophragnia angolense gum (ENTA) as binder, in comparison with hydroxypropylcellulose. The result of the FTIR and UV peaks suggests the absence of any interaction between ENTA and ibuprofen. Interactions between the polymers and ibuprofen were determined using FTIR and UV determinations. The ranking of the individual effects on DT and BFI was X2 > X3 > X1 > X4, on TS; X3 > X2> X1 > X4 and on MT; X2> X > X4 > X3. The effects of changing the binder from hydroxypropylcellulose to ENTA led to an increase in DT and decrease in TS, BFI and MT. Changing X2 and X3 to higher values increased the DT and TS. The interaction between X1 and X2 had the highest influence on BEI and MT, while interaction between "X3 and X4", and "X2 and X3" had the highest influence on DT and TS, respectively. Ibuprofen tablets prepared by wet granulation method and containing Entandophragma angolense gum showed lower capping/lamination tendencies and better mucoadhesive drug release profiles.


Subject(s)
Ibuprofen/chemistry , Adhesiveness , Chemistry, Pharmaceutical , Solubility , Spectrophotometry, Ultraviolet , Spectroscopy, Fourier Transform Infrared , Tablets , Tensile Strength
9.
Haemophilia ; 21(5): e344-58, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26390060

ABSTRACT

INTRODUCTION: Prophylaxis is effective in reducing the number of bleeding episodes in patients with severe or moderately severe haemophilia A and B, including those with inhibitors. However, data, predominantly from observational studies, suggest more equivocal effects on health-related quality of life (HRQoL). AIM: To examine the impact of prophylaxis on HRQoL from prospective clinical trials. METHODS: We performed a systematic literature review of clinical trials evaluating the efficacy of prophylaxis with factor VIII, FIX or bypassing agents. Trials assessing HRQoL via validated instruments were selected and summarized. RESULTS: Thirteen trials (haemophilia A [n = 8]; haemophilia B [n = 2]; inhibitors [n = 3]) met all inclusion criteria. HRQoL instruments included the EQ-5D, SF-36, Haem-QoL-A, Haem-A-QoL, Haemo-QoL and CHO-KLAT. Improvements in HRQoL following prophylaxis were observed with the EQ-VAS, SF-36 and haemophilia-specific instruments in adult patients and were associated with reduced pain, fewer restrictions in physical activities and better general health. Prophylaxis led to statistically significant or clinically meaningful HRQoL improvement in six trials and non-significant improvement in four trials; two trials found no improvement and one reported no data. Despite study differences, consistent trends suggested that patients previously treated solely on-demand and those who experienced marked reductions in the frequency of bleeding with prophylaxis had a greater improvement in HRQoL. CONCLUSION: Contrary to findings of observational studies, the results from the majority of prospective trials using validated instruments showed positive trends for improved HRQoL with prophylaxis in adults.


Subject(s)
Health , Hemophilia A/drug therapy , Hemophilia A/prevention & control , Quality of Life , Clinical Trials as Topic , Humans , Prospective Studies , Surveys and Questionnaires , Treatment Outcome
10.
BMC Health Serv Res ; 15: 314, 2015 Aug 11.
Article in English | MEDLINE | ID: mdl-26259953

ABSTRACT

BACKGROUND: Non-governmental organisations (NGOs) are expected to be in the vanguard, repositioning reproductive health as a central issue in population and development in Nigeria. However, most of them have insufficient knowledge or access to policy and planning processes necessary at engaging effectively with the government. This article highlights the processes and outcome of an intervention aimed at strengthening the capacity of 12 non-governmental organisations on advocacy and policy related activities with emphasis on reproductive health issues. METHODS: The study employed a one group, pre and post test study design. Thirty six (36) staff from 12 NGOs was purposively selected and interviewed using a semi-structured questionnaire at baseline to assess their knowledge and level of involvement in reproductive health, advocacy and policy issues. In-depth interviews were conducted with 6 officials of the ministries of health and women affairs to document previous reproductive health and policy related collaborative efforts with the NGOs. Baseline findings were used in developing and implementing a capacity building intervention. A post intervention evaluation was conducted to assess the outcomes. RESULTS: All respondents (100%) had tertiary level education and were from a multidisciplinary background such as nursing (41.7%) medicine (25%) and administration (13.9%). The mean knowledge score on advocacy and policy issues at pre-test and post test was 39.1 ± 17.6 and 76.2 ± 14.2 respectively (p = 0.00). Participants reported making use of advocacy methods and the three most utilized were Phone calls (28.1%), Face to Face meetings (26%) and networking with other organisations for stronger impact (17.1%). The outcome of their advocacy efforts include the provision of free air time by a television station to educate the populace on maternal health issues, donation of landed property to build a youth friendly centre, donation of a blog site for disseminating information on Reproductive health issues and training of other staff of their organisations on advocacy activities. The major challenges experienced by staff of the NGOs were financial (89%) and time constraints (11%). CONCLUSION: Empowered non-governmental organisations can effectively advocate for the implementation of reproductive health policies and programmes.


Subject(s)
Health Knowledge, Attitudes, Practice , Mentors , Organizations , Patient Advocacy , Reproductive Health , Adult , Capacity Building , Female , Health Policy , Humans , Interviews as Topic , Male , Middle Aged , Nigeria , Qualitative Research , Surveys and Questionnaires , Young Adult
11.
Niger J Surg ; 21(1): 52-5, 2015.
Article in English | MEDLINE | ID: mdl-25838768

ABSTRACT

CONTEXT: The Darning technique of inguinal hernia repair is a tissue-based technique with documented low recurrence rate in some parts of the world. Though practiced in our setting, little is documented on its outcome. AIMS: The aim was to review the outcome of Darning technique of inguinal hernia repair in our setting. STUDY DESIGN: A descriptive retrospective study. PATIENTS AND METHODS: Clinical records of all patients who had inguinal hernia repair using the Darning technique between January 2007 and December 2011 in our institution were obtained. Details of sociodemographic data, intraoperative findings and postoperative complications were reviewed. STATISTICAL ANALYSIS USED: simple frequencies, proportions and cross-tabulations. RESULTS: A total of 132 patients whose ages ranged from 15 to 84 years (mean = 49.4 years) with a male: female ratio of 12:1 were studied. Majority of the hernias were right sided (68.9%), mostly indirect (81.8%). The procedures were for emergencies in 17 (12.9%) cases whereas the rest (87.1%) were done electively. Most procedures, 110 (83.3%) were performed under local anesthesia. Surgical site infection was the most common complication occurring in six patients (4.5%), while four patients (3%) had chronic groin pain. At a mean follow-up period of 15 months there were two recurrences (1.5%) both occurring in patients with bilateral hernias (P = 0.001). CONCLUSIONS: The Darning technique of inguinal hernia repair is a safe and effective method for inguinal hernia repair in our setting.

12.
Trop Anim Health Prod ; 46(1): 197-202, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24077958

ABSTRACT

Twelve white Fulani × N'dama cross-bred calves weighing 83.79 ± 1.16 kg were used in an 84-day experiment to investigate the utilization of forage resources from natural grazing land. The experimental diets were sole grazing, grazing + hay, grazing + silage and grazing + Leucaena leucocephala leaves. The calves were divided into four groups of three animals each and were randomly assigned to the four experimental diets. Crude protein (CP) contents of the forages ranged from 59 to 171 g/kg dry matter (DM). Neutral detergent fibre (NDF) and acid detergent fibre (ADF) contents of the forages ranged from 560 to 705 g/kg DM and 363 to 440 g/kg DM, respectively. Significantly (P < 0.05) higher values in mineral contents (Ca, K, P and Mg) were recorded for L. leucocephala leaves compared to other forage resources. Variations (P < 0.05) were observed in the average daily gain. Animals on grazing + L. leucocephala leaves diet had the highest (113 g/day) average daily gain, while those on sole grazing showed the least value (26.2 g/day). Packed cell volume (PCV), total serum protein, urea and calcium concentration showed significant differences (P < 0.05). Effective utilization of forage resources from the natural pasture by the calves was attained on supplementation with conserved forages and L. leucocephala leaves without any deleterious effects on the haematological and serum parameters.


Subject(s)
Animal Feed/analysis , Cattle/growth & development , Fabaceae , Animal Husbandry , Animal Nutritional Physiological Phenomena , Animals , Diet/veterinary , Eating , Random Allocation , Seasons , Silage/analysis , Weight Gain
13.
Afr J Reprod Health ; 17(2): 80-8, 2013 Jun.
Article in English | MEDLINE | ID: mdl-24069754

ABSTRACT

This study reports on findings of a pilot of community-based distribution (CBD) of injectable contraceptives in two local government areas (LGAs) of Gombe State, Nigeria. From August 2009 to January 2010, the project enrolled, trained and equipped community health extension workers (CHEWs) to distribute condoms, oral and injectable contraceptives in communities. The project mobilized communities and stakeholders to promote Family Planning (FP) services in the selected communities. Using anonymised unlinked routine service data, the mean couple years of protection (CYP) achieved through CBD was compared to that achieved in FP clinics. The CBD mean CYP for injectables- depo medroxy-progesterone acetate (DMPA) and norethisterone enantate was higher (27.72 & 18.16 respectively) than the facility CYP (7.21 & 5.08 respectively) (p < 0.05) with no injection related complications. The CBD's mean CYP for all methods was also found to be four times higher (11.65) than that generated in health facilities (2.86) (p < 0.05). This suggests that the CBD of injectable contraceptives is feasible and effective, even in a setting like northern Nigeria that has sensitivities about FP.


Subject(s)
Community Health Workers , Contraceptive Agents, Female/administration & dosage , Delivery of Health Care/organization & administration , Health Promotion/organization & administration , Medroxyprogesterone Acetate/administration & dosage , Norethindrone/analogs & derivatives , Adolescent , Adult , Condoms , Condoms, Female , Feasibility Studies , Female , Humans , Injections , Male , Maternal Mortality , Middle Aged , Nigeria/epidemiology , Norethindrone/administration & dosage , Socioeconomic Factors
14.
J Clin Pharm Ther ; 38(3): 243-5, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23448320

ABSTRACT

WHAT IS KNOWN AND OBJECTIVE: Colchicine is an anti-inflammatory agent used primarily in treatment of gout and familial Mediterranean fever. Toxicity is uncommon, and depends on dose, hepatic or renal impairment, co-administration with P-glycoprotein or CYP3A4 inhibitors and route of administration. In patients taking p-glycoprotein inhibitors, maximum recommended dose is 0·3 mg per day. In renal or hepatic impairment, recommendation is to avoid concomitant administration of p-glycoprotein inhibitors and colchicine. CASE SUMMARY: We present an 82 year old patient, with a history of gout, chronic kidney disease and recurrent renal cell carcinoma who was admitted with features of colchicine toxicity after taking a cumulative dose of 41·4 mg over ten days, and taking sunitinib 50 mg daily from day seven of his high dose colchicine regimen. Symptoms started after commencing his cycle of sunitinib, which he had taken in 14 day cycles for many years. He developed severe diarrhea, normal anion gap metabolic acidosis, fever, pneumonia, white cell abnormalities including 30% bands and toxic granulation with Dohle bodies. Red cell abnormalities included anemia, burr cells and acanthocytosis. He also developed acute cardiovascular collapse with hypotension and acute systolic heart failure. Cardiac catheterization showed previously known coronary artery disease, with no significant progression to explain degree of cardiovascular collapse. WHAT IS NEW AND CONCLUSION: P-glycoprotein inhibition by sunitinib has been demonstrated. Interaction with colchicine metabolism precipitated colchicine toxicity in this case. Knowledge of p-glycoprotein and its role in drug interactions and potential drug toxicity may not be widespread among clinicians. We report the first case of colchicine toxicity precipitated by interaction with a tyrosine kinase inhibitor.


Subject(s)
Colchicine/administration & dosage , Colchicine/adverse effects , Indoles/administration & dosage , Indoles/adverse effects , Pyrroles/administration & dosage , Pyrroles/adverse effects , Aged, 80 and over , Angiogenesis Inhibitors/administration & dosage , Anti-Inflammatory Agents/administration & dosage , Drug Interactions , Humans , Male , Sunitinib
15.
Nig Q J Hosp Med ; 23(2): 139-41, 2013.
Article in English | MEDLINE | ID: mdl-24579512

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of ultrasound guided tranvaginal probe placed on the anterior abdominal wall for oocyte retrieval in a patient whose ovaries were not visible trans-vaginally. DESIGN: A case report SETTING: Medical ART Center, Nigeria- Private IVF clinic with an academic setting PATIENT(S): A 35 yr old woman undergoing IVF treatment with ovaries difficult to visualize trans-vaginally having ovarian stimulation pressure effect. INTERVENTION(S): Ultrasound guided oocyte aspiration through the abdominal wall using the trans-vaginal probe. MAIN OUTCOME MEASURES: Number of oocytes retrieved. RESULTS: 9 oocytes were successfully aspirated using the ultrasound scan guided probe placed over the anterior abdominal wall. CONCLUSION: Successful oocyte retrieval can be achieved via the abdominal puncture with the aid of a trans-vaginal ultrasound probe placed on the abdominal wall.


Subject(s)
Oocyte Retrieval/methods , Ovary/diagnostic imaging , Ultrasonography, Interventional/methods , Adult , Female , Humans
16.
Nig Q J Hosp Med ; 22(2): 80-4, 2012.
Article in English | MEDLINE | ID: mdl-23175902

ABSTRACT

BACKGROUND: Infertility is a major problem in Nigeria, which has caused many couples to be burdened with physical, psychological and social issues. IVF (In-vitro fertilization) has played a major role in reducing the burden among infertile couples. However, despite the role of IVF in solving infertility in Nigeria, it is important to address the issue of rising rates of multiple births from IVF. Also to create a balance between the number of embryo transferred and easing the burden couples face from infertility. OBJECTIVE: To determine the trend/rate in multiple gestations from IVF, identify possible factors responsible and proffer ways to reduce multiple gestation rates. METHODS: We did a case series review from 2009-2011 of IVF cycles performed at a private clinic with an academic setting in Nigeria. Our primary outcome of interest was multiple gestations/pregnancies All patients identified with outcome of interest, were included in the study sample. We reviewed the IVF process of each patient using medical records from pre-evaluation to clinical pregnancy confirmed by ultrasound. We reported the multiple gestation trend/rate. RESULTS: 25 women with the mean age of 39.9 +/- 7.3 years had multiple pregnancies from 2009 to 2011. Of the 25 women, 24% of the pregnancies, occurred in 2009, 40% occurred in 2010 and 36% in 2011. In 2009, 83% of the pregnancies were twin gestations and 17% triplets. In 2010, 40% were twin gestations, while triplet, quadruplet and quintuplet gestations were 20% each. In 2011, 66% were twin gestations and 34% quadruplet gestation. The factors we identified that could have lead to an increase in multiple gestations from 2009-2010 included improvement in pre-evaluation work up, stimulation protocol, efficacy of the IVF lab and mean of 5 embryos transferred. In 2011, embryo transferred was reduced to 3-4. From 2009 to 2011, mean number of embryos transferred was 4.2 (95% CI: 3.87-4.47). CONCLUSION: Multiple gestations and associated risk from IVF in Nigeria can be reduced by reduction in number of embryos transferred and possibly by improvement in practice process. As the IVF process becomes more efficacious, fertility centres in Nigeria will not need to transfer up to 4 embryos in order to have a positive pregnancy; and as a result they can move towards two to single embryo transfer.


Subject(s)
Embryo Transfer/methods , Embryo Transfer/statistics & numerical data , Fertilization in Vitro/methods , Fertilization in Vitro/statistics & numerical data , Pregnancy, Multiple/statistics & numerical data , Adult , Age Factors , Clinical Protocols , Female , Health Policy , Humans , Middle Aged , Multiple Birth Offspring/statistics & numerical data , Nigeria/epidemiology , Pregnancy
18.
Afr J Reprod Health ; 13(1): 159-65, 2009 Mar.
Article in English | MEDLINE | ID: mdl-20687273

ABSTRACT

Workplace exposures and hazards have detrimental effects on many organ systems in the body including the reproductive system. The evidence of the reproductive effects of occupational hazards is obtained through a synthesis of the available literature. These effects vary and overlap due to the multiple nature of exposures in the workplace. Hazardous agents include pesticides, solvents and heavy metals. The reproductive effects include reduced fecundity, abnormal sperm quality, increased risk of low birth weight, miscarriages and permanent sterility. These problems are not readily identified as having occupational causes in developing countries such as Nigeria where infertility has a high family and social consequence. Epidemiological studies in Nigeria are needed to evaluate the reproductive effects of workplace exposures. Protective measures such as proper house keeping, education and the use of personal protectives at the workplace are advocated.


Subject(s)
Hazardous Substances/adverse effects , Infertility, Male/etiology , Occupational Exposure/adverse effects , Female , Fertility , Humans , Male , Solvents , Spermatozoa , Temperature , Workplace
19.
Int. j. morphol ; 26(3): 643-652, Sept. 2008. ilus, tab
Article in English | LILACS | ID: lil-556726

ABSTRACT

Increasing concern has been expressed about the declining sperm count of humans and the potential environmental effects of both synthetic and natural estrogenic endocrine disruptors (EEDs) on human reproductive health in the last few decades. However, due to paucity of knowledge, we evaluate the chronic reproductive toxicity of sesame phytoestrogenic lignans on the male Sprague Dawley (SD) rats' testis. Thirty adult male SD rats weighing 150-200g were divided into three groups. Two treated groups received a daily dose of aqueous leaves extract of Sesamum radiatum at 14.0 mg/kg bw and 28.0mg /kg bw respectively via gastric gavage, while equal volume of normal saline was administered to the control group for six weeks. Seminal analysis and hormonal assay study were analyzed using SPSS software and P< 0.05 was considered statistically significant. The results showed significant (P< 0.05) body weight gains observed in all the animals with significant (P< 0.05) weight increase in their raw testicular weights compared to control. The relative testicular weight per 100g bw was significantly (P< 0.05) higher in control than treated. However, the weight gain was dose related with a reversal in their relative testicular weight. The cauda sperm count including the motility and morphology of the treated were significantly (P< 0.05) higher than control in a dose related manner. In addition, significant (P > 0.05) increases in testosterone and a significant decrease in FSH in the high dose (treated) compared to control. Sesame phytoestrogenic lignans improves spermatozoa quality in a dose related manner.


Una mayor preocupación se ha expresado en las últimas décadas por la disminución en la cantidad de espermatozoides de los seres humanos y los posibles efectos ambientales de disruptores endocrinos estrogénicos (DES) sintéticos y naturales sobre la salud reproductiva humana. Sin embargo, debido a la escasez de conocimientos, evaluamos la toxicidad crónica para la reproducción de fitoestrógenos lignanos del sésamo en el testículo de ratas Sprague Dawley (SD) macho. Treinta ratas macho adultas, de un peso de 150-200g se dividieron en tres grupos. Dos grupos de tratamiento recibieron una dosis diaria de extracto acuoso de las hojas Sesamum radiatum de 14,0 mg/kg de peso corporal y 28,0mg / kg de peso corporal, respectivamente, a través de una sonda gástrica, mientras que igual volumen de solución salina normal se administró al grupo control durante seis semanas. El análisis seminal y estudio de ensayo hormonal fueron analizados mediante el software SPSS y P <0,05 fue considerado estadísticamente significativo. Los resultados mostraron significativas (P <0,05) ganancias de peso corporal observados en todos los animales con un peso significativo (P <0.05), aumento de peso en su peso testicular bruto en comparación con el control. El relativo peso testicular por 100 g de peso corporal fue significativamente mayor (P <0,05) en control que en tratamiento. Sin embargo, el aumento de peso dosis se ha relacionado con un retroceso en su peso relativo testicular. La cantidad de espermatozoides, incluyendo la motilidad y morfología de los que recibieron tratamiento fue significativamente más alto que el control (P <0,05) en una dosis relacionados. Además, significativo aumento en los niveles de testosterona (P> 0,05) y una disminución significativa de FSH en la dosis alta (tratados), en comparación con el control. Fitoestrógenos lignanos del sésamo mejoran la calidad de los espermatozoides en una dosis adecuada.


Subject(s)
Male , Adult , Animals , Rats , Spermatogenesis , Rats, Sprague-Dawley/anatomy & histology , Rats, Sprague-Dawley/genetics , Semen , Semen/enzymology , Sesamum/metabolism , Sesamum/chemistry , Testis/anatomy & histology , Testis , Testis/metabolism , Gas Chromatography-Mass Spectrometry/methods , Estrogens/administration & dosage , Estrogens/metabolism , Estrogens/therapeutic use , Plant Preparations/therapeutic use
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