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Biomedical subjects

A O Fawole

Publications and source records attributed to A O Fawole.

13 recordsLinked to original sources
PubMed2006

Attitude of health-care workers to HIV/AIDS.

The current 5% prevalence rate of HIV in Nigeria represents a significant population of people living with HIV/AIDS (PLWHA). Discrimination against PLWHA has profound impact on the care and support required for their optimal management particularly in resource-constrained settings. The study sought to assess the knowledge of health-care providers about HIV/AIDS, determine the potential for discrimination in the provision of services based on patients' HIV sero-status and review the factors that may contribute to such attitude. Self-administered semi-structured questionnaires were administered to respondents who were selected by multi-stage sampling technique. The questionnaires explored the respondents' knowledge about HIV and their attitude and practice regarding PLWHA. Three hundred and forty-five questionnaires were completed. Only 77.1% correctly identified breastfeeding as a source of HIV transmission; 5.2%and 2.6% respectively thought transmission was possible through mosquito bite and handshake. About 10% and 15% respectively among trained nurses and auxiliary nurses were unaware that HIV could be transmitted to the child during delivery. Some 13.9% and 12.7% of respondents respectively were unwilling to take vital signs and carry out physical examination on PLWHA. Compared to physicians, trained nurses and auxiliary nurses were more likely to deny services based on HIV sero-status. Negative attitude was more likely if the source of the HIV infection was from homosexual exposure or bisexual indiscretion. The health-care workers studied manifested certain attitudes that are potentially discriminatory of PLWHA. Well-coordinated continuing education of HIV/AIDS for all categories of health-care workers is recommended as a vital strategy in the crusade against the epidemic.

Adolescent↗
PubMed2005

Parameters of nutrition in school girls in southwestern Nigeria.

OBJECTIVES: To document trends in parameters of nutrition in south-western Nigerian school girls in comparison with earlier reports and provide baseline data for future comparison. DESIGN: A cross-sectional study. SETTING: Fifteen secondary schools from the five local governments in Ibadan, Oyo State in south-western Nigeria. SUBJECTS: One thousand six hundred and seventy five apparently healthy female students aged between nine and twenty three years. RESULTS: One thousand six hundred and seventy three questionnaires were analysed. The mean age, mean height and mean body weight were 15.45 years +/- 2.06 (SD), 154.98cm +/- 8.4(SD) and 46.09kg +/- 8.8 (SD) respectively. The mean body fat was 11.12kg +/- 4.6 (SD); mean lean body mass (LBM) was 34.96kg +/- 4.6 (SD); mean total body water (TBW) was 25.17L +/- 3.3 (SD) and the mean body index (BMI) was 19.07kg/m2 +/- 2.7 (SD). Girls from upper socio-economic background had significantly higher values of anthropometric measurements and body composition for each age than lower socioeconomic class girls. Compared with their peers from another Nigerian city investigated two decades ago, girls in this study were significantly lighter and shorter. CONCLUSION: The study revealed a decline in nutritional parameters among adolescents. The implications of these findings for the reproductive health of Nigerian women are discussed. Serial studies to monitor trends in adolescents are recommended.

Adolescent↗
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

Does screening for cervical intra-epithelial neoplasm in developing countries prevent invasive cervical cancer?

In a bid to evaluate the practical relevance of screening for cervical intraepithelial neoplasia (CIN) in reducing the incidence of invasive cancer in Nigeria, we performed a comparative study of CIN and invasive carcinoma in Ibadan, Nigeria over a period of 8 and 16 years respectively. 4.5% of patients with invasive cervical cancer were under the age of 30 years. It peaked at 28% in the age group 41-50 years. In comparison, <3% of patients with CIN were below 20 years of age while it had the highest incidence of 37%, 34% and 36% respectively in age 40 years and below. The mean age for CIN was 39.6 +/- 9.6 (SD) years compared to 51.3 +/- 11.1 (SD) years for invasive cervical cancer (p < 0.01). There was a 10 year interval between the onset and peak age incidence of invasive cancer and CIN respectively, even though there was an overlap of cases from the third decade. We therefore suggest a combined approach of public education to encourage early presentation and provision of health service outlets for cervical cancer screening in Nigeria to reduce the burden of cervical cancer.

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

Fertility regulatory methods and development of complications after evacuation of complete hydatidiform mole.

In a prospective, simple randomised study, we evaluated the relative efficacy of hormonal (oral contraceptive pill) and non-hormonal (intrauterine contraceptive device) methods of contraception as fertility regulatory agents in patients with complete hydatidiform moles and assessed the development of complications and sequelae if any, following their use. Fifty-six patients each on oral contraceptive pills (OCP) and intrauterine contraceptive device (IUCD) were recruited into the study. Ten patients, six on OCP and four on IUCD discontinued for varying reasons. Five patients (two on OCP, and three on IUCD) developed a gestational trophoblastic tumour and were admitted for chemotherapy. There was no complication attributable to any of the methods.

Clinical Trial↗
PubMed2000

Genital ulcers disease among sexually transmitted disease clinic attendees in Ibadan, Nigeria.

Genital ulcer disease (GUD) is a risk factor in the transmission of human immuno deficiency virus (HIV). The goal of this study is to estimate proportion, identify risk factors, and improve prevention and control of GUD. This is a retrospective study of 211 cases of GUD seen between 1993 and 1997 in an urban public sexually transmitted disease (STD) clinic. Genital ulcers form 7.6% of all STDs seen. Overall, genital herpes was commonest (89 or 42.25%). It was the predominant infection (84 or 44.7%) in the males, while lymphogranuloma venereum (52 or 24.7%) was in females. The peak incidence in both sexes occurred in the 20-29 age group. Males out numbered females by a ratio of 8:1. Most of the patients were single 114 (68.3%) and most 70 or 33.3% were students. Risk markers identified were: casual sex (103 or 53.5%) and multiple sexual partners (77 or 36.5%). Both were significantly higher (P < 0.05) in single patients. Self-treatment, use of multiple drugs and incomplete course of antibiotics were also common. The need to intensify STDS education programmes to all occupational groups and to students in particular is highlighted. Commercial sex workers require periodic education, screening and treatment.

Adolescent↗
PubMed1999

Female genital mutilation - postcircumcision vulval complications in Nigerians.

Female genital mutilation is a cultural practice that can adversely affect the health of women. Vulval complications of female circumcision in 39 patients managed at the University College Hospital, Ibadan, Nigeria over a period of 10 years were reviewed. The complications were: labial adhesions of varying degrees (51.3%) and clitoral retention cysts (48.7%). However, both types of complications occurred concurrently in two (5.1%) patients. All patients were treated surgically with good outcome. The only immediate complication of treatment was secondary haemorrhage in one patient with clitoral cyst. Regrettably, one patient with labial adhesion required a repeat surgical procedure 2 months later. The histological examination of all the retention cysts revealed epidermal inclusion cysts. Emphasising the reproductive health implications of female genital mutilation may prove an effective strategy towards eradication of the practice.

Journal Article↗
PubMedDate not supplied

Squamous cell carcinoma of the cervix simulating an advanced malignancy of the ovaries.

A 40-year-old woman was diagnosed as having stage II squamous cell cervical carcinoma and managed with radiotherapy. Three months after treatment, she presented with features suggestive of an advanced ovarian tumour including gross abdominal swelling, bilateral ovarian tumours, multiple tumour seedlings in the abdominal cavity and ascites. There was also pleural effusion. Operative findings revealed widespread intra-abdominal metastases whose histology, contrary to expectations, showed squamous cell carcinoma of cervical origin. Distant metastases from squamous cell carcinoma of the cervix are rare. A high index of suspicion is necessary to detect this unusual mode of presentation.

Abdominal Neoplasms↗
PubMedDate not supplied

Jehovah's Witnesses and blood transfusion revisited: a review of the benefits and risks.

Physicians face a special challenge when treating Jehovah's witnesses. As a result of Jehovah's witnesses rigorous pursuit of medical alternatives to blood, many cardiac, obstetric and gynaecological, orthopaedic and urological surgeries that traditionally require blood transfusion can now be performed successfully without using blood or blood products. Despite the obvious advantages of this bloodless surgery, blood transfusion remains are important life saving procedure. Respecting the religious consciences of Jehovah's witnesses may challenge our skills. Though their reason for refusing blood transfusion may seem controversial, physicians should be careful to avoid being held liable in view of the laws that accommodate their belief. This paper attempts to give an overview on this issue.

Anemia↗
PubMedDate not supplied

Attitude of Abeokuta pregnant women to routine human immunodeficiency virus screening.

The attitudes of 200 pregnant women at the antenatal clinic, Federal Medical Centre, Abeokuta to routine HIV Screening for pregnant women were obtained between January and February 2000. One hundred and ninety six (96%) supported routine screening while 8(4%) did not. Reasons for supporting routine screening include protection of unborn baby (70%), initiation of early treatment if positive (50%), protection of other patients (40%) and protection of health care workers (20%). Reasons given by 8 (4%) who opposed routine screening include fear of a positive result 6(3%) and fear of societal discrimination 2(1%). If tested positive, 60% will request for medical treatment, 50% will inform their husband, 40% will seek divine intervention in the church, 20% do not know what to do while 10% will be isolated till death comes. The ethical, legal, emotional and societal implication of routine screening were discussed and recommendations based on available scientific evidence were made.

Adult↗
PubMedDate not supplied

A ten-year review of breech deliveries at Ibadan.

An audit of all breech deliveries at the University College Hospital, Ibadan over a ten-year period was done to determine the most important contributors to perinatal morbidity and mortality in breech deliveries. The data were obtained from the birth register and individual case records of patients seen at the hospital during the period. The audit revealed the occurrence of 263 breech deliveries out of a total 9,966 deliveries, giving an incidence of breech presentation of 2.6%. Breech presentation was commonest among primigravidae (32.0%) and decreased with increasing parity. Caesarean section was the commonest mode of delivery (46.1%) at term. The fresh stillbirth rate was 10.5%. Low birthweight and prematurity were noted in 31.0% and 35.2%, respectively. The corrected perinatal mortality rates for pre-term and term breech were 450.0 per 1000 and 62.5 per 1000, respectively. Caesarean section appeared to confer an advantage over vaginal delivery at term. Low birth-weight and prematurity remain significant predisposing factors to the high perinatal morbidity and mortality attending breech births.

Apgar Score↗