-
Limited Obstetrics Ultrasound in Primary Healthcare Delivery; Outputs for Strategic Considerations: A Review of Pilot Study in Gauteng Province, South Africa
Tshililo Mashamba,
Akpan Eyo,
Sikhonjiwe Masilela,
Anele Busakwe,
Olakunle Towobola
Issue:
Volume 10, Issue 2, March 2022
Pages:
52-59
Received:
10 January 2022
Accepted:
28 February 2022
Published:
9 March 2022
Abstract: In South Africa, midwives in primary healthcare setting are first responders to majority of the expectant mothers in the community. These pregnant mothers should benefit from at least one ultrasound in their pregnancy according to the WHO recommendation. However, these midwifes are not equipped to provide such limited obstetrics ultrasound services essential to accurately date the pregnancy, identify normal pregnancy and refer unsuspecting mothers in a timely manner following abnormality detected on ultrasound. The Advanced Midwifes could accurately diagnose morbidity related complications (for which ultrasound is perceived as the gold standard), they were trained to identify - placenta previa, breech presentation, intrauterine foetal demise and miscarriages, abnormal amniotic fluid levels, cervical incompetence, ectopic pregnancy, abnormal foetal growth and selected gross foetal anomalies. The Advanced Midwifes were accurately able to date the pregnancy on women who access the service did not know their last menstrual period (LMP) and on those who could recall their LMP had a significant disparity between gestational age by LMP and by composite ultrasound age (CUA). Limited obstetric ultrasound gestational age determination by advanced midwives was useful in not only assessing gestational age but also in identifying abnormalities associated with the pregnancies.
Abstract: In South Africa, midwives in primary healthcare setting are first responders to majority of the expectant mothers in the community. These pregnant mothers should benefit from at least one ultrasound in their pregnancy according to the WHO recommendation. However, these midwifes are not equipped to provide such limited obstetrics ultrasound services...
Show More
-
Maternal and Perinatal Complications of Vascular Pathologies Associated with Pregnancy: Frequency and Associated Factors in a Third Level Maternity in Benin
Tognifode Veronique,
Aboubakar Moufalilou,
Ogoudjobi Mathieu,
Dakin Mohamed,
Dangbemey Patrice,
Gayito René,
Hounkponou Fanny,
Tshabu Christiane,
Hounkpatin Benjamin,
Denakpo Jutsin Lewis
Issue:
Volume 10, Issue 2, March 2022
Pages:
60-68
Received:
28 January 2022
Accepted:
21 February 2022
Published:
9 March 2022
Abstract: Background and aims: Vascular pathologies (hypertensive disorders and diabetes) associated with pregnancy are important public health problem in Benin because of their frequencies and their complications. This study aims to analyze maternal and perinatal complications of vascular pathologies associated with pregnancy. Methods: This analytical cross-sectional study used retrospective data collected over a three-year period. All mothers who presented a vascular pathology and their newborns during the study period at the Clinique Universitaire de Gynécologie obstétrique (CUGO) of Centre National Hospitalier Universitaire Hubert Koutoukou Maga (CNHU-HKM) of Cotonou were included. Maternal complications associated neurological, hematological, cardio-pulmonary and renal complications whereas perinatal complications included intrauterine growth restriction, fetal asphyxia, prematurity, neonatal resuscitation, low birthweight and perinatal death. Factors associated to the complications were identified by using chi-square test and a multivariate binary logistic regression model. Analyzes were performed with SAS software version 9.4. Results: The frequency of vascular pathologies associated with pregnancy was 14.95%. Diabetes was associated in 4.57%. Their evolutions were marked by the occurrence of numerous maternal complications dominated by retroplacental hematoma (12.08%), eclampsia (08.37%) which passed through signs of eclampsism (21.07%); and hellp syndrome. Perinatal complications were dominated by prematurity (43.07%), low birthweight (29.12%), fetal asphyxia (12.32%) and perinatal death (18.59%). These complications were associated with the precocity of the diagnosis, admission mode and the importance of proteinuria. Conclusion: Maternal and perinatal complications of vascular pathologies associated with pregnancy are frequent in current obstetric practice. It is therefore urgent to implement health promotion interventions targeting the factors associated with them in order to reverse the trends.
Abstract: Background and aims: Vascular pathologies (hypertensive disorders and diabetes) associated with pregnancy are important public health problem in Benin because of their frequencies and their complications. This study aims to analyze maternal and perinatal complications of vascular pathologies associated with pregnancy. Methods: This analytical cross...
Show More
-
Displacement of Window of Implantation in Cases of Unexplained Recurrent Implantation Failure as Detected by Endometrial Receptivity Array Testing
Nagwan Ahmed Bahgat,
Waleed Syed
Issue:
Volume 10, Issue 2, March 2022
Pages:
69-74
Received:
6 February 2022
Accepted:
25 February 2022
Published:
9 March 2022
Abstract: Patients with recurrent implantation failure had to be extensively studied to find way to achieve clinical pregnancy, it is well known that defects in the embryo or the endometrium or the alteration between both could be the reason. Exclusion of the possibilities of embryo abnormalities could help us to concentrate on the endometrial factors of failure. In this study we concentrated on endometrial receptivity displacement as a factor of implantation failure in patients with recurrent unexplained IVF failure. This is done through studying gene expression of endometrium in those cases to determine the receptivity timing and the window of implantation. Through retrospective study of 93 patients with recurrent implantation failure who underwent endometrial receptivity array testing, we found that the incidence of non-receptive endometrium in such cases was 45% 38 patients of 83 which is higher than other studies in the same field. Prevalence of pre receptive endometrium in those cases more than post receptive, Indicates the need to more exposure to Progesterone to achieve receptivity. Polycystic ovarian syndrome patients included in this study showed also high incidence of non-receptive endometrium10 out of 11patients (90.9%). In conclusion personalized embryo transfer according to ERA test could be useful to this category of patients. However larger studies are needed in the same group of patient
Abstract: Patients with recurrent implantation failure had to be extensively studied to find way to achieve clinical pregnancy, it is well known that defects in the embryo or the endometrium or the alteration between both could be the reason. Exclusion of the possibilities of embryo abnormalities could help us to concentrate on the endometrial factors of fai...
Show More
-
Limited Obstetrics Ultrasound by Midwifes in Gauteng, South Africa: Benefit of Service-oriented Competency Development in Primary Healthcare Delivery: A Pilot Study
Tshililo Mashamba,
Akpan Eyo,
Olakunle Towobola,
Anele Busakwe,
Sikhonjiwe Masilela
Issue:
Volume 10, Issue 2, March 2022
Pages:
75-81
Received:
10 January 2022
Accepted:
28 February 2022
Published:
15 March 2022
Abstract: In South Africa advanced midwifes are expected to independently provide comprehensive midwifery care from prenatal to postnatal stage. The integration of obstetric ultrasound diagnostics capability into routine pregnancy care delivery by the first healthcare responders will augment clinical decision making and appropriate case management action. The current PHC service delivery has not integrated basic ultrasound capability into routine pregnancy care service. Advanced midwifes were trained on basic obstetric ultrasound and make a care management decision based on ultrasound findings performed. Midwifes could accurately diagnose morbidity related complications. We conclude that advance midwifes care management plan is augmented when competence and provision of limited obstetrics ultrasound is integrated as a routine pregnancy care service in a maternity outpatient unit and community health centre. Because close to fifty percent of women from the community who attend these clinics could not accurately recall their last menstrual period, it is appropriate, and should become an expectation for these first responders to utilise ultrasound to offset potential morbidity induced by uncertainty of gestational age and weight estimation. These should be an integral component where this program is transferred or reproduced.
Abstract: In South Africa advanced midwifes are expected to independently provide comprehensive midwifery care from prenatal to postnatal stage. The integration of obstetric ultrasound diagnostics capability into routine pregnancy care delivery by the first healthcare responders will augment clinical decision making and appropriate case management action. Th...
Show More
-
Association of Pre-Gestational Diabetes Mellitus (Type 1 & Type 2), Gestational Diabetes, and Pre-Eclampsia with Preterm Birth Among Omani Women
Zainab Khalfan Al Maqbali
Issue:
Volume 10, Issue 2, March 2022
Pages:
82-91
Received:
16 February 2022
Accepted:
7 March 2022
Published:
15 March 2022
Abstract: Background: To understand what results in preterm birth, the purpose of this quantitative cross-sectional study was to determine if and to what extent rates of pre-gestational diabetes mellitus, gestational diabetes mellitus, and pre-eclampsia differ between Omani women who deliver preterm infants and Omani women who deliver term infants. Shonkoff’s bio-developmental framework provided the theoretical foundation for the study. Methodology: A quantitative method. Specifically, this is a retrospective cross-sectional study using secondary data Secondary. Data were gathered from a simple random sample of 400 women who delivered preterm or term infants between 2015 and 2017 at Ibri hospital in Oman. Controls group included 200 women with full-term and 200 cases women with pre-term (case to control ratio was 1:1). After data extraction and cleaning, descriptive analyses and Chi-square tests of independence were conducted. Results: A total of 400 randomly selected participants (mean age of the participants was 29.26 (SD±5.75) years) were included in the study (200 participants gave birth to preterm infants and 200 participants gave birth to full term infants). The demographics of the women, maternal clinical characteristics, neonatal clinical characteristics, maternal complications in previous pregnancy, and maternal complications in current pregnancy, were summarized. According to the results of chi-square tests of independence, there was no association between delivery term and complications in current pregnancy, in terms of pre-gestational diabetes mellitus, GDM, and pre-eclampsia. Nonetheless, numerous statistically significant association were found between risk of preterm birth and demographic as well as clinical factors. Conclusion: According to the results, there was no statistically significant association between delivery term and complications in current pregnancy, in terms of pre-gestational diabetes mellitus and pre-eclampsia. However, most of the indicators related to determine the connection between education, number of infants born prematurely, maternal family history of GDM, maternal family history of gestational hypertension, maternal family history of obesity, infants’ birth weight, Apgar score at 1 minute and Apgar score at 5 minutes, and fetal demise the second research question were statistically significant with preterm birth. Finally, the researcher recommends addressing the current study’s limitation of Omani specific results in broader studies covering a greater population and diverse population demographics. Also the researcher recommends the results of this study be applied to nursing practice and education by training nurses and nursing students to identify factors in patient family histories which might suggest high risk pregnancies.
Abstract: Background: To understand what results in preterm birth, the purpose of this quantitative cross-sectional study was to determine if and to what extent rates of pre-gestational diabetes mellitus, gestational diabetes mellitus, and pre-eclampsia differ between Omani women who deliver preterm infants and Omani women who deliver term infants. Shonkoff’...
Show More
-
Breech Presentation: Determinants of the Delivery Route and Neonatal Prognosis at the University Hospital Center of Brazzaville (Republic of Congo)
Buambo Gauthier Regis Jostin,
Eouani Levy Max Emery,
Ngami Ariane Glore,
Mokoko Jules Cesar,
Potokoue Mpia Sekangue Samantha Nuelly,
Itoua Clautaire,
Iloki Leon Herve
Issue:
Volume 10, Issue 2, March 2022
Pages:
92-96
Received:
26 February 2022
Accepted:
14 March 2022
Published:
18 March 2022
Abstract: Objective. To analyze the determinants of the delivery route and the neonatal prognosis in case of breech presentation at the University Hospital Center of Brazzaville. Method. Monocentric analytical cross-sectional study conducted from January 1 to December 31, 2019 in the Obstetrics Gynecology Department of the University Hospital Center of Brazzaville, comparing 54 women who gave birth by cesarean section and 23 women who gave birth vaginally. Were included all women who gave birth to a fetus in breech presentation whose chronological age was greater than or equal to 28 weeks of amenorrhea or a birth weight greater than 1000 g and their newborn. The variables studied were pre, per and post partal. The p-value of the probability was considered significant for a value less than 0.05. Results. Breech delivery represented 1.6% of deliveries, i.e. 97 out of 6075. The women delivered were not different in age [29 (24-34) vs 29 (26-33), p>0.05] nor in parity [1 (0-3) vs 2 (0-3), p>0.05]. Most of them gave birth by caesarean section (63.9% vs 36.1%). The determinants of the delivery route were: level of education (48.1% vs 73.9%; OR=3.1 [1.04-8.9]; p<0.05), gestational age less than 34 WA (0% vs 13%; p<0.05), the existence of a uterine scar (22.2% vs 0%; p<0.05) and insufficient fundal height (3.7% vs 26.1%; OR=0.12 [0.02 – 0.7]; p<0.05). Neonatal morbidity was not influenced by the route of delivery. Newborns from the vaginal route were the most transferred to neonatology (5.6% vs 34.8%; OR=0.11 [0.3 – 0.47]; p<0.05) and died (0% vs. 17.4%; p<0.05). Conclusion. The decision of the way of delivery in case of breech presentation at the University Hospital of Brazzaville depends on both maternal and obstetrical factors. Identifying the determinants requires careful questioning and rigorous obstetrical examination.
Abstract: Objective. To analyze the determinants of the delivery route and the neonatal prognosis in case of breech presentation at the University Hospital Center of Brazzaville. Method. Monocentric analytical cross-sectional study conducted from January 1 to December 31, 2019 in the Obstetrics Gynecology Department of the University Hospital Center of Brazz...
Show More
-
Effect of Oxysophocarpine on Proliferation and Invasion of Endometrial Cancer HEC-1-B Cells and Related Proteins
Issue:
Volume 10, Issue 2, March 2022
Pages:
97-107
Received:
16 March 2021
Accepted:
9 April 2021
Published:
23 March 2022
Abstract: Endometrial cancer is one of the most common cancer of the female reproductive tract, which has been one of the primary causes of cancer related deaths and accounts for approximately ¼ of these patients. In this paper, HEC-1 cell l i n e s that are known to propagate endometrial cancer have been considered as potential sites of action for various therapeutic agents in an attempt to combat proliferation. Ancient Chinese remedies are by far the most recognized therapeutic method which have been found to relieve patients suffering from a tumor and also suppresses tumor growth. This study researches the effect of an injection formulation of the compound Kushen, which is a large oxysophocarpine-associated compound. In CKI- handled tumor cells, cellular proliferation through DNA synthesis and mobile differentiation seems to be a surprisingly modified mechanism. Cell cycle inhibition is seen to be one of the key mechanisms in CKI mediated tumor suppression in most instances. This is based on the fact that aggregates display certain 2-D specifications and dimerization of genes within the proposed mechanisms [10]. There is, nevertheless, little to no proof that oxysophocarpine, specifically in endometrial cells HEC-1B, inhibits the growth of most cancers’ cells.
Abstract: Endometrial cancer is one of the most common cancer of the female reproductive tract, which has been one of the primary causes of cancer related deaths and accounts for approximately ¼ of these patients. In this paper, HEC-1 cell l i n e s that are known to propagate endometrial cancer have been considered as potential sites of action for various t...
Show More
-
TSLC-1 and STAT-3 Expression and Its Implication in Cervical Adenocarcinoma
Issue:
Volume 10, Issue 2, March 2022
Pages:
108-119
Received:
16 March 2021
Accepted:
6 April 2021
Published:
23 March 2022
Abstract: Inserting A549 the incorporation of cDNA into lung cancer (non-small cell) lines as well as tumor genomic clones repressor gene cancer of the lungs 1 (TSLC-1) helps these cell lines reverse tumor enlargement trends. Signal transducer and transcription activator 3 (STAT3) were phosphorylated chronically in 22 percent to 65 percent cancers of the non-small cell lung cancer. Tyrosine kinase receptors, for example EGFR (EGF stands for epidermal growth factor.), MET receptors as well as cytokine receptors, activate STAT3. IL-6, for example non-receptor kinases, as well as SRC were found to be involved as well. In resected NSCLC, overexpression of total or phosphorylated STAT-3 results in a poor prognosis. Gene expression and cell cycle variations show TSLC1 downstream pathways that serve as a bridge between the two repression of tumor products in A549 cells. The activation of STAT3 by stromal cells can be beneficial to NSCLC cell oncogenic outcomes.
Abstract: Inserting A549 the incorporation of cDNA into lung cancer (non-small cell) lines as well as tumor genomic clones repressor gene cancer of the lungs 1 (TSLC-1) helps these cell lines reverse tumor enlargement trends. Signal transducer and transcription activator 3 (STAT3) were phosphorylated chronically in 22 percent to 65 percent cancers of the non...
Show More
-
Indication of Laparoscopy in Case of Tubal Infertility at the University Hospital of Brazzaville (Republic of Congo)
Potokoue Mpia Sekangue Samantha Nuelly,
Buambo Gauthier Regis Jostin,
Eouani Levy Max Emery,
Bidzi Mbiene Pacome,
Mokoko Jules Cesar,
Itoua Clautaire,
Iloki Leon Herve
Issue:
Volume 10, Issue 2, March 2022
Pages:
120-125
Received:
13 March 2022
Accepted:
30 March 2022
Published:
9 April 2022
Abstract: Objective: Analyze the determinants of the indication for laparoscopy in case of tubal obstruction on hysterosalpingography at the University Hospital Center of Brazzaville. Methods: Cross-sectional analytical study, conducted from January 1, 2015 to December 31, 2019, in the Obstetrics Gynecology Department of the University Hospital Center of Brazzaville, comparing 108 infertile patients with tubal obstruction to hysterosalpingography confirmed by methylene blue test (MBT-) in laparoscopy and 78 infertile patients with positive methylene blue test (MBT+) invalidating tubal obstruction in laparoscopy. Epi Info 7 software was used for statistical analysis. The p-value was considered significant for a p value < 5%. Results: Tubal obstruction was confirmed (MBT-) in 108 patients among the 186 selected for the study, i.e. 58.1%, and reversed (MBT+) in 78 patients, i.e. 41.9%. Tubal obstruction on laparoscopy was most observed in patients over 30 years old (84.3% vs 70.5%; OR=2.2 [1.1-4.6]; p<0.05), history of abortive endo-uterine maneuver (ORa=26 [17.9-38.9]; p<0.05), ectopic pregnancy (ORa=3.2 [1.4-52.1]; p<0.05), pelvic surgeries such as myomectomy (ORa=4.1 [1.2-18.4]; p<0.05), appendectomy (ORa=28.5 [1.5-54.7]; p<0.05) and salpingectomy (ORa=4.8 [2.3-12.5]; p<0.05) and suffering from chronic pelvic pain (ORa =4.1 [1.1-15.7]; p<0.03). The distal location of the tubal obstruction on HSG (ORa=2.8 [1.5-14.3]; p<0.05) and seropositivity for chlamydia trachomatis (ORa=41.2 [7.2 -234.8]; p<0.05) were most associated with negative MBT. Conclusion: The decision to perform a laparoscopy for tubal obstruction revealed by hysterosalpingography should take into account the determinants thus identified, especially when it comes to proximal tubal obstruction.
Abstract: Objective: Analyze the determinants of the indication for laparoscopy in case of tubal obstruction on hysterosalpingography at the University Hospital Center of Brazzaville. Methods: Cross-sectional analytical study, conducted from January 1, 2015 to December 31, 2019, in the Obstetrics Gynecology Department of the University Hospital Center of Bra...
Show More
-
Performance of the sFLT-1 / PLGF Ratio in the Diagnosis of Preeclampsia in Four Hospitals in Brazzaville (Republic of Congo)
Eouani Levy Max Emery,
Buambo Gauthier Regis Jostin,
Mouhingou Belmar Nick-Desy,
Mokoko Jules Cesar,
Potokoue Mpia Sekangue Samantha Nuelly,
Itoua Clautaire,
Iloki Leon Herve
Issue:
Volume 10, Issue 2, March 2022
Pages:
126-130
Received:
21 March 2022
Accepted:
7 April 2022
Published:
14 April 2022
Abstract: Preeclampsia is a serious obstetric situation, responsible for high maternal and perinatal morbidity and mortality. Its diagnosis is clinical and biological, with confirmation either by proteinuria on the urine dipstick or by 24-hour proteinuria constituting the gold standard. Current revisions to the definition of preeclampsia tend to free themselves from reliance on proteinuria for diagnosis. They are oriented towards a broader model where the involvement of a target organ concomitant with gestational hypertension is sufficient to make the diagnosis of preeclampsia. Late positivity of proteinuria after the onset of arterial hypertension (HTA) has been reported, contrasting with the precocity of angiogenic factors such as soluble Fms tyrosine kinase type 1 (sFlt-1) and placental growth factor (PlGF). Objective. To evaluate the performance of the sFLT-1/PLGF ratio in the diagnosis of preeclampsia. Methods. Cross-sectional multicenter analytical study conducted from October 17 to December 17, 2020 including hypertensive pregnant women, treated or not, with more than 20 weeks of amenorrhea. These all benefited from the Elisa assay of sFLT-1 and PlGF after carrying out the proteinuria on the urine dipstick during the consultation. Preeclampsia was defined by the double positivity of proteinuria on the urine dipstick associated with high blood pressure (Systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg). SPSS software was used for statistical analysis and calculation of performance indices (Se; Sp; PPV; NPV; Youden “J” index, AUC). The p-value of the probability was considered significant for a value < 0.05. Results. Pregnant women were mostly multiparous with a median age of 31 years (24-35). Preeclampsia was noted in 69.2% of cases. sFLT-1 was significantly higher in preeclamptic pregnant women (409±18.9 vs 194.6±12.9; p<0.05). No significant difference was noted for PlGF (11.9 vs 13.6; p< 0.05). The sFlt-1/PlGF ratio was higher in case of preeclampsia (39.3 vs 14.6; p< 0.05). The threshold for the sFlt-/PlGF ratio retained was 18.5 (Se=86.4%; Sp=84.6%; PPV=90.5%; NPV=78.6%; J = 0.7; AUC =0.9). Conclusion. The sFlt-1/PlGF ratio was effective in the diagnosis of preeclampsia.
Abstract: Preeclampsia is a serious obstetric situation, responsible for high maternal and perinatal morbidity and mortality. Its diagnosis is clinical and biological, with confirmation either by proteinuria on the urine dipstick or by 24-hour proteinuria constituting the gold standard. Current revisions to the definition of preeclampsia tend to free themsel...
Show More
-
Women’s Satisfaction with the Quality of Antenatal Care Services Being Offered in Bamenda Health District
Eyvonne Ngequih Tumasang,
Eric Nuvadga Kamando,
Kinga Bertila Mayin
Issue:
Volume 10, Issue 2, March 2022
Pages:
131-138
Received:
16 March 2022
Accepted:
12 April 2022
Published:
20 April 2022
Abstract: Background: Antenatal care is the care women receive while pregnant. It is an important health service which detects and sometimes curbs the risk of complications among pregnant women (PW). The way women perceive the quality-of-care render during ANC influences utilization and consequently the outcome of pregnancy. This study investigated women’s satisfaction with the quality of antenatal care in the BHD. Women presenting for antenatal care for their second or subsequent visits at 14 health facilities in the Bamenda health district were interviewed in a cross-sectional designed study, using a semi-structured questionnaire. The questionnaire included sociodemographic and obstetric variables, and level of satisfaction with various aspects of antenatal care. Data analysis was done using EPI info. The p-value was set at P<0.05. 396 women participated in the study. 70% of the women were between 20 and 30yrs of age. 81.8% of them were married while. 49.2% had secondary education, 49.7% were self- employed while 10.4% were unemployed. Parity mean of 1.55 ± 1.357. 73.2% began ANC after the first trimester of pregnancy, mean number of ANC visits was 3.82 ±1.721. 84.6% of women were satisfied with elements of quality ANC services, 81.3% with the health education they received and only 41.0% were satisfied interventions for physiological problems of pregnancy. Women who attended faith-based health facilities (FBHF) were more satisfied with elements of quality ANC than those who attended public health facilities the reverse was true for health education messages received where women were more satisfied with public health facilities. There was no significant difference in the interventions during pregnancy for both faith-based and public health facilities (PHF). We concluded that apart from the physiological interventions during pregnancy, women were satisfied with the ANC services they receive in the BHD although there were gaps to be filled to improve on the quality of ANC. The use of antenatal care guidelines was recommended to enable a comprehensive delivery of antenatal care for an optimum satisfaction.
Abstract: Background: Antenatal care is the care women receive while pregnant. It is an important health service which detects and sometimes curbs the risk of complications among pregnant women (PW). The way women perceive the quality-of-care render during ANC influences utilization and consequently the outcome of pregnancy. This study investigated women’s s...
Show More
-
Research Progress in Drug Treatment of Adenomyosis
Zhenyue Qin,
Zhiyong Dong,
Junling Liu,
Shoufeng Zhang,
Huihui Wang,
Mingyue Bao,
Weiwei Wei,
Ruxia Shi,
Jiming Chen,
Bairong Xia
Issue:
Volume 10, Issue 2, March 2022
Pages:
139-143
Received:
16 March 2022
Accepted:
6 April 2022
Published:
20 April 2022
Abstract: Background: Adenomyosis is caused by endometrial glands and stroma invading the myometrium. It is more common in parturients after the age of 30. At present, there are many drugs for the treatment of adenomyosis, and drug treatment is also one of the important treatments for adenomyosis. Objective: To summarize the drugs that can be used for the treatment of adenomyosis, hoping to be helpful to the clinical treatment. Method: Relevant studies were retrieved from the MEDLINE, Embase, Cochrane Library, CENTRAL and ClinicalTrials.gov. The retrieval time range was from January 2000 to March 2022. English search terms included "(treatment)","(adenomyosis) OR (endometrioma) OR (adenomyoma)". Result: Drug therapy can relieve the clinical symptoms of patients, inhibit the proliferation of lesions, and cooperate with surgical treatment to improve the curative effect. The efficacy and adverse reactions of the drug are closely related to the duration of use. At present, there is no specific drug for the treatment of adenomyosis, and there is a certain degree of recurrence after drug withdrawal. Some clinical scholars have adopted a combination regimen for the treatment of adenomyosis and achieved certain results. Conclusion: About the drug treatment of adenomyosis, it is necessary to personalize the treatment plan by combining the severity of the patients' clinical symptoms, age, fertility needs, patients' economic conditions, whether they can regulate the use of drugs, and the adverse reactions after the use of drugs.
Abstract: Background: Adenomyosis is caused by endometrial glands and stroma invading the myometrium. It is more common in parturients after the age of 30. At present, there are many drugs for the treatment of adenomyosis, and drug treatment is also one of the important treatments for adenomyosis. Objective: To summarize the drugs that can be used for the tr...
Show More
-
Obstetric Fistula Repair Through Transvaginal Approach: The Experience in DMCH
Bipul Kumar Biswas,
Sabrin Farhad,
Monoroma Sarkar,
Joyonto Kumar Das
Issue:
Volume 10, Issue 2, March 2022
Pages:
144-151
Received:
12 March 2022
Accepted:
6 April 2022
Published:
26 April 2022
Abstract: Background: Vesicovaginal fistula (VVF) is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault. The successful closure depends on many factors, although the majority of genitourinary fistulas can be closed surgically. Aim of the study: The aim of the study was to find out the outcome of obstetric fistula repair through a transvaginal approach. Methods: This prospective observational study was conducted in the Department of Gynecology & Obstetrics, Dhaka Medical College Hospital Dhaka, Bangladesh from June 2006 to May 2007. A total of 30 women with VVF difficulties who were admitted to the hospital were recruited as the study population. To repair the obstetrics fistula of women, the transvaginal surgical procedure was followed. For data analysis, statistical software SPSS version 22.0. All data were presented in mean values. The results were presented in tables, figures. The observations were recorded as statistically significant (p-value <0.05). Results: Postoperative complications were not found in 28 (93.3%) cases and no information was found in 2 (6.7%). Duration of retaining catheter (days) <10 in 1 (3.3%), 10-15 in 19 (63.3%), 16-21 in 8 (26.7%) and no information found in 2 (6.7%). Total length of stay (week) was 3-4 week in 13 (43.3%), 5-8 week in 10 (33.3%), 9-12 in 3 (10.0%), 13-24 in 4 (13.4%). The patient developed stress incontinence in 8 (26.7%) and no information was found in 22 (73.3%). 20 (66.7%) cases resulted successfully, Stress incontinence was found in 3 (10.0%), failed VVF in 1 (3.3%), Failed RVF in 6 (20.0%). The reason for failure was 2 (6.7%) bad cases and no information was found in 28 (93.3%). Conclusion: The transvaginal approach is less invasive and achieves comparable success rates as compared to other methods of VVF repair. Genital fistula repair surgery with Foley catheter has a high success rate, reduced morbidity, minimal blood loss, and short tome hospital stay.
Abstract: Background: Vesicovaginal fistula (VVF) is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault. The successful closure depends on many factors, although the majority of genitourinary fistulas can be closed surgically. Aim of the study: The aim of t...
Show More
-
Knowledge of Cervical Cancer and Attitudes Towards Its Prevention Among Women Attending Antenatal Clinics in Primary Health Centres in a Niger Delta Capital City
Matthias Gabriel Abah,
Bles Akpabio Atat,
Emmanuel Bassey Edu,
Essien Iniokpon Attah,
Iniobong Abah
Issue:
Volume 10, Issue 2, March 2022
Pages:
152-158
Received:
28 March 2022
Accepted:
15 April 2022
Published:
26 April 2022
Abstract: Introduction Cervical cancer is the fourth commonest cause of cancer and cancer-related deaths among women worldwide and commonest gynaecological cancer in Nigeria. This study sort to determine the awareness of cervical cancer, its prevention and determine the attitude and practice of these women towards screening. Materials and methods: This was a descriptive cross-sectional questionnaire-based study to assess the knowledge, attitude and utilisation of cervical cancer screening among pregnant women attending antenatal clinics in primary health centres in Uyo, South-south Nigeria. Results: The mean age of respondents was 34.7±8.9 years. The majority (76.7%) had post-secondary education, were married (69.6%), had 2 or more lifetime sexual partners (>60%) and had been pregnant twice (25%). Most (87.5%) have heard about cervical cancer, mainly from health workers, 116 (44.8%). The top 2 clinical features known were abnormal vaginal bleeding 177 (59.8%) and foul-smelling vaginal discharge 157 (53.0%) while the commonest risk factors mentioned were sex at early age 145 (49.0%) and multiple sexual partners 135 (45.6%). Preventive strategies known include quitting smoking (53.4%), avoiding early sexual intercourse (49%) and avoiding multiple sexual partners (48.3%). The majority, 186 (62.8%) knew about screening measures but less than a quarter knew that all sexually active women should be screened 46 (15.5%), while only 24.7% were aware of free services, 15.2% had ever been screened. The commonest reasons for non-screening were not feeling at risk 68 (27.1%) and being unaware of screening 57 (22.7%) while most had a positive attitude towards screening for cervical cancer. 167 (56.4%). Conclusion: The good knowledge of cervical cancer and attitude towards its screening was not matched by action as only a few had ever been screened despite their high lifetime risk for it. There is therefore the need for further awareness creation on cervical cancer prevention with the aim of increasing their uptake of available screening services in the state.
Abstract: Introduction Cervical cancer is the fourth commonest cause of cancer and cancer-related deaths among women worldwide and commonest gynaecological cancer in Nigeria. This study sort to determine the awareness of cervical cancer, its prevention and determine the attitude and practice of these women towards screening. Materials and methods: This was a...
Show More
