Reproductive Health Issues and Incidence of Some Reproductive Tract Infections among Muslim Women in Purdah In Jos-Nigeria

Candidiasis and Trichomoniasis are the commonest Reproductive Tract Infections (RTIs) amongst women in purdah in the capital city of Jos- Nigeria. Majority of these women (>68%) have primary education as the highest educational qualification and majority of them (>92%) are full time house wives. The study has also revealed that there is a high level (57%) delay in seeking for reproductive health needs , which were only remedied due to persistence of symptoms. This gives us the inference as to the myriad of sequalae that might have resulted in cases of asymptomatic RTIs. The most reproductive health needs of women in purdah are inadequate facilities in clinics/hospitals. This factor as well as other factors such as poor education, unilateral decision making by some men in purdah in matters of reproductive needs, misunderstanding and misinterpretation of the Qu’ran have immensely contributed to the increasing cases of RTIs among these women. These problems can be reduced to the minimum by educating both the men and the women in purdah with the best medium being the radio/television programs.KEY WORDS: Purdah, Reproductive Health, Infection, Women

Expression of some selected cytokeratins and Ki67 protein in prostatic tumor: Can these be used as tumor markers

Introduction: Diagnosis of prostatic diseases with Immunohistochemistry still faces challenges because of the peculiar histology of the prostateand difference(s) in reactivity of Monoclonal antibodies (MoAb) to benign and malignant changes. Methods: Thirty (30) archived paraffin embedded tissue samples from primary prostate tumors (15 Benign Prostatic  Hyperplasia (BPH) and 15 Cancer of the prostate (CaP)) were sectioned at thickness of 5ìm and confirmed as BPH or CaP. Sections from each sample were stained by Immunohistochemistry using the Streptavidin-biotin method and using CK5/6, CK7, CK8,CK20 and Ki67 antibodies (Zymed Antibody products). Appropriate positive and negative controls for each antibody were setup alongside the test slides. Results: BPH samples were reactive to Ck5/6 (93.3%), Ck7 (80%) and Ck8 (100%). Only 13.3% of BPH samples were reactive to Ki67. The reactivity of Ck5/6, 7, 8 in CaP is a contrast with only 3(20%) of samples positive with Ck5/6, 2(13.3%) positive with Ck7 and 14(93.3%) with Ck8. While reactivity of Ck 8 is similar in BPH and CaP, no reaction was recorded in Ck 20 in both BPH and CaP.Ki67 was only reactive in 2(13.3) of BPH samples and 15(100%) of CaP. Only Ck 8 was expressed in both BPH and CaP. There was  co-expression of Ck5/6, 7,8andKi67 in13.3%; Ck7and Ki67 in 13.3% in both BPH and CaP.Conclusion: The various cytokeratins are individually expressed in both BPH and CaP. Ck5/6 and Ck7 are co-expressed and may be used in the diagnosis of BPH, Ck5/6,7,8 and Ki67 are coexpressed in Prostatic adenocarcinoma and squamous cell carcinoma of the prostate while Ck8 and Ki67 are co-expressed and may be used for diagnosis of Prostatic adenocarcinoma alone

Genital tract abnormalities among female sex workers who douche with Lemon/Lime juice in Nigeria

Vaginal douche products have been associated with cervical cancer. We examined female sex workers (FSWs) in Nigeria who douche with lemon or lime juice and compared the findings with that of nonusers. We obtained Pap smears and performed colposcopy of the vulva, vagina and cervix. A total of 374 FSWs comprising 81 Lemon users (LUs) and 293 non lemon users (NLUs) were examined. Their mean age was 27.8 ± 6.7 (range 16-63) years. At colposcopy, 17(4.5%) had genital warts [LUs 5(6.2%); NLUs 12(4.1%); p=0.43], 61(16.3%) had suspectedsquamous intraepithelial lesions (SILs) [LUs 17(21.0%); NLUs 44(15.0%); p=0.20] and 65(17.4%) had other findings. Pap smear cytology showed that 87(24.6%) had SILs [LUs 26(33.3%); NLUs 61(22.1%); p=0.03]. Lemon/lime use was associated with cervical dysplasia after controlling for HIV status (Adjusted OR=1.8; 95% CI,1.0-3.0). Our data suggests an association between the practice of douching with citrus juice and cervical dysplasia (Afr J Reprod Health 2009; 13[1]:37-45)

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Prevalence of Gynaecologic Morbidity in HIV-positive Women: A Comparison of Treated and Untreated Patients

Background: The 1994 International Conference on Population and Development in Cairo, Egypt drew attention to comprehensive reproductive health for women. The central role of reproduction in the lives of women in many parts of the world is now recognized. We sought to determine the prevalence of gynaecologic morbidity in a cohort of HIV-positive women with a view to determining the effect of HAART on their frequency of occurrence. Methodology: This was a cross-sectional study conducted in the ambulatory care HIV treatment clinic at the Jos University Teaching Hospital. A total of 369 HIV-positive women aged between 15 to 64 years were recruited. Demographic data, history of reproductive organ conditions and use of HAART were obtained. Pelvic examination was carried and Pap smears were obtained for cytology and interpreted using the Bethesda terminology. Results are presented as frequencies and means/median values using appropriate tests of comparison. Results: The mean age for those on HAART was 34&plusmn;7 and 33&plusmn;7 years for the HAART-naive group (p = 0.08). Median duration on HAART use was 12 (IQR: 1-41) months. The frequencies of the following self-reported symptoms were significantly higher in the HAART na&iuml;ve group compared to the HAART experienced group: abnormal vaginal discharge (21.6% vs 9.6%), vaginal itching (39.4% vs 16.7%), abnormal menstruation (36.9% vs 18.4%) and post coital bleeding (5.1% vs 1.8%). On examination, the HAART na&iuml;ve patients also had higher frequencies of purulent vaginal discharge, cervical erosion, cervical excitation tenderness, contact bleeding, cervical polyp and squamous intraepithelial lesions. Conclusion: This study revealed a higher prevalence of gynaecologic morbidity in HIVpositive women who are HAART-na&iuml;ve compared with those on HAART. Treating HIV-infection therefore has additional sex-specific benefits for women in terms of reproductive health morbidity.Key Words HIV, HAART, Reproductive-organ, Nigeri