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Biomedical subjects

I F Adewole

Publications and source records attributed to I F Adewole.

At least 37 records · Page 2Linked to original sources
PubMed1998

Determinants of utilisation of cervical cancer screening facility in a low socio-economic setting in Nigeria.

A prospective randomised structured questionnaire survey of 254 women in the low socio-economic class attending the general outpatient clinic at the University College Hospital (UCH), Ibadan revealed a high level of ignorance concerning cervical cancer prevention programmes. Only 3.5% of subjects have heard of a Papanicolaou smear and only 1.2% have had the test prior to this study. Peers (36%) were the most common source of information on cervical smears. The majority (84.6%) of the women were willing to be screened, however only 5.1% of those willing (4.3% of the women studied) actually reported for the test. Twenty-two percent (219) had high knowledge about cervical smears while moderate and poor knowledge were demonstrated in 33% respectively. Eleven per cent had no knowledge whatever. No significant association was found between the knowledge score on Papanicolaou smear and other variables. The cost of the test appeared to have prevented many of the women from having the test. It is recommended that more efforts need to be put into health education of women stressing the importance of the test and its availability.

Journal Article↗
PubMed1998

Knowledge and attitude of general outpatient attendants in Nigeria to cervical cancer.

OBJECTIVES: This study sets out to determine: a. How much women in low socio-economic settings know about cancer and cervical cancer. b. Their source of information. c. Their general attitude to cervical cancer. DESIGN: A cross sectional study. SETTING: General outpatient (GOP) department of a tertiary hospital in Ibadan, Nigeria. SUBJECTS: 254 randomly selected women aged 20 to 65 years attending or visiting the GOP department in a University Teaching Hospital were studied. MAIN OUTCOME MEASURES: Knowledge about cancer and cervical cancer as well as source of information. RESULTS: The response rate was 100%. Of the respondents, 90% had heard of cancer at one time or the other while only 15% had heard of cervical cancer. The media (38%) and peers (36%) were the major sources of information on cancer. Fifty five percent, 53% and 61% had no knowledge while 40% and 23% had poor to moderate overall knowledge of cervical cancer. CONCLUSION: Knowledge about cervical cancer is poor in these women, unlike findings in developed countries. There is need to educate our women on the early warning signs of cervical cancer as failure to recognise the early symptoms and signs contribute to the late presentation common in Nigeria.

Adult↗
PubMed1997

Maternal height and prior vaginal delivery as predictive factors in trial of labour after one caesarean section.

A retrospective study of 304 booked parturients with one previous lower segment caesarean section for non-recurrent indications was carried out with regards to factors predicting successful trial of vaginal delivery. The height of the parturients, as well as a history of a previous vaginal delivery appeared to be predictive factors of success. Seventy per cent of the parturients succeeded in delivering vaginally. The mean fetal birthweight was 3362 g for women with vaginal delivery, while the mean maternal height was 1.58 m. Of those who needed a repeat caesarean section, surgical intervention in 46.15% of the patients was indicated by poor cervicometric progress, which might have been appropriately addressed by oxytocin augmentation and careful monitoring in labour. Regarding prior vaginal delivery, only 31.1% of parturients with a negative history, but 63.15% with a positive history, had a successful trial. Three cases of ruptured uterus were all the result of unacceptable delay in carrying out an abdominal delivery when it was clearly indicated. A large prospective study into this aspect of obstetric care will probably define additive effects of these two definite factors.

Journal Article↗
PubMed1994

Cyclical menouria syndrome: a case report.

Cyclical menouria, a rare syndrome, occurred in a 32-year old Nigerian, who presented with cyclical haematuria. She was continent of urine. Hysterosalpingography revealed a vesicocervical fistula, which was successfully repaired at surgery.

Adult↗
PubMed1993

Triage of patients with abnormal cervical smears in the absence of colposcopy.

In a group of 246 patients with dyskaryotic cervical smears, 144 had 4-quadrant punch biopsies (4Q), while 102 had Lugol's iodine applied to the cervix before punch biopsies were taken from abnormally stained areas (ISD) to determine whether the latter will improve the chances of taking biopsies from areas of cervical intraepithelial neoplasia (CIN). In the ISD group, 66 (64.7%) of the patients had histological confirmation of CIN compared to 56 (38.9%) of those in the 4Q group. Follow-up smears in patients with benign histological findings revealed dyskaryosis in 54.7% and 25% in the 4Q and ISD groups respectively, which is suggestive of a higher false-negative rate in the 4Q group. It is suggested that where facilities for colposcopically-directed biopsy of the cervix is unavailable, patients with abnormal smears should have Lugol's iodine applied before punch cervical biopsies are taken.

Biopsy, Needle↗
PubMed1993

Cervical ripening and induction of labour by breast stimulation.

The value of gentle, unilateral breast stimulation in the ripening of cervix and induction of labour was studied. Three hundred patients with uncomplicated term pregnancies, (38-42 weeks) were recruited into the study, consisting of three separate randomised double blind prospective trials. The first trial was to evaluate the effectiveness of breast stimulation in ripening the cervices of 200 term primigravid patients. There was a mean change of 3.90 +/- 2.39 points in cervical score among the study group compared to 0.50 +/- 0.67 among the control group. Thirty-three per cent of the study group went into labour when compared with 4% among the control group. In a second study of cross-over trial involving 78 of the original 200 patients, the study (ex-control) group had a mean change in cervical score of 3.84 +/- 2.24 when compared with the control (ex-study) group, (1.43 +/- 1.08). In a third study involving 100 multiparous patients, a mean change in cervical score of 2.74 +/- 1.16 was observed in the study group when compared with the control group, 0.92 +/- 1.07. Forty-six per cent of the patients went into labour compared with 12% in the control group. All findings were highly significant and there were no maternal or fetal side-effects. The study confirmed the efficacy of breast stimulation in cervical ripening and induction of labour.

Adult↗
PubMed1992

Trends in postabortal mortality and morbidity in Ibadan, Nigeria.

Illegally induced abortion at the University College Hospital, Ibadan increased steadily over a 10-year period (1980-1989) despite increasing availability of family planning services. Abortion was the commonest cause of death in the gynecology service during the period of the study and constituted 36.6% of fatalities. The majority of patients (76.2%) did not accept contraceptives. Almost one-third of the illegal terminations were performed by physicians. Although the percentage of deaths decreased, the contribution of physicians to these fatalities increased, and accounted for 6/9 (66.7%) of fatalities in 1989. This circumstance probably signifies a defect in physician training and ability to perform abortion aftercare. Physicians should be trained in abortion care and laws changed in conjunction with greater drive to improve contraceptive utilization and reduce the incidence of unsafely induced abortion.

Abortion, Illegal↗
PubMed1987

Neuron-specific enolase (NSE) as a tumour marker and comparative evaluation with carcinoembryonic antigen (CEA) in small-cell lung cancer.

Serum neuron-specific enolase (NSE) was evaluated in a number of malignant tumours. It was elevated (greater than 12.5 micrograms l-1) in 13/17 (76.5%) patients with extensive small-cell lung carcinoma and in none of the three patients with limited disease. Of patients with carcinoma of the breast 4/12 (33.3%) had elevated concentrations. Normal concentrations were found in patients with non-Hodgkin's lymphoma (19) and Hodgkin's disease (15), carcinoma of the cervix (2), CSF and serum (5) of patients with gestational trophoblastic disease (with definite nervous system involvement). Comparative serial studies of NSE and carcinoembryonic antigen (CEA) concentrations were done in 15 patients with small-cell lung cancer (SCLC). Of these 7/15 (46.7%) had elevated pre-treatment concentrations of both CEA and NSE, 1/15 (6.7%) had CEA elevated only, while 2/15 (13.3%) had NSE alone elevated. Of those patients with normal pre-treatment marker concentrations 3/5 (60%) had elevated markers on recurrence. The mean survival period was 61.9 weeks; 66.8 weeks for the marker-negative group and 44.6 weeks for the marker-positive (both NSE and CEA) group. Combined NSE and CEA evaluation provide additional means of monitoring SCLC.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Invasive and in situ carcinoma of the cervix in young Nigerians: a clinico-pathologic study of 27 cases.

A study of young Nigerians aged 30 years and below with invasive and in-situ cervical carcinoma confirms the notion that cervical cancer occurs in all age group. All patients except one were married while all were parous. Forty four percent of the patients presented with stages III and IV disease and hence, were unsuitable for surgery. The youngest patient was aged 17 years, indicating the need tare cancer screening among adolescents and a vigorous family planning programme that emphasizes barrier contraception.

Adolescent↗
PubMedDate not supplied

Ovarian cancer associated with ovulation induction: a case report.

A case report of a 38 year old lady who developed ovarian malignancy following 3 cycles of ovulation induction therapy is presented. She was observed to have clinically normal ovaries at laparotomy for tubal infertility 12 months previously. Although direct causal link between ovarian stimulation and cancer has not been established yet, a case is made for increased monitoring of patients receiving ovulation induction medication by physicians.

Adenocarcinoma↗
PubMedDate not supplied

Evaluation of cases of eclampsia in the University College Hospital, Ibadan over a 10 year period.

A study of cases of eclampsia treated at the University College Hospital (UCH), Ibadan, over a 10 year period (1987-1996) was carried out to evaluate the clinical presentation and management outcome during the period of study. There were 140 cases of patients with eclampsia who received treatment out of a total number of 10,584 deliveries during the same period. The incidence of eclampsia was higher among the primigravidae, young women who are less than 25 of age, and unbooked patients. About 85% of the patient were pre-delivery eclampsia, out of which about 60% had emergency caesarean sections. Fifteen percent (15%) of them had repeated convulsion while on anticonvulsant, and more than half of the eclamptics had control of blood pressure within 48 hours of delivery. Eclampsia accounted for 9% of total maternal deaths and perinatal deaths associated with eclampsia was 10%. The common causes of maternal death were acute renal failure, sepsis, and Disseminated Intravascular Coagulopathy (DIC). Eclampsia remains an important cause of maternal morbidity and mortality in this environment.

Adolescent↗
PubMedDate not supplied

Intravesical Lippes loop following insertion for the treatment of Asherman's syndrome: a case report.

A case report of a 36-year-old Para 6+0 (1 alive) civil servant who developed Asherman's syndrome following repair of ruptured uterus is presented. She had adhesiolysis and insertion of Lippes loop. She defaulted 3 months after presentation and was seen 1 year after with intravesical translocation of the IUCD. This was successfully removed using a forward biting bladder biopsy forceps under direct cystoscopic view.

Adult↗