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Munir'deen A Ijaiya1, Hadijat O Raji1, Abiodun P Aboyeji1, Kike T Adesina1, Idowu O Adebara2, Grace G Ezeoke11Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, Ilorin, Nigeria; 2Department of Obstetrics and Gynaecology, Federal Medical Centre, Ido-Ekiti, NigeriaAbstract: Urinary leakage is an important gynecological challenge, which has a substantial impact on quality of life. The aim of this study was to determine the prevalence and types of non-fistulous urinary leakage among women attending the family planning clinic of the University of Ilorin teaching hospital, Ilorin, Nigeria. The study was a cross-sectional study carried out between January 3 and April 25 2009. One hundred and two women experienced urinary leakage out of 333 women interviewed, giving a prevalence rate of 30.6%. Stress incontinence was the most common urinary leakage (prevalence rate 12.0%). This is followed by urge incontinence (10.8%), urinary incontinence (4.8%), and overflow incontinence (3.0%). None of the women afflicted sought medical help. Conclusively, this study has demonstrated that non-fistulous urinary leakage is a common problem among women of reproductive age in this environment.Keywords: non-fistulous urinary leakage, family planning, women, prevalence, types

Background: Gestational Diabetes mellitus (GDM) is fast becoming an important cause of maternal and perinatal morbidity and mortality. The objective of this study is to assess the prevalence and the perinatal outcome of gestational diabetes in an antenatal population., Methodology: This was a cross-sectional study. The patients were pregnant women between 24-28 weeks of gestation without a prior diagnosis of diabetes mellitus. The consenting women were evaluated using fasting plasma glucose and oral glucose tolerance testing using 75 grams of glucose in 300ml of water orally., Results: Two hundred and fifteen women participated in the study and the prevalence of GDM was 9%. The mean fasting plasma glucose was 4.04mmol/l at the time of the Oral glucose tolerance test (OGTT) and 5.78mmol/l after the oral glucose load. When compared with pregnant normoglycaemic patients, GDM patients had significantly fewer vaginal deliveries (p=0.05), higher birth weight (3.71kg), and more neonatal admissions (50%)., Conclusions: Gestational diabetes mellitus is an important disease entity, and it is a cause of maternal and perinatal morbidities., Competing Interests: The authors have no conflict of interest to declare., (Copyright © 2023 Nigerian Medical Association.)

Background: Despite collaborative efforts aimed at its eradication, Female Genital Mutilation/Cutting (FGM/C) continues in endemic areas., Objective: To evaluate the experience and preparedness of female adolescents to protect their future daughters from FGM/C., Methods: A cross-sectional survey involving adolescent secondary school girls in North Central Nigeria. Participants were secondary school students who completed the study's self-administered questionnaire after informed parental or participant's consent. Data management was with SPSS 20.0 (IBM, USA), P-value <0.05 was significant., Results: There were 2000 participants aged 13-19 years (mean 15.56±1.75), prevalence of FGM/C was 35.0%, awareness was 86.1%, mutilation was performed between infancy and eight years of age (mean 3.85±3.24 years), 644(32.2%) desire to mutilatetheir future daughters, 722(36.1%) expressed support for FGM/C and 63.1% of victims of FM/C reported adverse post-mutilation experiences. Support for FGM/C was associated with low social class (P0.0010), opinion that FGM/C has benefit (P0.001) and desire to mutilate future daughters (P0.001) while awareness of efforts to eradicate FMG/C was 813(40.7%)., Conclusion: FGM/C remains prevalent with potential support for its continuation among female adolescents despite reported adverse post-mutilation experiences. The multi-pronged approach to eradicate FGM/C should prioritize re-orientation for adolescent girls, rehabilitation of mutilated girls and girl child formal education., (© 2021 Ezeoke GG et al.)

Objective: The study compared the reliability of nitrazine, urea, and creatinine in the diagnosis of premature rupture of membrane (PROM). Nitrazine strip measures pH levels while urea and creatinine are produced mainly in amniotic fluid and not in the maternal vagina., Methods: Sixty-four pregnant women with demonstrable passage or pooling of liquor par vaginum on speculum examination and 64 with no liquor drainage at 28-42 weeks gestation were studied. Vaginal fluid aspirates from both groups of patient were tested for urea, creatinine, and pH levels using nitrazine strip. Receiver Operating Characteristic (ROC) curves were plotted to determine cutoff values for urea and creatinine. Statistical analysis was done using SPSS version 23.0 and setting statistical significance at P ≤ 0.05., Results: Nitrazine test showed high level of specificity (100%) but a sensitivity of 87.5%. Predictive ability of urea at >12.7 mg/dl obtained as cutoff value from the ROC curve showed a sensitivity of 19.64% and specificity of 94.44% while for creatinine the cutoff value was at >0.8 mg/dl with sensitivity of 48.21% and specificity of 65.28%., Conclusion: Nitrazine strip was the most reliable of the three in the diagnosis of PROM. This was followed by creatinine and then urea. In view of the gaps in sensitivity and accuracy and the importance of precise diagnosis to prevent maternal and fetal complications, there is still the need to find other affordable, more sensitive and more accurate biochemical marker/s that will help in diagnosing PROM especially in difficult cases., (Copyright: © International Journal of Health Sciences.)

Objective: To compare the effectiveness of perioperative vaginal misoprostol with intraoperative pericervical hemostatic tourniquet in reducing blood loss during abdominal myomectomy., Material and Methods: A randomized controlled trial involving women with uterine leiomyoma who underwent abdominal myomectomy was conducted at a tertiary facility in Nigeria. Participants were recruited after they gave informed consent and randomized into group I (single dose 400 μg vaginal misoprostol one-hour before surgery) and group II (intraoperative pericervical hemostatic tourniquet). Eighty participants (40 in each group) were recruited. Uterine size was measured in centimeters above the pubic symphysis, and blood loss estimation involved direct volume measurement and gravimetric methods. The main outcome measures were intraoperative blood loss, blood transfusion, and recourse to hysterectomy. Ethical approval and trial registration were obtained; the data were analyzed using the SPSS software version 21.0; p<0.05 was considered significant., Results: Participants in group I had higher mean intraoperative blood loss (931.89±602.13 vs 848.40±588.85 mL, p=0.532), intra-operative blood transfusion rates (60 vs 55%; p=0.651) and mean units of blood transfused (1.30±1.20 vs 1.20±1.30; p=0.722) compared with group II. The mean uterine size (19.50±6.93 vs 20.05±6.98 cm; p=0.725) and number of fibroid nodules (11.25±7.99 vs 11.45±8.22; p=0.912) were comparable. The change in post-operative hematocrit was 2.66±2.21% vs 3.24±2.85% (p=0.315) and post-operation blood transfusion was 2.5 vs 5% (p=0.556). There was no recourse to hysterectomy in either of the study groups. While adverse effects of misoprostol occurred in 5 (12.5%) participants of group I., Conclusion: The effectiveness of perioperative vaginal misoprostol is comparable to intra-operative hemostatic pericervical tourniquet in reducing blood loss during abdominal myomectomy.

Oral diseases have been shown to negatively affect pregnancy outcomes, yet, routine oral health care is not a component of the antenatal care package in Nigeria. This study was designed to describe the pattern of the oral conditions in pregnancy compared to the non-pregnant controls. Two hundred and twenty-five pregnant women and 166 non-pregnant controls were studied from two healthcare facilities in Ilorin. Oral-related complaints were assessed in the pregnant population while both of the groups had an oral cavity examination. The mean age of the respondents was 28.24 years ±4.77 and 80% had at least a secondary school level of education. The prevalence of oral complaints among the pregnant women was 19.1%. Gingivitis was more common among the pregnant women than the non-pregnant women, and more demonstrable on examination. Oral healthcare should be a component of the antenatal care in our environment. Impact statement What is already known on this subject? Women experience oral disorders in pregnancy, which may be worsened by the physiological changes in pregnancy. What do the results of this study add? This study has demonstrated a higher prevalence of gingivitis in the pregnant women than in the non-pregnant women on oral examination. The signs of gingivitis were higher than its related complaints. What are the implications of these findings for clinical practice and/or further research? Therefore, dental care and an examination should be part of a routine antenatal care package to prevent the unwanted pregnancy outcomes that are related to oral disorders.

Background: Endometriosis is defined as the presence of endometrial tissue (stroma and functional glands) outside the uterine cavity in women of reproductive age. Ectopic sites are frequently located in the pelvis; extrapelvic sites have been reported in the gastrointestinal tract and thoracic cavity. Thoracic manifestation of endometriosis constitutes thoracic endometriosis syndrome (TES)., Objectives: To examine the presentation pattern and outcome of in the management of TES., Methods: This study is a retrospective review of medical records of patients diagnosed with endometriosis at the University of Ilorin Teaching Hospital over a 3.5-year period from January 2014 to June 2017., Results: A total of 21 patients presented with endometriosis, of whom 8 (38.1%) presented with TES. The most common variety of TES was catamenial pleural effusion (CPE) accounting for 75%, followed by catamenial chest pain (37.5%). Two patients (25%) each presented with catamenial pneumothorax and catamenial haemoptysis, while 1 (12.5%) had catamenial surgical emphysema. Closed thoracostomy tube drainage plus chemical pleurodesis was the most frequent intervention technique, accounting for 62.5%., Conclusion: TES remains an uncommon entity, despite being the most common extrapelvic manifestation of endometriosis. CPE appeared to be the most common variant of TES in our environment. Currently available treatment options need to be improved, and more use made of video-assisted thoracoscopic surgery., Competing Interests: Conflicts of interest: None.

Introduction. Enterovesical fistula is rare and is often caused by bowel inflammatory diseases and tumours in the urinary bladder or the intestine with local infiltration of bowel or bladder, respectively. The fistula usually presents with lower urinary tract symptoms, pneumaturia, and faecaluria or with food particles in the urine. Intra-abdominal retained surgical foreign bodies have also been reported as causes. Case Presentation. A case of atypical presentation in a woman with enterovesical fistula following abdominal hysterectomy. Investigations confirmed the presence of surgical towel in the urinary bladder and a pair of artery forceps in the abdomen. The towel was removed at cystoscopy after which she presented with food particles in the urine. She later had laparatomy to remove the haemostat and to repair the fistula. Discussion. A typical presentation of enterovesical fistula delayed the diagnosis and treatment in this patient. Conclusion. Managing patients with recurrent urinary tract infection after abdominal operation should include appropriate imaging of the abdomen with emphasis on pelvic organs. Also, surgical operation should always be given the best shot the first time and strict operation room standards and guidelines should always be followed.

Background: Despite the advances and improvement in science and surgical skills, post-surgical operation complications are oftentimes inevitable, although they could be minimized. Generally, complications occur because of several reasons including patient factors, the disease condition, management option, skills and expertise of the managing team as well as technical factors. Analysis of postoperative complications will help to understand their pathogeneses and identify ways of preventing such complications in the future., Aim & Objectives: To retrospectively analyse the urological complications arising from obstetrics and gynaecological procedures at the University of Ilorin Teaching Hospital, Ilorin, Nigeria., Methodology: Retrospective analysis of available records of patients with urological complications following either obstetrics or gynaecological procedures between the year 2010 - 2012 managed by the urology unit of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. The patients were identified from the unit and theatre records. From the patients' clinical records, the data retrieved included the biodata, presentation, details of the gynaecological operations (calibre of surgeons, notable events at operations) and the complications that were recorded. The urological interventions and outcomes were also recorded., Results: There were 11 patients with urological complications during the three year period. Their ages ranged from 28 and 65years (mean 43.8 +/-0.05 years), about 60% had hysterectomy for uterine fibroids. Various complications such as urinary fistulae (45.5%), ureteric obstructions (36.5%), retained surgical foreign bodies (9%) and ureteric transection (9%) were recorded. Corrective urological interventions were successful in majority (72.7 %) of them., Conclusion: Urological complications associated with gynaecological and obstetrics procedures are sometimes inevitable but their occurrence could be reduced when standard practices are observed.

Background: The magnitude of sexual health problems and availability of treatment options in the local environment is yet to be documented; thus, there is an urgent need for this, as sexual dysfunction may be a real social and psychological problem, needing urgent attention., Objective: The aim of this study was to investigate the prevalence of sexual dysfunction and pattern of sexual health seeking behavior, among secondary school teachers in Ilorin, Kwara State Nigeria., Methods: 450 teachers were invited to complete an anonymous self-administered sociodemographic questionnaire, as well as three other instruments measuring human sexuality and general mental health status., Main Outcome Measures: The survey instrument used were the International Index of Erectile Function (IIEF-5), a modified Sexual Activity Questionnaire (SAQ), and the General Health Questionnaire -30 (GHQ -30). Result were compared with established normative data, and validated cut-off scores that were available., Results: A total of 417 teachers (93%) responded to the questionnaire. The following prevalence rates were found: female anorgasmia (40%), lubrication failure (30%), dyspareunia (12%), erectile dysfunction, premature ejaculation and male orgasmic disorder (23% each), loss of sexual desire (24%), sexual life dissatisfaction, and relationship dissatisfaction six months prior to interview (10% each), and GHQ-30 scores were significant in sexual dysfunction in both genders, except for female anorgasmia and premature ejaculation in males. However, a presence of psychiatric morbidity was significantly found in overall sexual life dissatisfaction, as well as relationship dissatisfaction. The pattern of sexual health help-seeking behavior showed that majority (53%) do not seek treatment. Of these 53%, many (44%) gave the reason that they thought it transient, ignorance of hospital treatment service (30%), and fear of stigma (26%); also, among those that sought treatment, 46% chose alternative medicine., Conclusion: The prevalence of sexual dysfunctions found in this study is comparable to those reported in earlier Nigerian studies. Despite this and the significant "psychiatric morbidity" experienced in sexual difficulties, apparently no health services have been specially designed to address sexual dysfunction among the teacher's group or the general population at large. This study therefore draws urgent attention to the need for services geared towards alleviating sexual problems, more professional and patient education are recommended., (© 2010 International Society for Sexual Medicine.)