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Biomedical subjects

A O Adekunle

Publications and source records attributed to A O Adekunle.

At least 19 recordsLinked to original sources
PubMed2006

Female condom awareness, use and concerns among Nigerian female undergraduates.

A cross-sectional study of female condom awareness, usage and concerns among the female undergraduates of the University of Ibadan was conducted in September 2004. The results of 850 out of the 879 female students interviewed were used for analysis (96.6%). Over 80% had knowledge of the female condom as a form of modern contraception and the majority of them learnt about it through the mass media (39.9%) and health workers (34.4%). However, only 11.3% had ever used the female condom, with most (40%) using it to prevent both unwanted pregnancy and sexually transmitted infections including HIV (STI/HIV). The sexual partners' approval was appreciable, accounting for about 42.7% among those that had experience of the female condom usage. Major concerns mentioned such as difficulty of inserting it into the vagina and lack of sexual satisfaction, were not different from those in earlier studies. The result of this study looks promising judging from a high awareness level of the female condom, even though its usage is low. The female condom may be an alternative strategy to combat unsafe sexual practises and its sequelae in a country like Nigeria that is male dominated.

Adolescent↗
PubMed2006

Repeat ipsilateral ectopic gestation: a series of 3 cases.

Ectopic pregnancy remains an important cause of maternal mortality and morbidity as well as early foetal wastage in Nigeria and in other developing countries. We report 3 different cases of repeat ipsilateral ectopic pregnancy seen in the gynaecological emergency unit of the University College Hospital, Ibadan. Cases of repeat ectopic pregnancy often gives rise to diagnostic dilemma, and this becomes more difficult when it occurs at an ipsilateral location.

Adult↗
PubMed2004

Experience with intravaginal misoprostol in the management of intra-uterine fetal death.

This collaborative study between the departments of Obstetrics and Gynaecology of the University College Hospital, Ibadan and Federal Medical Centre, Abeokuta assessed the value of intravaginal misoprostol in the management of intra-uterine fetal death. Fifty-six women at gestational ages between 17 weeks and term admitted for intra-uterine death with no contraindications to misoprostol received 400mcg of misoprostol administered intravaginally 12-hourly, until the establishment of effective uterine contractions. The mean gestational age was 27.9 weeks+/-7.1(SD) and the mean Bishop score was 2.7+/-2.4(SD). The mean duration of onset of contractions was 5.0 hours+/-8.4 (SD); the mean induction-delivery interval was 17.5 hours+/-6.3(SD). Ninety three percent of the women had expelled within 48 hours. Successful induction was achieved in all women. Prophylactic vacuum aspiration was performed (lower gestation only) in 19.6% of cases. Fever, nausea and vomiting were the commonest side effects (7.1%). Neither gestational age nor the cervical score significantly affected the insertion-contraction or induction-delivery intervals. Intra-vaginal Misoprostol at the dosage administered is safe, effective and reduces staff workload.

Abortifacient Agents, Nonsteroidal↗
PubMed2003

Serum micronutrient levels, nucleic acid metabolism and antioxidant defences in pregnant Nigerians: implications for fetal and maternal health.

Micronutrients regulate numerous metabolic processes in pregnancy but their possible antioxidant function and contributions of alterations in their metabolism to fetal and maternal morbidity and mortality have received insufficients attention. Serum levels of copper, manganese and zinc were determined in 40 pregnant Nigerian women spread across the three trimesters of pregnancy and compared with those of 25 non-pregnant women of similar demographic and anthropometric characteristics. Serum levels of uric acid were also determined in both groups of women. The mean serum levels of manganese and zinc were significantly lower in the pregnant than in the non-pregnant state (P<0.02, P<0.002), respectively. Unlike manganese and zinc, copper was significantly elevated in the pregnant than in the non-pregnant state. The endogenous anti-oxidant, uric acid, was also significantly reduced in the pregnant than in the non-pregnant state (P<0.001). Copper levels increased progressively in all the three trimesters of pregnancy compared with controls (P<0.001). However, zinc levels declined steadily in all the 3 trimesters, but only the level of the third trimester was significantly different from the non-pregnant state (P<0.05). Unlike zinc, uric acid rose consistently in all the 3 trimesters compared with the non-pregnant state. Manganese and uric acid were significantly more elevated in the third than the first trimester. One way analysis of variance (ANOVA) and multiple comparisons (Tukey HSD) show that the differences in the antioxidant levels can be ascribed mainly to the second and third trimesters. The prevalence of zinc deficiency was 4.0% in the non-pregnant state as compared to 22.5% in the pregnant subjects. The implications of micronutrient deficiencies and associated antioxidant status in pregnancy are discussed. Considering their role in pregnancy, prevention of such deficiencies and attendant oxidative stress may contribute to a reduction in the incidence of fetal and maternal ill-health, and complications of pregnancy. Interventions should be aimed mainly at the second and third trimesters.

Adult↗
PubMed2002

Comparative evaluation of the effectiveness and safety of two regimens of levonorgestrel for emergency contraception in Nigerians.

Emergency contraception was introduced in Nigeria over two decades ago, but few women have used this method even in emergency situations because of the side effects. To find an acceptable levonorgestrel regimen for emergency contraception in our community, the two-dose regimen 0.75-mg levonorgestrel 12 h apart (group A) and the single dose 1.5-mg levonorgestrel (group B) were studied in 1118 volunteers. Mild side effects such as nausea, vomiting, lower abdominal pains, menorrhagia, dizziness, headache, and breast tenderness were reported. Significantly more women in the high-dose group reported headache, breast tenderness, and heavy menstrual flow. Eleven pregnancies (1.0%) were reported (7 in group A and 4 in group B). The crude relative risk of pregnancies was similar in the two groups (RR = 0.71, 95% CI = 0.32-1.55; p > 0.05) [corrected]. On the other hand, the estimated effectiveness rate of 86.80% in group A was significantly lower than the 92.99% for group B (p < 0.05). The pregnancy rates increased with delay in starting treatment and if further acts of unprotected sexual intercourse took place after treatment. It was concluded that both regimens were effective and safe.

Abdominal Pain↗
PubMed2002

Nutritive value of melon husk in the diet of chickens.

A study was conducted to investigate the nutritive value of melon husk (MH). Results showed that MH was low in crude protein but very high in crude fibre, ash and ether extract. The elemental analysis showed that MH was also high in calcium and phosphorus content. However, when MH was incorporated into starter diets of chicks, body weight gain decreased with increase in the level of MH in the diets. Birds fed on a 10% MH diet were superior to others in body weight gain (10.45 g/bird/day). Results of feed intake and efficiency of feed utilization were also superior on 10% MH diet with values of 43.07 g/bird/day and 4.12 recorded, respectively. The dietary treatment had significant effect (p < 0.05) on the protein efficiency ratio, which decreased with increase in level of MH in the diets. However, there appeared to be no treatment effects on haematological parameters. Up to 10% MH can replace maize in the starter diet of cockerels without adverse effect on performance.

Animal Feed↗
PubMed2002

Isolated umbilical endometriosis--a rare finding.

A 32 yr old multiparous Nigerian woman presented with histological confirmed umbilical endometriosis. There was no evidence of endometrotic deposits elsewhere. Apart from cyclical bleeding from the umbilicus, she was relatively free of any of the other signs and symptoms of Endometriosis. She had excision of the endometeriotic lesion and responded favourably to treatment. A high index of suspicion is required in making a diagnosis of endometriosis in remote extra pelvic sites especially with little or no characterisitic pointers to the disease.

Adult↗
PubMed2001

Three decades of acquired gynaetresia in Ibadan: clinical presentation and management.

A retrospective analysis of acquired gynaetresia (Vaginal Stenosis) managed at the University College Hospital Ibadan, Nigeria between 1967 and 1996 was conducted in terms of clinical presentation and management. The prevalence rate was 7/1000. The peak age incidence was 20-30 years. Chemical vaginitis resulting from insertion of caustic vaginal pessaries for various reasons was the major cause of acquired gynaetresia. Dyspareunia/apyreunia and vaginal stenosis/occlusion were the most common symptoms and clinical findings respectively. The various surgical treatment of acquired gynaetresia included one stage vaginoplasty, McIndole-Read's two stage vaginplasty, separation of labial agglutination, Williams's operation, and simple dilatation of the vagina. Successful correction was recorded in 68% of the patients while 28% had residual partial stenosis, 4% had complete stenosis and 6% were lost to follow-up. It was concluded that acquired gynaetresia is preventable. Efforts should be made by authorities to address this issue and create designated centres in the country for the management of these cases and training of junior gynaecologists.

Journal Article↗
PubMed2001

Serum immunoglobulins, total protein and albumin levels during UniplantR use by Nigerian women.

The effects of UniplantR (a new, long-acting, 19-nor-progesterone derivative contraceptive) on serum immunoglobulins, albumin and total proteins were determined in Nigerian women during one year of use. Blood samples were collected prior to implant insertion and then at the third, sixth and twelfth months of use. All volunteers were in the reproductive age, healthy and had no contraindications to hormonal contraception. The mean levels of IgG (+/- SD) increased from pre-insertion to the twelfth month. When compared with the pre-insertion level (1,393.93 +/- 93.51 mg/dL), there are statistically significant increases in the mean values of IgG at three (1,457.19 +/- 78.41 mg/dL, p < 0.05), six (1,458.12 +/- 65.26 mgd/L, p < 0.05) and 12 months (1,499.56 +/- 87.60 mg/dL, p < 0.001). There were no statistically significant changes observed in the mean serum levels of IgA, IgM and total proteins during twelve months of implant use. These results indicate that while Uniplant does not seem to alter the levels of IgA, IgM, albumin and total proteins over a period of twelve months, it may induce significant increase in IgG levels. The raised mean serum levels of IgG may suggest an improved humoral immunity of Uniplant--a change that is potentially beneficial.

Adult↗
PubMed2001

Pattern of condom use among commercial sex workers in Ibadan, Nigeria.

Regular condom use has been proven to remarkably reduce the transmission of sexually transmitted diseases (STDs) and its regular use for casual and commercial sex is important for the success of any STD/AIDS control programme. We studied the pattern of condom use among commercial sex workers in Ibadan, Nigeria in an attempt to identify the factors associated with it. Two hundred and ninety-five commercial sex workers in 21 brothels were randomly selected, using a multi-stage sampling technique, from a total of 31 identified in the 5 local government areas that make up Ibadan municipality. They were administered a pre-tested, semi-structured questionnaire by trained research assistants. Results showed that over half (53.2%) of the respondents were in the 20-29 year age group and most (71.5%) had been in the profession for less than a year. Sixty-five (22.0%) had no formal education, 29.8 % had some secondary education whilst 22.4 % had completed secondary school. Their overall knowledge of sexually transmitted diseases (STDs) was rated as poor (20.7%), moderate (64.1%) and good (15.2%). Their perceived risk of contracting HIV/AIDS was low (21.7%) although 87.8% regard it as a health problem in Nigeria. Eighty-three percent of the respondents always insisted that their clients used condoms, 13.2% did so frequently whilst 1.4% only occasionally. Of those who asked clients to use condoms, 69.5% of the women would refuse sex without condoms, 49 (16.6%) would do nothing and have sex without condoms, but 4.4% would charge extra money. No factor was found to have a significant association with the practice of asking clients to use condoms or of refusing sex without condoms. We concluded that consistent condom use was high among sex workers in brothels in Ibadan and was independent of the sex workers knowledge and perception of STDs.

Adolescent↗
PubMed2001

Experience with computed tomography (CT) pelvimetry in Ibadan, Nigeria: a preliminary report.

Computed tomography (CT) pelvimetry has largely replaced conventional radiography in the antenatal assessment of pelvic dimensions, but its usefulness in the Nigerian setting is yet to be assessed. This study was undertaken to ascertain if there is a relationship between antenatal CT pelvimetric measurements and the mode of delivery at the end of the pregnancy. A group of thirty-one patients who had antenatal pelvimetry were categorised into two groups depending on whether they achieved vaginal delivery or not and the pelvimetric and other obstetrrc characteristics of the two groups were compared. The only parameters that showed statistically significant differences between the groups were the higher maternal height and the lower head circumference in the neonates of women achieving vaginal delivery. The findings suggest that fetal parameters may be more predictive of mode of delivery than absolute pelvic measurements.

Birth Weight↗
PubMed2000

The effects of nomegestrol acetate subdermal implant (Uniplant) on serum cholesterol, triglycerides, and lipoproteins in Nigerian users.

The study was conducted to assess the effects of a nomegestrol acetate subdermal contraceptive implant (Uniplant(R)) on the lipid profiles of indigenous Nigerian women. Cholesterol content of the major lipoproteins, along with total cholesterol and triglycerides, were measured in fasting blood samples collected before implant insertion and then at months 1, 3, 6, and 12 of use. All volunteers were of the reproductive age, healthy, and had no contraindications to hormonal contraception. The mean levels of cholesterol and low density lipoprotein-cholesterol (LDL-C) increased gradually, albeit insignificantly, from insertion to month 12 of implant use. An initial decline in the mean levels of high density lipoprotein-cholesterol (HDL-C), reaching a minimal level (37.31 +/- 4.95 mg/dl) at month 3 of implant use, was observed. This was followed by a gradual rise that peaked (39.73 +/- 5.53 mg/dL) at month 12. These values were, however, not significantly different from the preinsertion value. The only significant difference (p <0. 005 ) was in the mean level of triglycerides at month 12 (90.90 +/- 17.75 mg/dL) when compared with the preinsertion mean level of 81.77 +/- 24.14 mg/dL. Both values were, however, within normal limits. These results indicate that Uniplant does not have a deleterious effect on the lipid profiles of Nigerian acceptors and can be safely prescribed to women seeking contraception.

Adult↗
PubMed2000

Gossypol blood levels and inhibition of spermatogenesis in men taking gossypol as a contraceptive. A multicenter, international, dose-finding study.

The safety and efficacy of gossypol continues to be controversial. The aim of this study was to evaluate gossypol as a contraceptive pill for men at doses lower than those previously prescribed and in men from various ethnic origin. A total of 151 men from Brazil, Nigeria, Kenya, and China were divided into two groups. Both groups received 15 mg gossypol/day for 12 or 16 weeks to reach spermatogenesis suppression. Subjects were then randomized to either 7.5 or 10 mg/day for 40 weeks. In addition, 51 men were enrolled as a control group. In all, 81 subjects attained spermatogenesis suppression. Only one man discontinued treatment because of tiredness. Potassium levels fluctuated within the normal range. FSH increased consistently. Testicular volume decreased, but after discontinuation, values returned to levels not statistically different from admission. Of 19 subjects on the 7.5 mg/day dose group, 12 recovered sperm counts >20 million/mL within 12 months of discontinuing gossypol. In the 10 mg/day group, sperm counts recovered in only 10 of 24 subjects. Eight of the 43 patients remained azoospermic 1 year after stopping gossypol. All men diagnosed with varicocele failed to reverse spermatogenesis suppression. Gossypol blood levels indicated that sperm suppression occurs independently of concentration, whereas spermatogenesis recovery appears to be concentration-dependent. Gossypol may become a medical alternative to surgical vasectomy when the delay in onset of infertility is acceptable. When taken for 1 year, gossypol causes no reduction in sexual desire or frequency of intercourse. The possibility of reversal, occurring in 51% of the men on this regimen within 1 year after stopping gossypol, is an advantage of this compound as compared with surgical sterilization in many parts of the world.

Adult↗
PubMed2000

Perceptions and attitudes of Nigerian women about the menopause.

The attitudes of women to the menopause are strongly influenced by social, cultural and economic settings in which they live and may also reflect the differences in modes of treatment for or perception of its symptoms. The object of this study was to determine the perception and attitude of post-menopausal Nigerian women to the menopause. We interviewed 676 women who had experienced at least 24 months of amenorrhoea using a structured questionnaire. Menopause was considered a normal physiological manifestation of the ageing process by 95.56% of the respondents while 2.66% believed it was a disease condition. The majority of the women had a positive attitude to the menopause and indicated that it did not affect their relationships with their spouses or children. For most of the women (71.13%), sexual life ended with menopause. None of the women was on hormone replacement therapy but among those sexually active, reduced libido/frequency and vaginal dryness were reported by 24.59%. The most commonly reported advantage of menopause was freedom from cyclical bleeding. We conclude that although Nigerian post-menopausal women have a positive disposition towards menopause, they may have a significant reproductive health burden which has been tolerated for so long. It is important to determine the influence of sociocultural belief on sexuality after menopause and also evaluate the benefits of hormone replacement therapy in our environment.

Journal Article↗
PubMed2000

Emergency contraception: survey of knowledge, attitudes and practice of health care professionals in Ibadan, Nigeria.

This survey was conducted to determine the knowledge, and prescribing attitudes of emergency contraception among healthcare professionals in Ibadan, Nigeria. A questionnaire was administered to 735 health care professionals in selected healthcare facilities in Ibadan. These facilities were randomly selected as part of an ongoing programme designed to introduce emergency contraceptive pills (ECPs) as a clinic based method of family planning in service delivery outlets in the city. The response rate was 87.5%, comprising nurses (59.3%) and physicians (25.0%). Others were pharmacists, social workers and administrators. The results revealed that healthcare professionals' knowledge of various methods that can be used emergency contraception is very low. Less than half (35.1%) of the respondents were aware that combined oestrogen/progestin or progestin-only pills can be used as emergency contraception. Similarly, only 26.7% and 13.3% of the respondents were aware that intrauterine contraceptive devices and mifepristone respectively could be used as emergency contraception. While only 16.3% of the respondents had ever prescribed the combined pills as emergency contraception, 10.9% and 8.2% had prescribed progestin-only pills and intrauterine contraceptive devices for this purpose in the past. Circumstances under which emergency contraception could be used vary among the respondents but 71.4% and 64.4% were of the opinion that condom breakage and sexual assault would be appropriate indications for its use. Two main sources, hospitals (68.4%) and pharmacies (8.8%) were identified by participants. It is apparent that one of the major barriers to frequent use of emergency contraception in Ibadan is the lack of awareness of its use by healthcare professionals. Therefore, there is an urgent need to educate these practitioners and include emergency contraception in the family planning curriculum of nursing and medical schools.

Journal Article↗
PubMed2000

Perception and practice of emergency contraception by post-secondary school students in southwest Nigeria.

A survey of 1500 students in post-secondary institutions in southwest Nigeria showed that the concept of emergency contraception (EC) was well known. Respectively, 32.4%, 20.4% and 19.8% knew that combined pills, progesterone only pills and intrauterine contraceptive device (IUCD) were usable for EC, while 56.7% mentioned the use of traditional methods. Only 11.8% had ever used either pills or IUCD and 10.7% had used a traditional method. Few students (11.5% and 2.3% respectively) knew the correct timing of EC pills and IUCD. The respondents reported varying circumstances under which EC was indicated but the majority cited condom breakage and sexual assault. The popular media represent the commonest source of information while hospitals/clinics were the commonest sources of procurement. About 37% of the respondents planned to use EC in future while 58% would not and 4.7% were uncertain. Reasons for these responses were explored.

Adolescent↗
PubMed2000

Comparative analysis of blood plasma epidermal growth factor concentrations, hormonal profiles and semen parameters of fertile and infertile males.

The relationship between male reproductive function and the blood plasma level of epidermal growth factor (EGF) is of interest in the light of the role that circulating EGF appears to play in regulating mouse spermatogenesis. We measured the concentrations of EGF in the blood plasma of 39 fertile men (sperm count > 20 x 10(6)/ml) and compared them with those of 31 infertile men (sperm < 20 x 10(6)/ml). Blood plasma levels of follicle stimulating hormone (FSH), luiteinising hormone (LH), prolactin and testosterone were also determined. The infertile patients had mean blood plasma EGF concentrations of 0.75 +/- 0.10 ug/L. The value was significantly lower than that of the fertile group (1.28 +/- 0.14 ug/L; P < 0.005). There were statistically significant differences between the fertile and infertile groups in sperm count, sperm viability, mean forward progression, testosterone, LH and FSH (P values between 0.0001 and 0.023). There was no significant difference in the prolactin concentrations between the two groups. Although overall average blood plasma EGF concentrations are significantly lower in the infertile males, regression analysis failed to reveal any direct relationships among the various parameters studied.

Adult↗