High Prevalence of Vulvovaginal Candidiasis and Other Vaginal Infections among Women in Tight Fitting Underwears: A Threat to Future Reproductive Function | Chapter 17 | Emerging Research in Medical Sciences Vol. 1

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.

Author(s) Details

Christopher E. Ekpenyong
Department of Physiology, College of Health Sciences, University of Uyo, Uyo, Nigeria.

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Detecting Incident Type 2 Diabetes Mellitus in South Eastern Nigeria: The Role of Adiposity Indices in Relation to Gender | Chapter 16 | Emerging Research in Medical Sciences Vol. 1

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.

Author(s) Details

Christopher E. Ekpenyong
Department of Human Physiology, Faculty of Basic Medical Sciences, University of Uyo, Nigeria.

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Associations between Vaginal Douching Practice and Lower Genital Tract Symptoms and Menstrual Disorders among Young Women: A Search for Risk Modulating Factors | Chapter 15 | Emerging Research in Medical Sciences Vol. 1

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.

Author(s) Details

Christopher E. Ekpenyong
Department of Human Physiology, Faculty of Basic Medical Sciences, University of Uyo, Nigeria.

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Academic Stress and Menstrual Disorders among Female Undergraduates in Uyo, South Eastern Nigeria – The Need for Health Education | Chapter 14 | Emerging Research in Medical Sciences Vol. 1

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.

Author(s) Details

Christopher E. Ekpenyong
Department of Physiology, College of Health Sciences, University of Uyo, Uyo, Nigeria.

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Correlation of GSTP1 Polymorphism with Severity of Prostate Cancer in an Eastern Indian Population | Chapter 13 | Emerging Research in Medical Sciences Vol. 1

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.

Author(s) Details

Dr. Suparna Roy
Department of Biochemistry, Calcutta National Medical College, Kolkata-14, India.

Dr. Anindya Dasgupta
Department of Biochemistry, Calcutta National Medical College, Kolkata-14, India.

Miss Subarnarekha Chatterji
Department of Biotechnology, School of Life Sciences, Manipal University, Manipal, India.

Dilip Karmakar
Department of Urology, Calcutta National Medical College, Kolkata-14, India.

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Effect of Storage of Blood (with or without Irradiation) on Lipid Profile | Chapter 12 | Emerging Research in Medical Sciences Vol. 1

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.

Author(s) Details

Dr. Kiran Dahiya
Department of Biochemistry, Pt. BD Sharma PGIMS, Rohtak, Haryana, India.

Rakesh Dhankhar
Department of Radiotherapy, Pt. BD Sharma PGIMS, Rohtak, Haryana, India.

Monica Verma
Department of Biochemistry, Pt. BD Sharma PGIMS, Rohtak, Haryana, India.

Deepika Dalal
Department of Biochemistry, Pt. BD Sharma PGIMS, Rohtak, Haryana, India.

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Contextual Trend in Preventing Obesity Epidemic in Developing Countries: Role of the Key Players | Chapter 11 | Emerging Research in Medical Sciences Vol. 1

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.

Author(s) Details

Christopher E. Ekpenyong
Department of Physiology, College of Health Sciences, University of Uyo, Uyo, Nigeria.

Ernest Akpan
Department of Physiology, College of Health Sciences, University of Uyo, Uyo, Nigeria.

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Surgery as a Career Choice among Rotatory Interns in North Central Nigeria – A Multi-center Study | Chapter 10 | Emerging Research in Medical Sciences Vol. 1

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.

Author(s) Details

B. A. Eke
Department of Surgery, College of Health Sciences, Benue State University, Makurdi, Nigeria.

B. A. Ojo
Department of Anatomic Pathology, College of Health Sciences, Benue State University, Makurdi, Nigeria.

A. Adekwu
Department of Surgery, College of Health Sciences, Benue State University, Makurdi, Nigeria.

I. O. Ochola
Faculty of Clinical Science, College of Health Sciences, Benue State University, Makurdi, Nigeria.

D. Gyenger
Department of Anatomic Pathology, College of Health Sciences, Benue State University, Makurdi, Nigeria.

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Lemongrass Leaf Extract Attenuates Hydrocarbon- Induced Oxidative Stress and Macrocytic Hypochromic Anaemia in Rats | Chapter 09 | Emerging Research in Medical Sciences Vol. 1

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.

Author(s) Details

Christopher E. Ekpenyong
Department of Physiology, College of Health Sciences, University of Uyo, Uyo, Nigeria.

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Sudden Loss of Vision Associated with Use of Systemic Non-steroidal Anti-inflammatory Drugs | Chapter 08 | Emerging Research in Medical Sciences Vol. 1

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.

Author(s) Details

Adeoti Caroline Olufunlayo
Department of Ophthalmology, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria.

Olaopa Adedolapo Olufunke
Department of Ophthalmology, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria.

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