The Pattern of Cervical Cytology in Obstetrics and Gynaecology Clinics in Nnewi; South-Eastern Nigeria

Background: Cervical cytology screening has decreased the incidence of and mortality from invasive cervical cancer in developed and even some developing countries. The story is still different in Nigeria because there is no national screening programme in place.Objectives: The aim of this study was to evaluate the pattern of cervical cytology and relate it to some known risk factors such as age; parity; age at coitarche; number of sexual partners and clinical presentation.Subjects and Methods: A total of 100 women were seen at two Obstetrics and Gynaecology clinics in Nnewi over a three month period (May-July 2005) were screened. Conventional method of staining was used. The first fifty sexually active women that consented to completing the study questionnaire in the two clinics were included.Main Outcome Measures: The work noted the pattern of reports in relation to some known risk factors and adequacy of the sampling.Results: Sampling adequacy was 93; epithelial cell abnormality was reported in only one smear; 58 were reported as normal; 14 showed benign cellular changes (i.e. infective); and 18 reactive changes (i.e. atrophy). Conclusion: Now that infective aetiology has been established in cancer of the cervix; the co-factors may be some of these causes of benign cellular changes of the cervix

Knowledge, awareness and perception of sexually transmitted diseases (STDs) among antenatal patients at Nnewi, Nigeria.

This study investigates STD knowledge, awareness and perception among antenatal patients at a Nigerian teaching hospital. There was general awareness of the common STDs, such as gonorrhoea, 95.5% (n=127) and syphilis 66.92% (n=89), while the least awareness was recorded in chlamydial diseases, 6% (n=8). HIV/AIDS recorded the highest awareness, 96.2% (n=128). There knowledge of causes and treatment was remarkably poor. Only 58.6% (n=78) could recognise bacteria as causing STD. Surprisingly more than half, 72.2% (n=96) still believed that remedy could be obtained from prayer houses, herbs and other non-scientific means. The most common source of information was through media houses: radio 72.9% (n=97), television 64.7% (n=86). Preventive awareness was high, more than half believing that STD is preventable either by abstinence, barrier contraception or by mutual fidelity. Superstitious beliefs, greater influence of traditional medical practices and poverty are some of the numerous problems the few existing STD clinics face in the developing countries. Efforts should be geared towards establishing standard STD clinics and appropriate information disseminating organs. A situation where the herbalists and traditional medical personnel capture the mostly ignorant populace through unrestricted access to the media houses, as currently practiced in Nigeria, should be checked.

Lipid and lipoprotein cardiovascular risk factor changes during normal pregnancy in Africans.

OBJECTIVES: The study was designed to determine how pregnancy affects lipid and lipoprotein profiles among women living in a typical suburban commercial community in Africa, and to highlight the consequences of such changes. STUDY DESIGN: Lipid and lipoprotein levels and coronary heart disease (CHD) risk predictor index [High density lipoprotein-cholesterol (HDLC)/Total cholesterol (TC)] were evaluated in 27 African pregnant and 17 non-pregnant women of the same age and demographic profiles. RESULTS: Total cholesterol and low density lipoprotein-cholesterol (LDLC) levels increased, while HDLC level and HDLC/TC ratio decreased in the pregnant women. CONCLUSIONS: These findings suggest that African women are more prone to hyperlipidemia during normal pregnancy. The consequences of the adverse lipid and lipoprotein changes as seen in the pregnant women, on the fetal development and welfare should be explored in further studies. In general, these results have added to our understanding and knowledge of the numerous factors that could cause abnormal lipid and lipoprotein levels in African women.

Features of uterine fibroids treated by abdominal myomectomy at Nnewi, Nigeria.

Seventy-two women with symptomatic uterine fibroids were treated by abdominal myomectomy from January 1994 to December 1996. Important features were a mean age of 32.3 years (range 25-49 years) and parity of 0 to 6; 83% ( n = 60) were nulliparous and 68% ( n = 49) were unmarried. The average estimated blood loss was 480 ml with 1.6 g/dl mean haemoglobin drop and 15.3% required blood transfusion. Complications were mild and infrequent; 7% ( n = 5) had mild wound infection and 16.7% ( n 12) had a febrile complication. The average hospital stay was 8.1 days. There was no mortality. In this study, symptomatic uterine fibroids requiring abdominal myomectomy predominantly affected young women who were mainly unmarried and nulliparous. Although the the operation was safe and well tolerated, preoperative GnRH(a) is recommended to reduce fibroid size and need for blood transfusion.