Dr. Ashish Anand,
Department of Orthopaedic Surgery, GV Montgomery Veteran Affairs Medical Center, Jackson, MS, USA.



ISBN 978-93-89246-66-7 (Print)
ISBN 978-93-89246-67-4 (eBook)
DOI: 10.9734/bpi/erms/v1


This book covers all areas of medical sciences. The contributions by the authors include hospitals, supervisory nursing, genitourinary, fistula, obstetrics, gynaecology, benign breast diseases, fibroadenoma, blood transfusion, storage lesions, biochemical changes, irradiation, lipid profile, infidelity, aripiprazole, psychotherapy, depression, suicide attempt, non-steroidal anti-inflammatory drug, loss of vision, retinal haemorrhage, newborns, NICU, prostate cancer, GSTP1 polymorphism, single nucleotide polymorphism, restriction digestion, academic stress, menstrual disorders, vaginal douching, perceived health effects, adiposity indices, diabetes mellitus, vaginal infections, vulvovaginal candidiasis,  gasoline fumes, haematotoxicity, amelioration, rat, vaginal douching practice, adverse reproductive tract outcome, risk modulating factor, obesity etc. This book contains various materials suitable for students, researchers and academicians in the field of medical sciences.


Experiences of Fathers of Babies Admitted into a Neonatal Unit in a Tertiary Hospital in Port Harcourt, Nigeria

P. I. Opara, E. A. Alinnor

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 1-10

Introduction: In time past mothers were regarded as sole caregivers of NICU babies, however the fathers’ role is now increasingly being recognized. Mothers are involved in providing care such as feeding, hygiene, and kangaroo mother care. Fathers are usually called on for medical bills and usually enter the neonatal unit for observational visits. The aim of the study was to determine experiences of fathers during the hospitalization of their babies in the neonatal intensive care unit (NICU) which is referred to as the Special Care Baby Unit (SCBU) of University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria.

Materials and Methods: This was a cross sectional study carried out in the neonatal clinic of UPTH over a period of 10 weeks. Participants were fathers who had brought their babies for follow up. Information obtained using interviewer administered questionnaires included biodata, occupation and experiences during their babies’ stay in SCBU.

Results: There were thirty seven participants, 15 (40.5%) of whom were in the middle socioeconomic class. Generally the experience was described as stressful by 25 (62.5%), confusing by 5 (12%), and pleasant by 7 (18.9%) fathers.

Contributors to stress were financial implications of babies’ care (13: 35.1%), illness in the mother (5: 13.5%), lack of care for other children (16: 43.2%) and worries about procedures and equipment used on their babies (14; 37.8%). Fathers also experienced disruptions in family (14; 35.1%) and social life (22; 55%). Thirty three (82.5%) fathers had family support. Religion and prayers were some of the strategies fathers employed to cope with their stress.

Conclusion: Fathers found the SCBU experience stressful. The financial burden of care contributed to the stress and some fathers resorted to prayers as a coping mechanism.

A Comparison of Nursing and Non-nursing Supervisory Managers’ Competence at an Urban Tertiary Hospital in North Central Nigeria

M. Dankyau, M. Z. Goni, E. I. Ibbi

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 11-18

Aims: Supervisory managers are key to ensuring that hospitals are effective, and they also contribute to employee satisfaction in the workplace. There is inadequate knowledge regarding their competences, skills and skill gaps. The study aimed to determine supervisory managers’ self-assessed managerial competence, and compare nursing and non-nursing managers.

Study Design: A cross-sectional survey of all consenting supervisory managers.

Place and Duration of Study: Bingham University Teaching Hospital Jos, February to March 2016.

Methodology: A two-part, self-administered questionnaire was used to obtain data on socio-demographic, work context and supervisor management competence. Data was entered to a data entry form in Statistical Package for Social Sciences (SPSS 21).

Results: A total of 48 managers completed the study giving a study response rate of 85.7%. Most of the participants were female (70.8%), with a mean age of 46.7±8.67 (Nurses 53.1±4.26 vs Non-nurses 43.1±8.49, P<.001) and mostly from the Health Service Provider cadre (64.6%). They had a mean duration of service of 19.9±10.3 years (Nurses 28.1±4.71 vs Non-nurses 15.4±9.72, P<.001). Median duration of management experience was 4 years and range of 1-26 years. Overall, 52.1% of the managers assessed themselves as competent (Nurses 58.8% vs Non-nurses 48.4%, P=.509).

“Gaining acceptance as Supervisor” and “Counselling a trouble employee” were the domains with the highest proportion (81.25%) of managers self-assessing as competent. “Dealing with performance problems” was the domain that the least proportion of managers (41.7%) felt competent. There were no statistically significant differences in competences of Nurse and Non-Nurse managers. Age, gender, occupation, education, years of service and years in management were not significant predictors of overall management competence.

Conclusion: Just over half of the managers were competent overall. There were significant gaps in managers competence in the performance related areas.

Vaginal Douching Behavior among Young Adult Women and the Perceived Adverse Health Effects

Christopher E. Ekpenyong

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 19-29

Aim: Several health belief models suggest that health risk perception could enhance behavioral modification to reduce lifestyle-related risks. Perceived health risks associated with vaginal douching (VD), propensity to douche and effects on douching behaviors were assessed in a cross-sectional survey of 1,463 female undergraduates, aged 18 to 35 years, randomly selected in a tertiary institution between 2011 and 2012.

Methodology: A 3-section semi-structured socio-demographic questionnaire on female genital tract hygiene practice was used for data collection. We conducted logistic regression analysis to test for association between douching and perceived health risk.

Results: The overall prevalence of VD was 79.2%. Most douchers (79.8%) lacked knowledge of risks associated with VD, 78.3% had misbeliefs about VD, 76.0% accepted the practice, 50.6% would have stopped if they had known the associated risks and 56.4% expressed fear of genital tract infections if they stopped douching. False beliefs and lack of knowledge about the health risks associated with VD increased the odds of douching among douchers (p < 0.05).

Conclusion: Low health risk perception and misconceptions about VD are the primary reasons for douching. Therefore, providing health education on the associated health risks of VD to female adolescents and young adult women may help to discourage VD among women in our societies.

Pattern and Outcome of Iatrogenic Genitourinary Fistula from Obstetric and Gynaecological Surgeries in a Tertiary Institution, North-Western Nigeria

S. Nasir, A. M. Elladan, M. Hassan, A. A. Panti

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 30-36

Introduction: Genitourinary fistula is commonly caused by prolonged obstructed labour; however, not all genitourinary fistulas are obstetric in origin. Inadvertent injuries to the urinary tract leading to fistulae do occur during obstetric and gynaecological procedures because of the close anatomical relationship between the urinary tract and the genital tract.

Objectives: This study aims to determine the prevalence, aetiology and outcome of iatrogenic genitourinary fistula repair at the National Obstetric Fistula Centre, Katsina (NOFIC).

Methodology: This was a two-year retrospective review of all patients who had surgery for iatrogenic fistula between 1st January 2015 and 31st December 2016 at NOFIC, Katsina. All patient case notes on this procedure during the stated period were retrieved and analysed.

Results: A total of 728 genitourinary fistula surgeries were carried out in the Centre, out of which 117 (16.1%) were repairs for iatrogenic fistulae, giving a prevalence rate of 16.1%. Only 110 case notes were eligible for analysis, giving a retrieval rate of 94%. The mean age of the patients was 30.40 ± 8.39 years, and the modal parity was 1. All presented with a history of continuous urine leakage, and 71 (64.5%) had a history of a previous caesarean section. The procedures that lead to the development of the fistula were conducted at secondary healthcare centres in 84 (87.5%) of the patients. The fistulae were a result of emergency caesarean sections in 73.6% of the cases, yankan gishiri in 9.1%, caesarean hysterectomies for ruptured uterus in 6.4%, elective caesarean sections in 4.5% and gynaecologic hysterectomies in 5.4%. A diagnosis of vesicocervicovaginal fistula (VCVF) was made in 62.7% of the cases, vesicouterine fistula (VUF) in 12.7% and ureteric fistula in various combinations in 10%. The abdominal route was used for the repair in 20.9% of the patients. Intraoperative bleeding was the commonest (21%) complication associated with vaginal repair of VCVF. At discharge, 73.6% were successfully closed and continent, while 19.1% had residual fistula.

Conclusion: The prevalence of 16.1% found in this study was high, and the most common cause of iatrogenic fistula was emergency caesarean sections. The majority of the causal procedures were done at secondary healthcare centres; therefore, this study recommends adequate training, mentoring and ongoing supervision of doctors conducting caesarean sections and other gynaecological procedures in secondary health centres as well as increased community education and involvement in preventing harmful traditional practices like yankan gishiri.

Delusional Jealousy looked through the lens of a concise Literature Review and Case Report of 'Unfaithful Husband' with Sociocultural Repercussions

Naseem Akhtar Qureshi, Abdulhameed Abdullah Al-Habeeb

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 37-56

Background: Pure delusional jealousy [DJL] is an uncommon disorder and is characterized by unshakable false belief of infidelity, lack of hallucination, thought disorder and mood disturbance, and not associated with alcohol or other drug abuse or any co-morbid psychophysical illness.

Objective: This paper aims to review qualitatively the relevant literature (2000-2019) and present a case of delusional jealousy.

Case History: A 31-year-old housewife with three minor children developed an unshakable belief that her husband was having an extramarital affair since 5 years and no longer loved her. She was diagnosed with delusional jealousy and was managed with aripiprazole and brief psychotherapy. Within three months, most of her symptoms improved, however she developed post-psychotic depression and attempted suicide by taking 125mg diazepam. She was immediately rushed to a private hospital and admitted to the intensive care unit (ICU). She recovered within five days and was shifted to the public hospital for the management of depression, where she was stabilized and discharged after two weeks.

Conclusion: Typical and atypical antipsychotic drugs combined with psychotherapy are the main treatment options for patients with DJL with or without co-morbid physical and psychiatric disorders. Post-psychotic depression and suicide attempts, devastating biosocial consequences among patients with DJL need timely and appropriate interventions and continued followup for better outcome and good quality of life.

Benign Breast Diseases in Makurdi, North Central Nigeria: A Retrospective Review of One Hundred and Thirty Five (135) Cases

B. A. Eke, B. A. Ojo, C. E. Okonkwo, I. N. Mba, J. A. Ngbea, R. Vhriterhire

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 57-63

Benign Breast Disease (BBDs) encompasses a diverse group of lesions that may present with a wide range of symptoms or may be detected as incidental microscopic findings. We presented a retrospective review of 249 cases of histopathologically diagnosed breast lesions seen at Benue State University Teaching Hospital, Makurdi, Nigeria between October, 2012 and January, 2017. BBDs accounted for 135 (54%) of all breast biopsies seen. Fibroadenoma was the commonest histological lesion comprising 74 (54.1%) of cases and with a peak age of incidence at 20-29 years. This was followed by fibrocystic changes (FCCs) with 26.3% of cases and with similar peak incidence age of 20-29 years. Other less common lesions including inflammatory lesions, fibroadenoma with fibrocystic change, fat necrosis, phylloides tumour, breast abscess, tubular adenoma, atypical hyperplasia, granular cell tumor and gynecomastia all together accounted for the remaining 19.9%. Benign breast diseases, a diverse group of lesions constitute the vast majority of breast lesions in Makurdi .With increase advocacy, awareness and health education coupled with use of mammography and needle biopsies, its diagnosis can be established.

In vitro Impact Assessment of Aqueous Extract of Sida cordifolia Linn. Upon Rat Spermatozoa Parameters

Mradu Gupta

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 64-74

Sida cordifolia Linn. finds frequent mention in Ayurvedic System of Medicine for many therapeutic properties including beneficial effect upon male reproductive processes. Aim of present in vitro study was to evaluate impact of aqueous extract of Sida cordifolia roots on rat spermatozoa in terms of count, motility & morphology and through HOS study following standard assessment methods to assess any likely reproductive toxicity, spermicidal action, lethality or abnormalities in animal experimentation. Sexually mature (18-22 weeks old) male Wister rats weighing 180 to 260 gm were used. Sperms were collected from cauda epididymis of rat testes and sperm suspension was prepared by mixing them with 2 ml of 5% Sucrose at 37°C, dividing into 4 samples – control (A) and 3 drug treated samples (B, C & D) containing 10, 20 or 30 mg/ml of aqueous extract of Sida cordifolia. The various sperm parameters were observed under Olympus CX41 microscope. Sperm concentration, Progressive and Non-Progressive motility were calculated using the Neubauer Chamber. The viability and morphology of sperm suspensions were assessed using Eosin Y and Nigrosin staining method using 400 X magnification under Phase contrast microscope. Hypo-osmotic swelling (HOS) test was used to evaluate the functional integrity of plasma membrane. Treatment with aqueous extract of Sida cordifolia resulted in no significant adverse impact upon sperm count up to 30 mg/ml dose, suggesting no noticeable spermicidal effect. Progressive motility increased marginally due to intervention of Sida cordifolia in a concentration-dependent manner from 40.00±1.07 in Sample A to 43.50± 2.05 in Sample D. Similarly, percentage of normal sperms and their viability exhibited steady enhancements with increasing concentrations of research drug. The HOS test indicated no adverse structural changes in plasma membrane integrity of sperms up to 30mg/ml level. Thus, in vitro assessment of sperm motility, morphology and viability due to treatment with Sida cordifolia aqueous extract indicated no spermicidal or toxic effect and indicated small but significant enhancement in various parameters which was concentration-dependent.

Sudden Loss of Vision Associated with Use of Systemic Non-steroidal Anti-inflammatory Drugs

Adeoti Caroline Olufunlayo, Olaopa Adedolapo Olufunke

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 75-78

Non-steroidal anti inflammatory agents have long been used in ocular therapeutics as a result of their effect on infllammation coupled with the undesirable side effects of steroids in Ophthalmology. Bleeding peptic ulcers have been strongly associated with use of oral non-steroidal anti inflammatory drugs. We present the case of a 51 year old male patient who presented with 4 days history of visual loss in his right eye following the use of 400 mg Ibuprofen three times a day for 3 days one week prior to presentation. Fundus examination revealed a pre-retinal hemorrhage. There may be need to be cautious with the use of these drugs.

Lemongrass Leaf Extract Attenuates Hydrocarbon-Induced Oxidative Stress and Macrocytic Hypochromic Anaemia in Rats

Christopher E. Ekpenyong

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 79-87

Aim: The therapeutic use of medicinal plants and plant products to mitigate solvent/xenobiotic-induced haematological disorders has not been adequately explored. The aim of this study was to evaluate the effect of Cymbopogon citratus (C. citratus) leaf decoctions on gasoline vapour (GV)-induced haematological disorders and oxidative stress in rats.

Methodology: Seventy-two female rats weighing 180-200g were randomly selected and divided into six groups (n = 12 per group). Animals in group 1 served as unexposed controls, while animals in group 2 were exposed to gasoline vapour (GV) alone for 35 days. Animals in groups 3, 4 and 5 were exposed to GV and co-administered C. citratus leaf extract (500 mg/kg, 1000 mg/kg, and 1500 mg/kg, respectively) and animals in group 6 were exposed to GV and co-administered vitamin C (200 mg/kg) for the same time period.

Results: Exposure of animals to GV alone significantly (p < 0.05) decreased packed cell volume (PCV), haemoglobin concentration (HB), total red blood cells (RBC), mean cell haemoglobin (MCH) and mean cell haemoglobin concentration (MCHC). Total white blood cells (WBC), WBC lineages and malondialdehyde (MDA) levels significantly increased (p < 0.05) compared to the corresponding values in the control group. Supplementation with C. citratus leaf decoction and vitamin C reversed these GV-induced changes in haematological indices and MDA levels.

Conclusion: Therefore, C. citratus leaf decoctions and vitamin C supplementation provided an ameliorative effect on GV-induced haematotoxicity and oxidative stress in a rat model of gasoline exposure.

Surgery as a Career Choice among Rotatory Interns in North Central Nigeria – A Multi-center Study

B. A. Eke, B. A. Ojo, A. Adekwu, I. O. Ochola, D. Gyenger

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 88-94

Background: The future specialty of choice of interns determine the composition of medical practitioners  workforce and the factors that underline this choice needs to be explored to help in healthcare planning and policy formulation for an economically  poor country like Nigeria.

Aim: The study aims to examine the factors that influence rotatory interns on their specialty choice with special reference to surgery with the hope that the information obtained might be of help in improving any imbalances in distribution of medical manpower in our country.

Materials and Methods: This is a survey of 126 interns, using an objective pre tested semi structured questionnaire which explores factors influencing specialty choices among interns in three tertiary hospitals in North Central Nigeria, namely, Federal Medical Center, Makurdi, Benue State University Teaching Hospital, Makurdi and Jos University Teaching Hospital, Jos.

Results: The three most popular specialties were Surgery (30.2%), Pediatrics (14.3%) and Obstetrics and Gynecology (14.3%). The least preferred specialty of choice was Family Medicine and Community Medicine at 1.6% each. These choices are determined by natural interest (38.1%), job satisfaction (38.1%), personal convenience (19%), financial rewards (3.2%) and personal aptitude (1.6%). Among the female interns, a possibility of job satisfaction is the most important determinant of specialty choice. Majority of the respondents consider surgery as important and interesting with 32% saying it’s difficult to understand.

Conclusions: Our findings have implication for provision of specialty health care for Nigerians. Health care service delivery planners have to devise means of attracting interns to the less preferred specialty choice.

Contextual Trend in Preventing Obesity Epidemic in Developing Countries: Role of the Key Players

Christopher E. Ekpenyong, Ernest Akpan

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 95-110

Aim: Today, the World Health Organization warns that the greater future burden of obesity and diabetes will affect developing countries with the extent doubling with urbanization. Aside from the estimation that, currently, more than 1.6 billion (age 15+ years) adults are overweight and at least 400 million of them are obese, it was also estimated that obesity is responsible for 2-6 % of the total health care cost in several developed countries and some estimates put the figure as high as 7%. The true costs are undoubtedly much greater as not all obesity related conditions are calculated. Some developing countries aimed to attain the millennium development goals (MDGs), which prospect the reduction in rate of tuberculosis, malaria, maternal and infant mortality rates, and childhood malnutrition, however little or nothing is done to curb the increasing obesity epidemic and its accompanying non-communicable diseases (NCDs) burden. The fact therefore is that, the developing countries’ health sector garbled with the double burden of diseases from the threat of both NCDs and infectious diseases.

Methodology: Literature search from PubMed, MEDLINE and Google Scholar was conducted with the aim of highlighting the prospects in preventing and managing obesity epidemics in developing countries through evidence based multi-strategic, multi-dimensional and proactive approaches.

Results: Numerous established studies recommended that, beyond individual action, the government, schools, families, employers, media, medical practitioners, food producers, manu-facturers, wholesalers, retailers, caterers, transporters, urban planners and community groups could formulate and implement a multi-strategic intervention plans to promote healthy eating habits and regular physical activity as well as manage those already overweight to prevent future obesity.

 Conclusion: There is therefore, the need for a less cost effective, multi-sectional, far reaching population based intervention plans by the key players of the health sector in such countries which should incorporate the need for regular exercising, good nutritional habits, bodyweight image assessment and reduced stigmatization of affected individuals.

Effect of Storage of Blood (with or without Irradiation) on Lipid Profile

Kiran Dahiya, Rakesh Dhankhar, Monica Verma, Deepika Dalal

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 111-117

Blood transfusion is mandatory for treatment of a number of clinical conditions. Blood to be transfused needs to be stored for future use in blood banks. To prevent the risk of graft versus host disease, blood is irradiated with gamma radiation before storage. During storage, blood components undergo a variety of alterations known as storage lesions. These lesions might differ when blood is pre-irradiated as compared to non-irradiated one. Many reports are there to explain the alteration of a number of parameters in stored blood but literature is very scant regarding effect of blood storage on lipid profile. Through this chapter an attempt has been made to throw some light on effect of storage on lipid profile as well as to compare the effect in pre-irradiated and non-irradiated blood samples.

Correlation of GSTP1 Polymorphism with Severity of Prostate Cancer in an Eastern Indian Population

Suparna Roy, Anindya Dasgupta, Subarnarekha Chatterji, Dilip Karmakar

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 118-127

Background: GSTP1 is one of the Glutathione-S-Transferases (GSTs) which suppress tumor genesis by detoxifying toxic carcinogens and reactive oxygen species (ROS). Prostate cancer is related to several mutations affecting the expression of GSTP1. A single nucleotide polymorphism (SNP: Ile105Val) in the GSTP1 gene results insignificant reduction in its anticancer activity. The current case control study was conducted to ascertain the risk of association of GSTP1polymorphism with risk of cancer prostate in an Eastern Indian population.

Materials and Methods: During a study period of 2 years, DNA was isolated using the phenol chloroform extraction method from the blood of 225 histopathologically diagnosed prostate cancer patients and 120 matched controls. The GSTP1 polymorphism was assessed by PCR amplification of the gene followed by restriction digestion with Alw261 (a restriction enzyme derived from Acinetobactro lwoffi RFL26). Histopathological grading in the case group was performed using Gleason’s scores and International Society of Urological Pathology (ISUP) grading.

Results: Comparison of the distribution of different GSTP1 alleles between the case and control groups was performed by chi square test and odds ratio analysis. A χ2 value of 18.56 suggested significantly higher number of G alleles in the case group. An odds ratio of 2.25 with a confidence interval of 1.52 to 3.34 for 95% CI showed that the G allele in GSTP1 gene were linked with greater risk of prostate cancer. Post hoc ANOVA and logistic regression suggested that cases having G alleles had more progressive form of diseases as evident from ISUP grades.

Conclusion: From our study we can conclude that GSTP1 polymorphism is not only significantly associated with risk of prostate cancer but also with its severity in our Eastern Indian population. GSTP1 polymorphism should be considered as a prognostic indicator for prostate cancer patients along with planning for more aggressive management of the disease.

Academic Stress and Menstrual Disorders among Female Undergraduates in Uyo, South Eastern Nigeria – The Need for Health Education

Christopher E. Ekpenyong

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 128-133

Aims: The aim of this study was to determine the association between academic stress and menstrual disorders among female undergraduates in Uyo, Akwa Ibom State, Nigeria.

Methodology: Three hundred and ninety-three female students of the University of Uyo, aged 16-35 years were randomly selected from different departments in the University, and assessed during the 2009/2010 academic session. Menstrual history and Student’s Stress Assessment Questionnaires (SSAQ) were used to survey the participants.

Results: Prevalence of menstrual disorders among participants was 34.6%. Menstrual disorders were found to be significantly associated with academic stress. Students with high level of stress reported various pattern of menstrual disorders, with the most common menstrual disorder being menorrhagia (37.5%). Others were: Pre-menstrual Syndrome (PMS) (33.1%), Oligomenorrhea (19.9%), and amenorrhea (5.9%). The odds for menstrual disorder was twice higher in those who reported high level of academic stress (OR: 2.0, C.I = 1.224-2.837) than the low academic stress group.

Conclusion: This study has demonstrated a significant association between academic stress and menstrual disorders among female undergraduates in Uyo, Akwa Ibom State, Nigeria.

Associations between Vaginal Douching Practice and Lower Genital Tract Symptoms and Menstrual Disorders among Young Women: A Search for Risk Modulating Factors

Christopher E. Ekpenyong

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 134-144

Aim: This study assessed the associations between vaginal douching practice and the adverse reproductive tract outcomes, and the risk modulating factors among young women.

Methodology: The data source was a cross-sectional population based sample of 1488 women aged 18 - 35 years in a university community. Self-administered socio-demographic and female genital hygiene practices questionnaire were used to survey the participants.

Results: The overall prevalence of vaginal douching was 79.8%. Pelvic pain, vaginal itching, and vaginal discharge were significantly associated with higher odds for douching. Moreover, participants with menstrual disorders such as menorrhagia, oligomenorrhea, and inter-menstrual bleeding douche more often than those without these disorders. Early-onset, higher-frequency, and prolonged douching, as well as douching with commercial vaginal deodorant and inserting the nozzle of the douching tube inside the vagina were associated with higher rate of pelvic and menstrual disorders.

Conclusion: The present study revealed a paradoxical relation between vaginal douching and adverse reproductive tract disorders, which supports the hypothesis of confounding by indication. The direction of the association is dependent on several modifiable and un-modifiable risk factors.

Detecting Incident Type 2 Diabetes Mellitus in South Eastern Nigeria: The Role of Adiposity Indices in Relation to Gender

Christopher E. Ekpenyong

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 145-151

Aim: The aim of the present study was to assess the predicting powers of different adiposity indices on incident type 2 diabetes mellitus (T2DM) among adult men and women in Uyo Metropolis, Nigeria.

Methodology: Three thousand five hundred adult civil servants (1532 men and 1968 women), aged 18 - 60 years, were assessed for incident T2DM using 2011 Expert Committee Revised criteria for the diagnosis of T2DM.

Results: Incident T2DM was found in 180 (5.4%) participants, 73 men (4.8%) and 116 women (5.9%). Results of comparison between diabetic men and women showed that body mass index (BMI) and mid arm circumference (MAC) did not differ significantly between groups. Waist circumference (WC) and waist-hip ratios (WHR) of women with T2DM were significantly higher than those of men with T2DM (WC: P =0.001 and WHR: P=0.034). BMI and MAC had equal predicting powers in both genders with odds ratios (OR) and 95% confidence intervals (CI) as follows: BMI (OR=2.41, C.I=1.728 - 7.01 for men and 2.02, 1.51 - 6.402 for women); MAC (OR =1.624, C.I=1.824 - 7.051 for men and 1.51, 1.62 - 6.59 for women); WHR and WC were predictive of T2DM only in women. OR and C.I were as follows: - WHR (OR=2.435, 0.951- 6.413 for women and 0.729, 0.547 - 1.14 for men); WC: (2.834, 1.270 - 5.421 for women and 1.21, 0.695 -1.845 for men) respectively.

Conclusion: All adiposity indices measured were significantly associated with incident T2DM in women, with only BMI and MAC showing significant association with T2DM in men.

High Prevalence of Vulvovaginal Candidiasis and Other Vaginal Infections among Women in Tight Fitting Underwears: A Threat to Future Reproductive Function

Christopher E. Ekpenyong

Emerging Research in Medical Sciences Vol. 1, , 2 October 2019, Page 152-158

Background: Vulvovaginal Candidiasis (VVC) is a common infection of the female genital tract. It is estimated that about 75% of women will experience VVC infection at least once in their life-time, however, lifestyle habits have been implicated in the higher susceptibility to VVC infection in some women than others. The aim of this cross sectional study was to assess the effect of tight fitting and loose under-wears made of nylon and cotton on the prevalence of VVC and other vaginal infections among non-pregnant women in southern Nigeria.

Methodology: The study was carried out in seven health centers between January and July 2009 in Uyo Metropolis, Nigeria. One hundred and ninety one (76.4%) of the 250 participants who were selected by sequential randomization met the inclusion criteria and participated in the study. Self administered structured questionnaire was used to assess the regular pattern of dressing and associated gynaecological problems of participants for a year prior to the study period. Vaginal smear/swab was taken from each participant for microscopy, culture and sensitivity.

Results: Prevalences of VVC infection in women who regularly wear nylon tight synthetic pants (NTSP) and cotton tight cotton pants (CTCP) were 76.8% and 42.9% respectively. Incident vaginal symptoms in regular users of NTSP versus (vs) CTCP were as follows: Acute vaginal discharge (VD) 82.64% vs 25.7%, recurrent abnormal VD 25.7% vs 1.43%, green-yellow VD 10.7% vs 7.14%, yellow VD 7.43% vs 28.57%, acute vaginal itching 66.12% vs 21.43%, recurrent vaginal itching 6.61% vs 2.86%, and vaginal soreness 19% vs 2.86%. Proportions of women who regularly wear NTSP vs CTCP with positive cultures for different micro-organisms were as follows: Candida albicans 76.86% vs 42.80%, Trichomonas vaginalis 23.86% vs 17.14% and Neiseria gonorrhea 4.96% vs 2.86%.

Conclusion: Regular wearing of NTSP is associated with higher prevalence of VVC and other vaginal infections than regular wearing of CTCP.