Cervical Ectopic Pregnancy Presenting With Ruptured Posterior Cervical Lip: A Case Report.

Cervical ectopic pregnancy (CEP) is a rare but fatal early pregnancy complication. A rare case of cervical ectopic gestation with rupture of the posterior cervical lip is reported due to the rarity of this presentation and the need to consider it in patients presenting with miscarriages. We present a 19-year-old G2P0 +1 at a gestational age of 11 weeks and six days who presented with a cervical ectopic gestation with rupture of the posterior cervical lip. Transvaginal ultrasound showed features of a cervical ectopic gestation. The products of conception were evacuated through the cervical defect posteriorly after infiltration of vasopressin and the defect on the posterior lip was repaired. A ruptured cervical lip is a possible presentation of CEP. It may present the clinician with a diagnostic challenge. A high index of suspicion and proficiency in transvaginal ultrasonography is required for prompt diagnosis.

Beta-cell dysfunction and abnormal glucose metabolism among non-diabetic women with recurrent miscarriages.

BACKGROUND: Subclinical beta-cell (ß-cell) dysfunction is an endocrine abnormality and its association with recurrent miscarriages (RM) has not been extensively studied. OBJECTIVE: This study aimed to determine the prevalence of ß-cell dysfunction and abnormal glucose metabolism [fasting blood glucose (FBG) ≥ 5.1 mmol/L] among non-diabetic women with recurrent miscarriages and to establish if there was an association between RM and ß-cell dysfunction and FBG ≥ 5.1 mmol/L. METHODOLOGY: This was a cross-sectional study involving 80 women with miscarriages at ≤ 13 weeks gestation and 80 women with normal pregnancies at ≤ 13 weeks of gestation with at least one successful live-birth and no history of miscarriage (comparison group). Interviewer-administered questionnaire was used to obtain relevant information. From each participant, FBG and fasting insulin were assayed. ß-Cell function was computed. The data obtained was analysed using IBM-SPSS version 22.0. RESULTS: A significantly higher prevalence of ß-cell dysfunction and abnormal glucose metabolism were observed among non-diabetic women with RM compared to age-matched controls (38.8% vs 10.0%, P < 0.001) and (27.5% vs 6.3%, P = 0.005) respectively. The mean ß-cell function of the cases was 59.0% of the controls (264.41 ± 105.13 vs 447.82 ± 181.24, P < 0.001). Mean FBG was significantly higher in the case-group compared to the controls (4.77 ± 1.14 mmol/L vs 3.58 ± 0.78 mmol/L, P < 0.001). There was a significant association between RM and FBG ≥ 5.1 mmol/L and low ß-cell function (P < 0.001). CONCLUSION: This study suggests that women with recurrent miscarriages are more likely to have impaired ß-cell function and abnormal glucose metabolism (FBG ≥ 5.1 mmol/L).

Knowledge of HIV prevention and willingness to collaborate in vaginal microbicides trials-survey of Nigerian gynecologists.

BACKGROUND: Gynecologists being the primary care physicians and advocates for women sexual and reproductive health are critical in delivering messages on effective intervention to prevent heterosexual HIV transmission. Their knowledge and opinions on the effectiveness of HIV prevention technologies may influence the acceptance and use of these technologies among women at risk. METHODS: A cross sectional survey was self-administered to Nigerian gynecologist attending an Annual Scientific conference; "Kanon Dabo" between November 17 and 21, 2009, in Kano, Nigeria. Their opinions on various HIV prevention strategies as well as their willingness to collaborate on vaginal microbicides trials were assessed on a Likert scale. The mean scores of the responses were tested using student's T-test. Statistical analyses were done with STATA version 11, College Station, Texas, USA. RESULTS: Of the 100 questionnaires distributed to the participants at the conference, we had a survey response rate of 74.0%. The mean age of the participants was 42.38 +/- 6.67 years with range 30-58 years. Male participants constituted 84.9%, and Female participants 15.1%. Twenty five percent (25%) of the surveyed participants were aware of vaginal microbicides, and only 3% correctly mentioned an example of a vaginal microbicide for HIV prevention. The willingness of the participants to collaborate on vaginal microbicides trials was not significantly related to their knowledge on vaginal microbicides (p = 0.475). CONCLUSION: We concluded that the current knowledge of Nigerian gynecologist on vaginal microbicides is poor. Efforts to create awareness among these women advocates on recent HIV prevention technology, particularly, vaginal microbicides are required.

Prevalence of HIV and other sexually transmissible infections in relation to lemon or lime juice douching among female sex workers in Jos, Nigeria.

BACKGROUND: The rates of sexually transmissible infections (STI), including HIV, are high among female sex workers (FSW) in Nigeria and the use of various local vaginal cleansing agents to prevent infection is a common practice. The present study was aimed at determining whether any association exists between current lime or lemon douching and the prevalence of STI and HIV infections among FSW in Jos, Nigeria. METHODS: Consenting FSW who were users of lemon or lime (UL) or non-users (NUL) were recruited for the study between May and September 2006. A structured questionnaire was administered by trained counsellors. Pre-HIV test counselling was done. Participant's blood samples were tested for HIV and syphilis. Genital examination was done and high vaginal and endocervical samples were collected. The samples obtained were processed for STI using standard laboratory procedures. FSW found with treatable STI received free drugs. HIV results were disclosed after post-test counselling and positive FSW were referred to a HIV/AIDS facility for care, support and antiretroviral therapy. RESULTS: A total of 398 FSW (86 UL and 312 NUL) participated in the study. Their mean age was 27.6+/-7.0 years (range 16-63 years). HIV prevalence was high for both UL and NUL: 48.8 and 48.2%, respectively (odds ratio 1.0; 95% confidence interval 0.6-1.2, P=0.9427). The rates of bacterial vaginosis were not significantly higher in UL (UL 55.8%, NUL 44.0%, odds ratio 1.59, 95% confidence interval 0.96-2.65, P=0.06). There were no associations between the use of citrus douching and other STI. CONCLUSION: There were no significant associations between the prevalence of STI and HIV and lime or lemon juice usage.