Breastfeeding practices of physician-mothers in Ife and Ilesa zones, Osun State, Nigeria.

BACKGROUND: Physician-mothers' breastfeeding behaviour is being studied because it is believed to impact their anticipatory guidance to their patients, which in turn influences patients' breastfeeding initiation and continuation. Study assessed the breastfeeding practices of physician-mothers; their reasons for stopping exclusive breastfeeding and factors associated with their breastfeeding practices. METHODS: Study design was cross-sectional, conducted in Osun East Senatorial District, Nigeria. A self-administered semi-structured questionnaire was administered to all eligible 56 physician-mothers in public primary, secondary and tertiary health facilities in the reproductive age-group whose youngest child was aged d"five years. Informed consent was obtained. Outcome measures were time breastfeeding was initiated, duration of exclusive breastfeeding; reasons for stopping exclusive breastfeeding and duration of continued breastfeeding. Data was analysed using SPSS version 17, statistical significance was determined at p-value < 0.05. RESULTS: Fifty (89.3%) responded. Seventy per cent initiated breastfeeding within 1 hour after birth; exclusive breastfeeding rate was 28.0% with a mean duration of 4.1 +/- 1.9 months. Mean duration of continued breastfeeding was 14.5 +/- 4.5 months. Commonest reason for stopping exclusive breastfeeding was 'baby old enough' (35.8%). Mode of delivery was statistically significantly associated with time to initiate breastfeeding. Time to initiate breastfeeding was statistically significantly associated with duration of exclusive breastfeeding. CONCLUSION: Breastfeeding practices of physician-mothers do not conform to the standards in the Innocenti Declaration. The impact of this on their professional support to clients' should be measured in further studies. It is recommended that targeted interventions be done to improve the attitude and breastfeeding practices of physician-mothers.

A comparative study of school based violence and strategies for control in public and private secondary schools in Osun State.

BACKGROUND: Violence is universal; it occurs in schools (both public and private). The study aim was to assess the rates of violence as well as existing violence prevention strategies in public and private schools in Osun state. METHODOLOGY: A cross sectional study was conducted among 800 secondary school students (599 in public and 201 in private schools) selected by multistage sampling technique using quantitative and qualitative methods of data collection. RESULTS: The mean age for all the respondents was 14.26 years +/- 2.001 Males make up about 51% of the respondents in both public and private schools. Respondents from public schools assaulted other students and staff with a weapon more than their colleagues in private schools (24.7% and 9.7% against 12.9% and 6.5% respectively). The commonest violence 'prevention' strategy in both schools was punishment for violent acts (>90%). CONCLUSION: Respondents in public schools perpetrated and experienced virtually all forms of school-related violence more than those in private, schools. There were mild differences in existing violence prevention strategies in both schools. School connectedness seems to be a major factor in the differential rates of violence between both groups of schools.

Retrospective Analysis of Mathieu's Urethroplasty for Anterior Hypospadias Repair in Circumcised Children: a Single Center Experience

Introduction: Mathieu's technique (peri-meatal based flap) makes use of the urethral plate in the repair of anterior hypospadias; thereby creating an almost natural neo-urethra. In a circumcised baby or after previous unsuccessful repair; Mathieu's flap may be one of the few options left to repair anterior hypospadias. Objectives: To evaluate the result of Mathieu's flap repair for anterior hypospadias in a resource poor setting.Materials and Method: This is a retrospective review of post-circumcision anterior hypospadias managed by Mathieu's flap repair between January 1996 and December 2006 in the paediatric surgical unit of the Obafemi Awolowo University Teaching Hospital; a tertiary hospital in the South Western Nigeria. Results: Mathieu's flap repair was performed in 16 patients with isolated anterior hypospadias; 15 (93.8) were circumcised before presentation. The complications were urethrocutaneous fistula in 3 (18.8); wound infection in 2 (12.5) and flap necrosis in 1 patient (6.3). Final outcome was satisfactory in all patients. Conclusion: Mathieu's flap remains a viable option in the repair of anterior hypospadias even after circumcision

Experience with transverse preputial island flap for repair of hypospadias in Ile-Ife, Nigeria.

OBJECTIVE: To review our experience with the use of transverse preputial island flap in the repair of hypospadias in the paediatric surgical unit of our University Teaching Hospital, Nigeria. PATIENTS AND METHODS: We reviewed the cases of hypospadias managed by transverse preputial island flap repair over a ten year period (1996 and 2006) in the paediatric surgical unit of our institution. Data was retrieved from the case notes and analysed. RESULTS: Fifty-one patients had hypospadias repair during the period, 22 of whom were by transverse preputial island flap repair. Hypospadisas were in penile shaft in 16 (72.7%), penoscrotal in 5 (22.7%) and perineal in 1 (4.55%). All the patients had intact prepuce at presentation and chordee was present in 18 (81.8%). The commonest complication was urethrocutaneous fistula in five patients, which closed spontaneously in three leaving 2 patients (9.1%) with persistent urethrocutaneous fistular. CONCLUSION: Transverse preputial island flap urethroplasty remains a viable option in the management of hypospadias especially when the meatal opening is proximal, with associated chordee limiting the options in the repair.

Subjective assessment of childhood fever by mothers utilizing primary health care facilities in Osogbo, Osun State, Nigeria.

OBJECTIVE: To assess the accuracy of tactile examination by mothers as a method of fever determination in their children and thus determine the reliability of mothers' history about the presence or absence of fever in their children. METHODOLOGY: A descriptive cross-sectional study conducted in four health centers randomly selected in Osogbo metropolis. Three hundred mothers were studied, a semi-structured questionnaire was utilized. RESULTS: The study found the sensitivity and specificity of tactile examination for mothers as a means of detecting fever in their children to be 82.3% and 54.1% respectively. Mother's socio-demographic characteristics and the age of child did not affect mother's subjective assessment of childhood fever (p>0.05). CONCLUSION: Mothers are able to provide accurate information about the presence or absence of fever in their children by palpation without the use of a thermometer. Tactile examination was found to be adequate for mothers as a means of detecting fever in their children. Physicians should accept as reliable mothers' history of fever and give prompt management.

Challenges of Surgical Repair of Hypospadias in Ile-Ife; Nigeria

Objective: To document the presentation; outcome and challenges of management of hypospadias in a resource-limited setting. Patients and Methods: For this retrospective study we analyzed the files of all patients with hypospadias managed at the Obafemi Awolowo University Teaching Hospital; Ile-Ife; Nigeria between 1996 and 2006. The parameters studied were the patients' bio-data; clinical presentation; treatment and outcome. Results: During the 10-year period under review 51 cases of hypospadias were managed. The majority of the patients (n=39; 76.5) presented within the first year of life with a mean age at presentation of 1 year and 8 months; though most of the repairs were done in the 2nd; 3rd and 4th years of life. Of the 51 patients 46 (90.2) came from rural and semi-urban areas and 18 (35.3) had been circumcised before presentation. Surgical repair consisted of preputial island flap in 22 patients (43.1) followed by a peri-meatal based flap (Mathieu procedure) in 16 patients (31.4). The MAGPI procedure was used in 5 patients (9.8) and the Snodgrass procedure in 1 (2). Staged repair was necessary in 7 patients (13.7). Post-operative complications were encountered in 15 patients with urethrocutaneous fistula being the commonest one (11 patients; 21.6). Conclusion: Our results show that hypospadias can be successfully managed in a low- resource setting