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History of Chlamydia Trachomatis Infection Threatens Fertility in Women with Unilateral Tubal Occlusion
Satoko Goa,
Keiichi Kumasawa,
Masaaki Ono,
Takeshi Taniguchi
Issue:
Volume 4, Issue 6, November 2016
Pages:
34-37
Received:
18 August 2016
Accepted:
12 September 2016
Published:
8 October 2016
Abstract: Tubal factors are associated with infertility. To evaluate the influence of past Chlamydial infections on female fertility with unilateral tubal occlusion, we compared the cumulative pregnancy rate of Chlamydia antibody seropositive women with those who are seronegative. A retrospective, case-controlled study was designed. A total of 54 consecutive infertile women with unilateral tubal occlusion diagnosed by hysterosalpingography (HSG) during January, 2009 to April, 2013 were enrolled in this study. Each patient was followed up for three years. The study group was composed of 19 Chlamydia antibody seropositive women. The control group consisted of 35 who are seronegative. The cumulative pregnancy rate of the study group was 6/19 (31.5%) and that of the control group was 19/35 (54.3%). This suggested that the patients with past Chlamydial infections had more difficulty becoming pregnant than those without prior infections. There were no significant differences of clinical parameters between the two groups. This study suggested that past Chlamydia infection may contribute to lower pregnancy rates in infertile women with unilateral tubal occlusion. Patients with both unilateral tubal occlusion and Chlamydia antibody seropositive may do better to proceed to in vitro fertilization (IVF).
Abstract: Tubal factors are associated with infertility. To evaluate the influence of past Chlamydial infections on female fertility with unilateral tubal occlusion, we compared the cumulative pregnancy rate of Chlamydia antibody seropositive women with those who are seronegative. A retrospective, case-controlled study was designed. A total of 54 consecutive...
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Management of Proliferative Endometrium on Biopsy in Post-Menopausal Women
Sidharth Srinivas,
Sachchidananda Maiti,
Perunkulam Jothilakshmi
Issue:
Volume 4, Issue 6, November 2016
Pages:
38-43
Received:
4 September 2016
Accepted:
21 September 2016
Published:
15 October 2016
Abstract: Post-menopausal bleeding (PMB) is usually caused by several endometrial conditions (hyperplasia and carcinoma) for which there are evidence-based treatments. However, there is little literature and no evidence-based treatments for a finding of proliferative endometrium without atypia on Pipelle endometrial biopsy in women presenting with PMB. Our aim is to explore management and treatment options for this subset of women. This is a retrospective, observational case series review of women presenting with PMB to a gynaecology rapid access clinic at a District General Hospital in Manchester, UK over a period of three weeks. Four women who were found to have a proliferative or secretory endometrium on endometrial Pipelle biopsy were chosen. Their history, examination findings, investigations, treatment and follow-up findings were then analysed. This case series has identified the management dilemma posed by patients with proliferative endometrium with no atypia on endometrial sampling. The four patients were followed-up with a repeat Pipelle endometrial biopsy six weeks after presentation to the specialist gynaecology unit. They were subsequently counselled or treated with oral progesterone therapy for six to eight weeks. The management options included the Mirena intrauterine system (IUS), oral progesterone therapy and discharging the patient back to primary care. There is no consensus on the importance of oral progesterone or the duration of follow up necessary to monitor for the development of endometrial hyperplasia or cancer in this subset of patients. Further research is needed to develop evidence-based, management guidelines for proliferative endometrium in women with PMB.
Abstract: Post-menopausal bleeding (PMB) is usually caused by several endometrial conditions (hyperplasia and carcinoma) for which there are evidence-based treatments. However, there is little literature and no evidence-based treatments for a finding of proliferative endometrium without atypia on Pipelle endometrial biopsy in women presenting with PMB. Our a...
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Magnitude of Safe Delivery Services Utilization and Associated Factors Among Women of Childbearing Age in Egela Sub-Woreda, Tigray, Northern Ethiopia
Andemariyam Yohannes,
Teshome Gobana,
Fitsum Araya,
Nigusse Obse
Issue:
Volume 4, Issue 6, November 2016
Pages:
44-52
Received:
22 September 2016
Accepted:
26 October 2016
Published:
8 December 2016
Abstract: In Ethiopia, the levels of maternal and infant mortality and morbidity are among the highest in the world. Community based studies about safe delivery service utilization are not enough. As per the few studies done, professional assisted delivery is low in the country and particularly in Tigray region where the study was conducted. Community based cross sectional both quantitative and qualitative study were conducted in subworeda Egela, Northern Ethiopia on assessment of safe delivery service utilization and associated factors in mothers of childbearing age. The data for the quantitative method was collected using a pretested structured questionnaire on a sample of 380 mothers. The qualitative data were collected by FGDs with mothers of childbearing age, with the administrative bodies in the Subworeda and health professionals. The data were entered and analyzed using SPSS 16.0 and the appropriate statistical methods was used in the presentation, test of significant associations of variables at CI of 95%. The study revealed that 10.3% of the women deliver in health institution. 25% of the urban and 6.3% of the rural women deliver at health institutions. The socio-demographic variables s, obstetric factors, ANC attendance, TT vaccination & distance of health institution, were significantly associated with institutional delivery. In general this study revealed that the proportion of births delivered in the health institutions were unsatisfactory. The socio-demographic, obstetric and health service factors like distance of health institution were determinant factors. Therefore, establishing centers for emergency obstetric care other than the health center in accessible areas, providing health education for women of childbearing age by focusing on the Multi-para are the possible solutions should be recommended.
Abstract: In Ethiopia, the levels of maternal and infant mortality and morbidity are among the highest in the world. Community based studies about safe delivery service utilization are not enough. As per the few studies done, professional assisted delivery is low in the country and particularly in Tigray region where the study was conducted. Community based ...
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Discontinuation Pattern Among Intrauterine Contraceptive Device Users at Jos University Teaching Hospital, Jos, Nigeria
Anyaka Charles,
Ocheke Amaka,
Shambe Iornum,
Kahansim Makshwar,
Oyebode Tinuade,
Pam Victor,
Ekwempu Chinedu
Issue:
Volume 4, Issue 6, November 2016
Pages:
53-56
Received:
13 May 2016
Accepted:
22 June 2016
Published:
3 January 2017
Abstract: Context: Despite the high uptake of the intrauterine contraceptive device (IUCD), among family planning clients at Jos University Teaching Hospital (JUTH), some users discontinued its use for a variety of reasons. Objectives: To determine the discontinuation rate and factors responsible among IUCD users in the hospital over a 3 year period. Study Design: This was a 3 year retrospective descriptive study of all clients requesting for the removal of intrauterine devices (IUCDs) at the Family Planning clinic Jos University Teaching Hospital, Jos Nigeria. The study period was between January 1 st 2005 and December 31st 2007. Results: A total of 849 clients were seen during the study period; 393 (46.3%) clients discontinued within 3 years with the highest rate at 1 year 24.2%. All the women were married with 0.8% of the clients been nullipara. The most common reasons for discontinuation were the desire for pregnancy (50.9%), excessive menstrual bleeding (10.4%), vaginal discharge PID (9.0%) and others. The mean age of the clients was 33.6 ± 5.2 years. Conclusion: The discontinuation rate of IUCD in the family planning clinic at Jos University Teaching Hospital is high. More effective counseling may be appropriate for alternative contraceptive methods for this category of clients instead of the IUCD’s currently being used. The findings suggest a need for training the care providers to prevent early discontinuation of IUCD among JUTH clients and by addressing the health challenges via proper counseling, effective follow-up and prompt referral in case of complications.
Abstract: Context: Despite the high uptake of the intrauterine contraceptive device (IUCD), among family planning clients at Jos University Teaching Hospital (JUTH), some users discontinued its use for a variety of reasons. Objectives: To determine the discontinuation rate and factors responsible among IUCD users in the hospital over a 3 year period. Study D...
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Postpartum Hysterectomy a Case Report of a Saving Life Surgery
Alfredo de Almeida Cunha,
Cláudio de Oliveira Soeiro,
Sérgio Araujo Martins Teixeira,
Emílio de Assis
Issue:
Volume 4, Issue 6, November 2016
Pages:
57-61
Received:
3 July 2016
Accepted:
5 December 2016
Published:
7 January 2017
Abstract: Postpartum hemorrhage (PPH) is the most cause of maternal mortality all over the world important. Its prevalence is about 4 cases in 10,000 deliveries. However, the risk of maternal death is nearly 16% of all maternal deaths in developing countries, especially in Africa. It depends on the resources to stop bleeding, medical and surgical. The first ones are uterotonics medication (prostaglandin, methylergonovine and oxytocin), and the latest professional apt to perform surgical procedures, such as B-Lynch surgery and the peripartum hysterectomy. A woman, 20 years old, GI, P0, A0, with a single pregnancy, 42 weeks of gestational age and 5 prenatal bookings was attended at the emergency on April 12th 2015. The next day the patient delivered a male baby. The uterus was soft and at the examination she expelled a great amount of clots. She was prescribed Ringer lactate 500 ml + oxytocin 15 IU + methylergonovine 0.2 mg IM + misoprostol 800 µg per rectum. She continued bleeding and a hysterectomy was performed. The patient was discharge in good condition. The pathology revealed myometrium permeated by trophoblasts (placenta accreta).
Abstract: Postpartum hemorrhage (PPH) is the most cause of maternal mortality all over the world important. Its prevalence is about 4 cases in 10,000 deliveries. However, the risk of maternal death is nearly 16% of all maternal deaths in developing countries, especially in Africa. It depends on the resources to stop bleeding, medical and surgical. The first ...
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Correlation Between Expressions of VEGF and CA-125 with Stage, Level of Differentiation and Histopathology Type of Epithelial Ovarian Cancer
Farid Abdullah,
Syahrul Rauf,
Nusratuddin Abdullah,
Maisuri T. Chalid,
Deviana S. Riu,
Upik A. Miskad
Issue:
Volume 4, Issue 6, November 2016
Pages:
62-67
Received:
4 December 2016
Accepted:
15 December 2016
Published:
10 January 2017
Abstract: Cancer Antigen (CA-125) is a tumor marker used to detect ovarian cancer. This study aims to determine the relationship of VEGF expression and the levels of CA-125 on primary tumor associated with stage, degree of differentiation and histopathological types of epithelial ovarian cancer. This study is an observational study with a cross sectional design in Wahidin Sudirohusodo Hospital and some parts teaching hospital of Obstetrics and Gynecology began in August 2015 to February 2016. The population was all patients with epithelial ovarian cancer who were treated and underwent surgery at the hospital who met the inclusion criteria. The data were processed using SPSS with bivariate analysis Mann Whitney, Kruskal Wallis and Spearman's Rho. The result there were significant differences of VEGF expression in cell differentiation and histopathological type (p <0.05). There are significant differences in the levels of CA-125 with clinical stage, differentiation of cells and histopathological type (p <0.05). The expression of VEGF is getting stronger when the type of epithelial ovarian cancer is getting bad influence on the degree of cells differentiation and the histopathological type. CA-125 levels obtained increased at an advanced stage and degree of cells differentiation are bad for ovarian cancer. There is a positive correlation between the expression of VEGF and CA-125 levels in epithelial ovarian cancer but was not significantly different and the relationship is weak.
Abstract: Cancer Antigen (CA-125) is a tumor marker used to detect ovarian cancer. This study aims to determine the relationship of VEGF expression and the levels of CA-125 on primary tumor associated with stage, degree of differentiation and histopathological types of epithelial ovarian cancer. This study is an observational study with a cross sectional des...
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Bacterial Vaginosis as a Risk Factor for Preterm Labour-An Analysis of Age and Duration of Marriage
Zaheera Saadia,
Robina Farrukh,
Sadia Asghar
Issue:
Volume 4, Issue 6, November 2016
Pages:
68-71
Received:
5 December 2016
Accepted:
16 December 2016
Published:
12 January 2017
Abstract: Preterm labour is the onset of labour between ≥ 24 weeks to < 37 weeks of gestation. Bacterial Vaginosis (BV) is a polymicrobial condition with predominant lactobacilli in the vaginal flora. It is an important risk factor for preterm labour with an incidence of 5-18% of all deliveries causing increased perinatal morbidity and mortality with subsequent neurodevelopmental problems as cerebral palsy. We aimed to determine the association of BV with preterm labour population. A case control study was conducted comparing the prevalence of bacterial vaginosis in women having term labour with those who had preterm delivery. Chi square test was used to compare differences in participants’ age, duration of pregnancy and duration of marriage. Odd ratio and CI was calculated for the association between BV and preterm labour. Nearly half of the participants that experienced preterm labour were between 21 and 25 years old (46.7%, n = 35) and nearly half of the participants that experienced term pregnancy were between 21 and 25 years old as well (48.0%, n = 36). Additionally, the majority of participants had been married for three to four years, for those that experienced preterm labour (64.0%, n = 48) and term pregnancy (52.0%, n = 39). Furthermore, nearly half of the participants’ duration of pregnancy was between 33 and 34 weeks (49.3%, n = 37) and 52.0% of participants who experienced term pregnancy had been pregnant for 37 to 38 weeks (n = 39). Women with Bacterial Vaginosis, experienced preterm labour in 26.7% cases (n = 20) as compared to those who had term pregnancy 12.0% (n = 9). BV was significantly associated with preterm labour (OR=7.3, 95% CI =1.9-27.5, P=0.003). There was no significant difference in participants’ age between preterm labour and term pregnancy groups, (p value=0.880). Additionally, there was no significant difference in participants’ duration of marriage between preterm labour and term pregnancy groups, (p value=0.801). Bacterial Vaginosis is a risk factor for preterm labor. The study also concluded that there is no significant association between age, duration of pregnancy and duration of marriage between preterm labour and term pregnancy groups.
Abstract: Preterm labour is the onset of labour between ≥ 24 weeks to < 37 weeks of gestation. Bacterial Vaginosis (BV) is a polymicrobial condition with predominant lactobacilli in the vaginal flora. It is an important risk factor for preterm labour with an incidence of 5-18% of all deliveries causing increased perinatal morbidity and mortality with subs...
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The Prevalence of Exclusive Breast Feeding and Associated Factors Among Mothers of Less than Two Years Children in Kurkur Kebele, Dessie Town
Fikir Alebachew,
Natnael Girma,
Natnael Taye Tessema
Issue:
Volume 4, Issue 6, November 2016
Pages:
72-80
Received:
16 October 2016
Accepted:
2 November 2016
Published:
13 January 2017
Abstract: Breast milk is the one and only natural, complete and complex nutrition for human infants. It is superior to any product given to a baby. It is immediately available, fresh, constant, and economical. It provides all infants nutritional and fluid needs in the first six months and is a perfect combination of proteins, fats, carbohydrate and fluids. Nutrients such as vitamins A and C, iron, zinc and vitamin D are more easily absorbed from breast milk than from other milk. And it contains essential fatty acids needed for the infant’s growing brain, eyes, and blood vessels and these are not available in other milks. The aim of the this study is to assess prevalence of exclusive breast feeding and factors associated with it among mothers with children of less than 2 years old in Dessie town, South Wollo, Ethiopia, 2016. The community based quantitative cross-sectional study was carried out. From the total mothers who had ever breastfed their infant 332, about 326 (98.2%) of them were breastfeeding at the time of the survey. The prevalence of exclusive breastfeeding for the children in the study area was 49.7%. From the study subjects 296(89.2%) had previous experience of breast feeding practice, among them 78 (26.4%) had exclusive breast feeding practice. 236 (72.4) children were given food items. As to the given items, 236(100 %), 82 (34.7%), 34 (14.4%), 158 (66.9%), 209 (88.6) and 142 (60.2%) children were given plain water, juice, infant formula, animal milk, solid foods and other fluids respectively. From the total respondents 1(0.3%) had given water before initiation of breast feeding and 6 (1.8%) had stopped breast feeding at the time of survey and all stopped after one year of age of the child. In this study, the duration of exclusive breastfeeding was below the World Health Organization and national infant and young child feeding recommendations.
Abstract: Breast milk is the one and only natural, complete and complex nutrition for human infants. It is superior to any product given to a baby. It is immediately available, fresh, constant, and economical. It provides all infants nutritional and fluid needs in the first six months and is a perfect combination of proteins, fats, carbohydrate and fluids. N...
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