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Recent Articles

2020-01-10 Research Article

Oral Clindamycin and Metronidazole in the treatment of bacterial vaginosis in pregnant black women: Comparison of efficacy and pregnancy outcome

Abstract

Bacterial vaginosis (BV) is associated with adverse pregnancy outcomes with various treatment options.

Objective: To compare the efficacy and effect on pregnancy outcome of Metronidazole and Clindamycin in women with bacterial vaginosis in Port Harcourt, Nigeria.

Methodology: Randomized controlled study of 136 pregnant women diagnosed with BV at the University of Port Harcourt Teaching Hospital. A structured proforma was used to obtain socio-demographic characteristics and other relevant data. Treatment was with either oral Metronidazole or oral Clindamycin for seven days. A secondary test and evaluation of the effect on adverse pregnancy outcomes were determined. Data analysis was done using the SPSS statistical package version 22.0.

Results: BV prevalence was 23%, with similar cure rates with both medications. The failure rates of clindamycin and metronidazole were 10.4% and 13% respectively (p = 0.639). The mean gestational age at delivery in the metronidazole treated group was 38.67 weeks ± 1.69 compared to 38.68 weeks ± 1.64 in the oral clindamycin group (p = 0.96). Pre-labour rupture of membranes and preterm delivery rates with both medications were similar (p = 0.73; OR 1.3; 95% CI 0.3-4.9) and (p = 0.73; OR 1.3; 95% CI 0.3-4.9) respectively.

Conclusion: Both medications have comparable efficacy and similar pregnancy outcomes in the treatment of bacterial vaginosis in low-risk asymptomatic pregnant Nigerian women and thus can be used interchangeably.

Abstract Read Full Article HTML DOI: 10.29328/journal.cjog.1001040 Cite this Article

2020-02-13 Research Article

Anal cytology in immunocompetent patients with high-grade intraepithelial neoplasia (CIN II and CIN III)

Abstract

Introduction: Anal cancer is directly related to the presence of high-grade HPV. Immunocompromised patients have defined conducts, something which is not observed in immunocompetent patients.

Objective: To study the anal cytology of patients with high-grade intraepithelial neoplasia (CINII and III) in order to propose a protocol to be followed by the Oncology Gynaecology Service at the Samuel Libânio Clinical Hospital (HCSL).

Methods: Clinical, prospective, transversal and single-centered study. Sampling was by convenience within one year. A total of 150 patients were studied. Out of these, 76 were patients with high-grade cervical intraepithelial lesions diagnosed through histopathological examination of the uterine cervix (Study Group) and 74 without high-grade intraepithelial lesions and with cervical cytology negative for neoplasia (Control Group). The following variables were analyzed: age, sexarc, tobacco use, alcohol consumption, STD history (not HPV), menopause, Hormone Replacement Therapy, anal sex practice, parity, number of sexual partners and contraceptive use.

Results: There was no significant difference between the number of cases in altered anal cancer oncology in the study group, in comparison with the control group.

Conclusion: There were changes in the anal cytology of the study group and these should be evaluated due to the risk of dealing with pre-neoplastic anal lesion. Clinical Trials: NCT03241680.

Abstract Read Full Article HTML DOI: 10.29328/journal.cjog.1001041 Cite this Article

2020-02-18 Research Article

Molecular profiles of hepatotoxicity and nephrotoxicity markers in dysmenorrheic (on treatment or not) students

Abstract

Background: Dysmenorrhea is menstrual disorder that affects about 40% - 90% of women worldwide, it is associated with oxidative stress. The current treatment of this condition is administration of non-steroidal anti-inflammatory drugs, which when frequently used, may affect organs.

Objective: Assess the hepatotoxicity and nephrotoxicity side effects related to dysmenorrhea and its treatment

Materials and methods: A survey (questionnaire) was designed and implemented on 689 female students of the University of Dschang. After this, and following the inclusion criteria, 191 blood samples were collected for assay of hepatotoxicity markers (transaminases, albumin), nephrotoxicity indicators (creatinine, urea, total protein) and the inflammation associated indicators. The measurements were performed on fully automated Olympus AU 400 Analyzer, using standard reagent kits.

Results: Subjects with untreated dymenorrhea lasting more than five years had a significantly high level (p < 0.05) of ALT (39.47 ± 15.74 IU/L) and AST (44.37 ± 13.74 IU/L). Transaminases levels were significantly associate (p < 0.01) and positively correlate (0.251 for ALT and 0. 223 for AST) with the disease duration. Dysmenorrheic individuals on medication for more than 9 years had significantly higher ALT (25.14 ± 7.85 IU/L) and AST (35.26 ± 0.70 IU/L) levels (p < 0.05) compared to those under treatment for less than 5 years (19.37 ± 8.27 UI/L and 27.68 ± 8.56 UI/L). The use of analgesics, regardless of the duration of treatment, had normal creatinine clearance (107.44 ± 30.86 ml/min), compared to those treated with either anti-inflammatory drugs (71.56 ± 26.44 ml/min), or a combination of analgesics and anti-inflammatory drugs (81.34 ± 31.97 ml/min), which was significantly reduced (p < 0.05).

Conclusion: Dysmenorrhea duration, type and duration of treatment potentially expose participants to liver and kidney disorders.

Abstract Read Full Article HTML DOI: 10.29328/journal.cjog.1001042 Cite this Article

2020-03-17 Review Article

Fetal Alcohol Spectrum Disorders – What does it mean?

Prenatal alcohol exposure is one of the most important causes of preventable cognitive impairment in the world. The developing neurological system is exquisitely sensitive to harm from alcohol and there is now also substantial evidence that alcohol-related harm can extend beyond the individual person, leading to epigenetic changes and intergenerational vulnerability and disadvantage [1].

Abstract Read Full Article HTML DOI: 10.29328/journal.cjog.1001043 Cite this Article

2020-03-27 Case Report

Effectiveness of prenatal intensive counselling on knowledge, attitude and acceptance of post placental intrauterine contraceptive device among mothers

Abstract

Introduction: Contraception is a method or device used to prevent pregnancy. In the first year of postpartum period around 65% of women are having unmet need of family planning. Post Placental Intrauterine Contraceptive Device is not only advantageous to the women and couples; even the service providers benefit from PPIUCD. PPIUCD insertion on the same delivery table saves time and separate clinical procedure is not required.

Methodology: The Quantitiative Pre-Experimental One Group Pre and Post Test research design was used. 70 Antenatal mothers were selected by using Purposive Sampling Technique who fulfilled the inclusion criteria and who were available during the period of data collection at selected hospital, Puducherrry. Data was collected by using Structured Interview Schedule.

Result: The Pre test mean score of Knowledge was 9.98 ± 2.38 and Post Test mean score of Knowledge was 14.91 ± 1.15. The calculated paired‘t’ value was (-20.82) found to be statistically significant at p < 0.001 level. The Pretest mean score of Attitude was 34.67 ± 5.67 and Post test mean score of Attitude was 44.27 ± 4.70. The calculated paired‘t’ value was (-17.25) found to be statistically significant at p < 0.001 level. The Pretest mean score of Acceptance was 0.11 ± 0.320 and Post Test mean score of Acceptance was 0.29 ± 0.455. The paired‘t’ value of t = -3.778 found to be statistically significant at p < 0.001 level. The Demographic and Obstetrical Variables like age at marriage, previous childbirth and decision maker of family about family planning have shown significant association with Post Test level of Knowledge, Attitude and Acceptance of PPIUCD at p < 0.05 and p < 0.001.

Conclusion: The researcher concluded that Prenatal Intensive Counselling increases the mother’s Knowledge, Attitude and Acceptance of PPIUCD. So Prenatal Intensive Counselling on PPIUCD can be given to Antenatal Mothers during their antenatal visits to meet the unmet needs of family planning.

Abstract Read Full Article HTML DOI: 10.29328/journal.cjog.1001044 Cite this Article

2020-04-09 Research Article

Timely initiation of breastfeeding and associated factors among mothers who have infants less than six months of age in Gunchire Town, Southern Ethiopia 2019

Abstract

Background: Timely starting of breastfeeding is defined as the starting of breastfeeding within one hour after childbirth. Globally mothers who practiced breastfeeding within one hour were less than half in percent. In least developed countries like Eastern and Southern Africa including Ethiopia infant breastfeeding practice within one hour were low. The aim of this study was to assess timely initiation of breastfeeding and associated factors among mothers who have an infant less than six months of age in Gunchire town, Southern Ethiopia.

Methods: The study was conducted from May 1 to 28, 2019 in Gunchire town. Data were collected by using a structured face to face interview questionnaire. The community based cross-sectional study was employed on 333 women. The study participants were selected by Simple random sampling techniques. The data were coded, entered, cleaned and analyzed by SPSS with windows version 21.0. Binary and multivariable logistic regression statistical model was used. Adjusted odds ratio with 95% CI was computed to see the strength of association.

Results: In this study the magnitude of timely initiation of breastfeeding was 80.5%. Governmental employed mothers (AOR=2.914, 95% CI: 1.139, 7.46), Antenatal care follow up (AOR=5.99, 95% CI: 1.29, 27.81), Baby skin to skin contact (AOR=2.4, 95% CI: 1.092, 5.34), Vaginal delivery (AOR=5.82 95% CI: 1.68, 20.14) Institutional delivery (AOR=5.5, 95 CI%: 1.66, 18.3), Good knowledge of breastfeeding (AOR=4.02, 95% CI: 1.04, 15.59) and Breast disease (AOR=0.24, 95% CI: 0.08, 0.73) were significantly associated with timely starting of breastfeeding.

Conclusion: More than two third of the mothers timely initiated breastfeeding within one hour after birth. Being governmentally employed, having Antenatal care follows up, skin to skin contact, mode of delivery, knowledge of mothers about breastfeeding and place of delivery were positively and significantly associated with timely initiation of breast feeding, whereas, breast disease was protective against timely starting of breast feeding. Therefore, we would like to recommend Enamore woreda health office and Gunchire primary Hospital staffs work at MCH clinic to provide appropriate services and stimulate the mothers to initiate breastfeeding, skin to skin contact enhancing within the first hour of birth.

Abstract Read Full Article HTML DOI: 10.29328/journal.cjog.1001045 Cite this Article

2020-04-09 Review Article

Amenorrhea-An abnormal cessation of normal menstrual cycle

Abstract

Amenorrhea is the absence or abnormal cessation of menstrual cycles in a woman of reproductive age. Prolonged cessation of menstrual cycles might results in complications such as infertility, psychosocial developmental delays, Osteoporosis, fractures etc. Better understanding of physiology of menstruation is essential to understand the various causes of primary and secondary amenorrhea. Any disruption or functional abnormality in the hypothalamic-pituitary-ovarian axis can result in abnormal menstruation or amenorrhea. Therefore it is crucial to identify this menstrual distress in women at early age to minimize the risks of reproductive dysfunction in premenstrual and postmenstrual conditions.

Abstract Read Full Article HTML DOI: 10.29328/journal.cjog.1001046 Cite this Article

2020-05-02 Review Article

Parabens: The love - hate molecule

Parabens are the esters of para-hydroxybenzoic acid [1], mimicking oestrogen, the hormone which makes a woman a woman; women love it and men hate it. However, with an excess use of this compound, even women can develop cancers of oestrogen responsive organs.

Abstract Read Full Article HTML DOI: 10.29328/journal.cjog.1001047 Cite this Article

2020-05-06 Research Article

Trial of labor after cesarean outcomes with excessive gestational weight gain

Summary

The success of vaginal birth after cesarean section (VBAC) has been correlated with a variety of maternal characteristics such as age, ethnicity, and body mass index (BMI, calculated as weight in kilograms divided by height in meters squared). The patient’s BMI just prior to delivery has been shown to be a better prognostic indicator of success than pre-pregnancy BMI.  Gestational weight gain was previously associated with a decreased rate of successful VBAC. More recent research has not supported such an association. The objective of our study was to further validate these findings with a larger population.

We performed a retrospective cohort study of women undergoing trial of labor after cesarean (TOLAC) at our institution from January 2010 to December 2019. Women were divided into three groups based on weight gain in pregnancy as compared to the American College of Obstetrics and Gynecology (ACOG) recommendations (i.e. < 25 pounds (lbs), 25-35 lbs, > 35 lbs). We further subdivided the pregnancies between term and preterm deliveries. The primary outcome was a successful VBAC.  Of 1087 patients attempting a TOLAC, 772 (71%) were successful and 315 (29%) failed VBAC. When grouped according to ACOG weight gain recommendations, 303 (31%) women were below ACOG guidelines, 318 (33%) met guidelines, and 339 (35%) exceeded guidelines. There was no difference in the rate of VBAC success among the three groups. When counseling patients, providers should still promote healthy dietary habits but should not correlate excess weight gain with chance of TOLAC success.

Abstract Read Full Article HTML DOI: 10.29328/journal.cjog.1001048 Cite this Article