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Biomedical subjects

I F Adewole

Publications and source records attributed to I F Adewole.

At least 19 recordsLinked to original sources
PubMed2006

Haematological profile of healthy pregnant women in Ibadan, south-western Nigeria.

There is a dearth of information on the reference values for haematological indices particularly according to the relevant trimesters of pregnant women in Nigeria. The objective of this study was to provide reference values for Nigerian pregnant women. The study took place at the Adeoyo Maternity Hospital and the University College Hospital, both in Ibadan. This descriptive study was carried out over a period of 8 months. Subjects were apparently healthy pregnant women that satisfied the inclusion and exclusion criteria. The mean values (and 95% confidence intervals, CI) of haematological indices were as follows -- First trimester: Haemoglobin (Hb) 112.44 (101.64 - 123.25) g/l, haematocrit (hct) 35 (32 - 38)%, WBC 5.488 (4.025 - 6.950) x 10(9)/l and platelet counts 227.56 (165.21 - 289.90) x 10(9)/l;Second trimester: Hb 100.39 (97.85 - 102.92) g/l, hct 29.3 (28.5 - 30.1)%, WBC 6.57 (6.19 - 6.95) x 10(9)/l, platelet count 229.56 (211.86 - 247.26); and the Third trimester: Hb 98.06 (96.12 - 100.00) g/l, hct 29.4 (28.7 - 29.9)%, WBC 6.92 (6.53 - 7.30), platelet count 186.52 (177.67 - 195.38) x 10(9)/l. These results were compared with those of 52 non-pregnant age matched women volunteers as controls whose mean haematological indices and 95% CI were: Hb 120.51 (116.61 - 124.41) g/l, hct 36 (25 - 48)%, WBC 5.28 (2.9 - 8.7) x 10(9), platelet count 330.87 (176 - 538) x 10(9)/l. The following haematological indices: WBC, platelet counts, RBC, PCT, and PDW, of women between the trimesters showed statistical significance (p value < 0.001 in each case). The WBC is inversely proportional to the PCT and the MCV in the pregnant women was slightly raised. In this study, pregnancy is characterised by lowest values of haemoglobin parameters in trimester three and there are statistically significant differences between the WBC, platelet counts, RBC, PCT, and PDW of women between the three trimesters.

Adolescent↗
PubMed2006

Biochemical and serological characterization of mycoplasma strains isolated from the genital tracts of humans in Nigeria.

Fifty-five (55) Mycoplasma strains isolated from the genital tracts of humans were biochemically characterized using various biochemical tests and also serologically identified by growth inhibition technique using 5 mycoplasma antisera namely M. hominis PG2 1: M. genitalium G37: M. penetrans GTU54 and 2 strains of M. fermentans PG18 (HRC 6-62-S-170 and MB713-501-069). Biochemically, 43 (78.2%) strains were identified as Mycoplasma hominis, 8 (14.5%) strains as M. fermentans and 4 (7.3%) as M. penetrans. The M. hominis strains hydrolyzed only arginine while the M. fermentans and M. penetrans strains in addition to arginine hydrolysis also broke down glucose fermentatively and oxidatively. The M. fermentans strains showed varying reactions to phosphatase activity and to the reduction of tetrazolium chloride. Serologically, 4 (7.3%) mycoplasma strains were confirmed as M. penetrans GTU54 and of the 8 M. fermentans strains, 4 (7.3%) were identified as M. fermentans PG18 serotype HRC 6-62-S-170 and the other 4 (7.3%) as M. fermentans PG18 serotype MB 713-501-069. Only 13 (30.2%) of the 43 M. hominis strains were identified as M. hominis serotype PG2 1. None was identified as M. genitalium. The heterogeneity of the mycoplasma strains especially M. hominis was observed in this study and the need for the use of multiple antisera in growth inhibition test is hereby supported.

Adult↗
PubMed2005

Contraceptive prevalence among young women in Nigeria.

In almost all societies in the world there is an increase in sexual activity among young persons (10-24 years). There is a need for contraceptive use among them to prevent high risk unintended pregnancies. This study was carried out to determine the contraceptive prevalence among young women in Nigeria. The study population was 832 young women between the ages of 15 and 24 years. Only 11.1% of the respondents had ever used contraceptives although 63.2% of them had had sexual intercourse. Contraceptive usage was significantly higher (p<0.05) among the single sexually active women (38.5%) than among the married women (7.7%). Only 7.3% of respondents are currently using a contraceptive method. The main methods in use were condoms and pills. There is an unmet need for contraceptives among young women in Nigeria. It is necessary to improve these young women's abilities to protect themselves against unwanted pregnancies.

Adolescent↗
PubMed2005

Total ovulating period: any contribution to ovarian carcinogenesis?

The etiology of ovarian cancer has many postulates including that of incessant ovulation. Women of high parity especially those that breastfeed in addition are supposed to be protected. Ovarian cancer patients in the developing world are of higher parity than their Caucasian counterparts. Our study compared the length of reproductive career (LRC), the physiological ovulation free period (PFP) and the total ovulating period (TOP) amongst histologically proven ovarian cancer patients and age - matched controls. This is a questionnaire survey of 21 ovarian cancer patients managed by us between 1st December 1998 and 31st July 2002 and 42 gynaecological patients not known to have ovarian cancer. The mean age among the patients was 45.7+16.9 years while among the controls it was 45.4 +/- 16.1 years. The mean parity of the patients was 3.6 +/- 2.2 compared to 3.4 +/- 2.9 in the controls. The patients had a mean LRC of 23.8 +/- 11.2 years while in the controls it was 25.7+10.8 years. The mean PFP of the patients was 7.4 +/- 5.6 years and for the controls 7.1 +/- 6.5 years. The patients had a mean TOP of 15.8 +/- 8.8 years while this was 18.6 +/- 8.1 years for the controls. None of these differences was statistically significant. Our study revealed no statistically significant differences in the total ovulating periods between ovarian cancer patients and age-matched controls. Further studies will be necessary.

Adult↗
PubMed2004

Ovarian cancer in Ibadan: characteristics and management.

Ovarian cancer has the highest case fatality rate among gynaecological cancers worldwide because of lack of effective screening methods and non-specific early warning symptoms with late presentation. A reinvigorated study is necessary in the developing countries because of a projected increase in its incidence. The decreasing fertility rate and increasing use of ovulation induction drugs are some of the reasons. The Ovarian Cancer Service of the Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Oyo State, Nigeria commenced the first longitudinal study of this malignancy from 1 December 1998 in order to establish a regional management and research centre. It is a questionnaire survey detailing the demography, clinical and staging laparotomy findings and histology of all confirmed cases. Twenty-one staging laparotomy and histologically confirmed ovarian cancer cases were managed from 1 December 1998 to 31 July 2002, about 1.5% of the 1387 gynaecological admissions. It is the third most common of the gynaecological cancers, representing 9.8% of the 214 cases. More than 60% of the patients were 50 years or younger. Only 19% were nulliparous, with 47.6% having had five or more deliveries. Only two patients (9.5%) had used the oral contraceptive pill, for a maximum period of 1 month. Only one patient (4.8%) had a positive family history of cancer. Abdominal swelling was the most common presenting symptom. Eighty-one per cent of the patients presented in Stages III and IV. Epithelial ovarian cancer constituted about 76.2% of the cases. Only 23.8% had adjuvant therapy, consisting of combination chemotherapy using cisplatin-based regimes. The case fatality rate 6 months after surgery was 76%. The ovarian cancer patients in this environment are younger and of higher parity than expected. The risk factors for this disease require further study.

Adolescent↗
PubMed2003

Cervical cytology service in Nigeria: providers' perspective.

It has been noted that efforts to organise an effective screening programme in developing countries will have to find adequate financial resources, develop the infrastructure, train the necessary manpower and elaborate surveillance mechanisms. In our study, we set out to determine (a) just how frequent is cervical cancer, to warrant the investment of funds in screening programmes; (b) what proportion of surveyed health facilities offer a cervical cytology screening programme; and (c) what basic facilities are currently available where such programmes exist? A pretested, self-completed questionnaire was sent to heads of department of obstetrics and gynaecology in public tertiary and secondary care hospitals in Nigeria as well as major mission hospitals. The response rate was 63%, monthly consultations included a mean of 114 (+/-11.7) new gynaecological patients and an average of 5 (4.7+/-0.8) cervical cancer cases. One-half of the institutions had a hospital-based cervical screening programme with an average of 27 patients being screened monthly. Finance was the main difficulty encountered in maintaining a screening service. Only four had a certified gynaecological oncologist. In conclusion, there is dismal utilisation of available services and a dearth of trained specialists should any cervical cancer screening programme be considered.

Animals↗
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↗
PubMed2002

A clinico-pathological study of complete and partial hydatidiform moles in a Nigerian population.

In a review of 208 cases of hydatidiform moles (HM) managed at the University College Hospital Ibadan, Nigeria between January 1966 and December 1996, there were 105 cases of complete hydatidiform mole (CHM) and 103 cases of partial hydatidiform mole (PHM). The ratio of PHM to CHM was 1:1. The institutional frequency for PHM is one per 667 deliveries, while that of CHM is one per 655 deliveries. In contrast to CHM, the presentation of PHM was less dramatic. The mean age for both types of HM was 28 years, although there was a slightly increased difference in the population of younger patients aged (21-30 years) for PHM (56.3%) as against CHM (40%), respectively. The pre-evacuation uterine size was larger than dates in CHM (40%) compared to PHM (8%), although the mean gestational age was higher in PHM (19.8 weeks) when compared to CHM (15.2 weeks). Sixty-five patients with CHM (61.9%) presented with heavy irregular vaginal bleeding before evacuation compared to five patients (4.9%) with PHM. Gestational trophoblastic tumour (GTT) occurred in 20 patients with CHM (19.0%) compared to two patients (2.1%) with PHM. We conclude that the incidence of PHM is higher in our environment than hitherto reported and consequently there is need for greater awareness among health-care providers of the clinicopathological features of this enigmatic but interesting disease entity and development of facilities for routine cytogenetics. It is advisable that the follow-up period in patients with PHM should not be more than a year, because of the rarity of post-evacuation sequelae.

Adult↗
PubMed2002

Pattern of sexually transmitted diseases among commercial sex workers (CSWs) in Ibadan, Nigeria.

The purpose of this study was to determine the pattern of STDs among commercial sex workers (CSWs) in Ibadan, Nigeria. The subjects were 169 CSWs randomly selected from 18 brothels, majority of who were examined and investigated in their rooms. Another 136 women without symptoms who visited the special treatment clinic, University College Hospital, Ibadan were selected as a normal control group. Vaginal candidiasis was the most common STD diagnosed in both CSWs and the control group. The other STDs in their order of frequency were HIV infection 34.3%, non-specific vaginosis 24.9%, trichomoniasis 21.9% and gonorrhoea and "genital ulcers" had an incidence of 16.6% each. Other important conditions were tinea cruris 18.9%, scabies 7.7% genital warts 6.5% and 4.1% of them had syphilis sero-positivity. All the 13 CSWs that had scabies, the 4 (36.4%) with genital warts and the 19 (67.9%) with "genital ulcers" had HIV infection. While there was no significant difference between the CSWs with vaginal candidiasis, gonorrhoea, trichomoniasis and the control group, the HIV positivity was significantly higher (P < 0.001) in CSWs than in the control subjects. These findings suggest that women who exchange sexual services for money can no longer be ignored, and should therefore be identified and made to participate in STD prevention and control programmes.

Adolescent↗
PubMed2002

The deficient perineum: oblique presentation of a clinically obvious anomaly.

The deficient perineum is a recognized anatomical defect attributable essentially to the trauma of vaginal delivery. We studied, retrospectively, 64 women with the deficient perineum who presented in our unit for other reasons. All were parous and had previous vaginal delivery. Eighty-four percent delivered recently outside a hospital. Presumed marital disharmony occurred in 45% and may have been profound. Perineorrhaphy in the women seen, had salutary effects.

Adult↗
PubMed2002

Sixty-one day twin to twin birth interval in a low technology setting.

Multiple pregnancy, whether spontaneous or from artificial reproductive techniques, is regarded as high risk. Limiting the twin-twin birth interval to within 30 minutes has been widely practised. However, conservative management of the retained live, immature second twin may be worthwhile. We report a case lasting sixty-one days in a low technology setting.

Anti-Bacterial Agents↗
PubMed2002

Breast and cervical cancer screening activities among family physicians in Nigeria.

Breast and cervical cancers are the two commonest malignancies among Nigerian women; where they constitute about 50% of female cancers. A total of 63 out of 82 family physicians from 4 out of the 6 health zones in Nigeria and the Federal Capital Territory, Abuja, Nigeria completed a self-administered questionnaire to determine their knowledge and screening practices for breast and cervical cancers. Forty nine percent (49%) of family physicians perceived cancer as one of the serious health problem facing women in Nigeria. Although 93.7% of responding physicians have heard of breast cancer screening facilities and 96.8% of cervical screening facilities, only 74.6% and 55.6% of these respondents offered screening services for breast and cervical cancers respectively. Breast examination was carried out monthly by 48.9% of the physicians on their regular patients. A comprehensive programme of continuing medical education and training in view of setting up facilities and offering service are recommended for family physicians. These stand to bridge the gap between the knowledge and the practice of breast and cervical cancer screening activities. The umbrella Association for Family Physicians and other regulating bodies should facilitate access to screening facilities and initiate training of willing physicians with a view to setting up services.

Adult↗
PubMed2001

Grandmultiparity--trends and complications: a study in two hospital settings.

Pregnancy after the fifth delivery is viewed with anxiety, especially by obstetricians in developing countries working with inadequate facilities. High parity is still common with serious consequences to the fetus, the mother, the family and society. In the last 40 years, non-governmental, national and international efforts have been made to reduce fertility rates. We therefore intended to determine the trend in the grandmultiparity rates from 1 January 1987 to 31 December 1994 in the South Western part of Nigeria. The obstetric performance of these grandmultiparae in two different settings were to be compared. This was a retrospective, case-note analysis of all the grandmultiparae delivered at the University College Hospital (UCH) (Group A) and the Oluyoro Catholic Hospital (OCH) (Group B), both in Ibadan city. The former is a tertiary health care centre while the latter is a secondary centre. The socio-clinico-demographic characteristics of these patients were collated and analysis and comparison performed using EPI-INFO software. In Group A, 828 grandmultiparae were seen among 9215 deliveries, a rate of 8.99% (10.90% in 1987 to 3.36% in 1994). In Group B, there were 1940 cases among 22 587 deliveries, i.e. 8.59% (12.75% to 6.07%), respectively. The modal age group was 31-35 years, and women above 35 years formed one-third of cases. The parity group 5-7 was the most frequent in both groups (91.6% vs. 94.9%). Only two mothers (both in group B) had parity above 10. Booked patients formed a larger percentage in Group B than in Group A (85.8% vs. 69.7%, respectively). In Group B 85.9% had spontaneous vertex delivery as opposed to 66.3% in Group A. Caesarean section was the mode of delivery in 9.0% and 24.2% in Groups B and A, respectively. Equal percentages had breech delivery. The modal birth weight was 2.51-3.00 kg in both groups. Macrosomic babies formed 3.7% in Group A and 2.4% in Group B, while low birth weight babies formed 17.7% and 11.7% in Groups A and B, respectively. The crude perinatal death ratio was 123/1000 in Group A and 68/1000 in Group B. Antepartum haemorrhage, anaemia and premature rupture of membranes in Group A and anaemia, hypertension and antepartum haemorrhage in Group B were the most common pregnancy complications noted. In labour, abnormal lie/presentation, prolonged labour and premature labour in Group A and abnormal lie/presentation, antepartum haemorrhage and birth asphyxia in Group B formed the majority of the complications. The most common puerperal complications were primary postpartum haemorrhage, wound/genital sepsis in Group A and anaemia and primary postpartum haemorrhage in Group B, respectively. Maternal death ratio was 10.85/100 000 total deliveries in Group A and 35.42/100 000 in Group B. High parity is still common in developing countries, although the incidence is declining, with rates of 3.4% and 6.1% of total deliveries in Groups A and B, respectively. More patients are delivered per abdomen at UCH compared to OCH. The perinatal mortality rate is higher at UCH than OCH but the maternal mortality rates follow the reverse. Recommendations are made concerning the reduction in high parity rates and its associated complications.

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↗
PubMed1999

Obstetric pubic symphysis arthropathy: a study of nine cases.

Nine Nigerian women who were either pregnant or recently delivered presented with a symptom complex comprising severe pain or tenderness over the symphysis pubis with ambulatory difficulty. Radiography and ultrasonography were used as complements to confirm diagnosis, and management was non-operative. Seven of the nine women recovered completely, but two died from presumed pulmonary embolism. There is no evidence that pelvic radiography influences diagnosis or management. We suggest routine thromboprophylaxis in the management of the entity and use of obstetric pubic symphysis arthropathy as a specific, descriptive and all encompassing nomenclature.

Journal Article↗