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Leaf samples of Ocimum gratissimum (L.) exhibiting vein banding, mosaic and chlorotic spots were collected randomly from the field. The symptomatic samples reacted positively to specific CMV antibody in antigen coated plate enzyme linked immunosorbent assay and to confirm the presence of CMV, RT-PCR was performed using CMV-specific primers that amplify a 519 bp region from the viral coat protein gene. The expected amplicon shared homology of 97.06% with a Nigerian isolate MH178110. Phylogenetic tree constructed revealed the isolate in close association with CMV strains belonging to subgroup II. This is the first molecular evidence of CMV in O. gratissimum in Nigeria and adds to the list of natural host for the virus.

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OBJECTIVES: The objective was to evaluate seminal fluid indices of male partners of infertile couples so as to identify the current status of the contributions of male factor to infertility in our environment. MATERIALS AND METHODS: This is a prospective study of the seminal fluid indices of consecutively consenting male partners of infertile couples seen at the Fertility and Endocrinology Research unit of the Department of Obstetrics Gynaecology and Perinatology, Obafemi Awolowo University Teaching Hospital Ile-Ife between May 2004 and June 2008. RESULTS: The results of the semen analysis of 661 male partners of the infertile couples were retrieved and analyzed. The patterns of semen parameters noted in infertile males were oligozoospermia, teratozoospermia, asthenozoospermia, azoospermia, oligoteratozoospermia, oligoasthenozoospermia, and oligoasthenoteratozoospermia, asthenoteratozoospermia found in 25.6%, 18.5%, 11.5%, 6.2%, 3.2%, 2.3%, 2.1%, and 0.9%, respectively. Among the age groups, age group 31-40 had a higher prevalence of oligozoospermia (13.3%) while among the occupational groups, the civil servants had the highest prevalence of oligozoospermia (12%). There was a high of level of leucocytospermia and bacterial infections in both normospermic and oligospermic semen. CONCLUSION: This study showed a high rate of abnormal semen quality of male partners of infertile couple in our environment and is an indication for the need to focus on the management of this condition and the institution of preventive program for male infertility. There is urgent need for advocacy for men to accept responsibility for their contribution to infertility and to reduce stigmatization and ostracizing of women for infertility.

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Ninety five men who accompanied their wives to the fertility clinic of a Nigerian teaching hospital (index group) were compared with 95 matched controls using the Hospital Anxiety and Depression Scale (HADS). Their rates of significant anxiety symptoms (24.2%) and depressive symptoms (20.0%) were higher than the corresponding rates of 13.7% and 9.5% for the controls. The higher rate of significant depressive symptoms in the infertility group was significant (p < 0.05). Their mean scores on the two subscales of HADS (anxiety and depressive subscales) were also significantly higher (p < 0.001). Results of multiple regression analysis indicated that lower anxiety symptoms were predicted by age group among subjects in the index group, indicating that belonging to higher age groups was associated with lower anxiety symptoms. In addition, lower anxiety symptoms were predicted by 'being very religious'. However, higher anxiety symptoms were predicted by previous exposure to couple counselling. On the predictors of depressive symptoms, lower symptoms were predicted by age group and religiosity while higher symptoms were predicted by respondents' previous exposure to couple counselling and higher number of wives. Other factors investigated such as level of education, duration of infertility, attitude towards child adoption, pressure from extended family members on account of infertility, expectation of the respondents on the possible outcome of treatment and the result of semen analysis were not observed as predictors of anxiety and/or depressive symptoms. The observations on emotional distress among these men, together with previous observations that counselling/support received from gynecological consultations is usually inadequate indicates that the quality of psychological support that is available to them needs to be improved and modified. Involvement of mental health professionals (psychiatrists and clinical psychologists) in the provision of psychological couple counselling for infertility-related emotional distress could improve the quality of support provided. The establishment of special counselling units in hospitals providing treatment for infertility is advocated.

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Between 1 January and 31 December, 2006, 34 consecutive cases of severe pre-eclampsia (12), imminent eclampsia (10) and eclampsia (12) who were admitted at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife in the south-western part of Nigeria, were investigated for the development of HELLP (haemolysis, elevated liver enzymes and low platelet count) syndrome in a prospective study. The ages of the women ranged from 18 to 38 years, parity 0-5 and the estimated gestational age from 18-41 weeks at presentation. A total of 26 (76.5%) of the patients were unbooked, six (17.6%) of the 34 cases developed HELLP syndrome. Four (33%) of the 12 eclamptics developed HELLP syndrome, while only one (10%) of the cases of imminent eclampsia and 1 (8.3%) of severe pre-eclamptic cases developed the syndrome. Using the Mississippi Triple class system, none of the HELLP syndrome cases belonged to Class I; 4 were categorised in Class II while 2 were in Class III. All of the four eclamptic cases with HELLP syndrome died giving a 100% fatality rate while none of the imminent eclamptic and severe pre-eclamptic patients with the syndrome died. Furthermore, there were six (15.8%) perinatal deaths among the 38 infants delivered by the 34 mothers with severe pre-eclampsia/eclampsia. Our data suggest that the development of HELLP syndrome is more likely in eclamptic patients and when it occurs in them, it is highly fatal. Most of the cases in this study were unbooked. Substandard care may have contributed to the progression of the disease state and consequently, to maternal mortality. It is imperative to draw up an action plan for the identification of the risk factors for the development of pre-eclampsia/eclampsia at peripheral hospitals and maternity centres and for prompt referral of such cases afterwards. Efforts should also be geared towards the minimising of treatment delay in all phases, so as to minimise both perinatal and maternal morbidity and mortality.

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INTRODUCTION: The study aimed to compare the sociodemographical characteristics, obstetrical complications and foetal outcome in delivered booked mothers and delivered unbooked mothers and to determine the correlation of maternal and perinatal outcomes. METHODS: In a prospective study over a 22-month period, outcomes of pregnancies of women booked for antenatal care were compared with that of unbooked women, who delivered in our unit at the Wesley Guild Hospital, Nigeria. RESULTS: 29 percent of the 1,154 deliveries in the study period comprised unbooked mothers. Compared with booked mothers, unbooked mothers had a higher tendency to be younger (29.3 +/- 6.08 vs. 31.12 +/- 4.80; p-value is less than 0.001), unmarried (9.2 percent vs. 1.8 percent; p-value is less than 0.01), with lower educational status (25.8 percent with postsecondary education vs. 58.7 percent; p-value is less than 0.01), lower social class (25.0 percent in upper class vs. 52.3 percent; p-value is less than 0.001) and with higher proportion of multipara (12.5 percent vs. 5.5 percent; p-value is less than 0.02), higher incidence of antepartum haemorrhage (odds-ratio [OR] 5.96, 95 percent confidence interval [CI] 2.53-14.29, p-value is less than 0.001), anaemia (OR 2.75, 95 percent CI 1.09-4.47, p-value is less than 0.001) and preeclampsia/eclampsia. Unbooked mothers were half as likely as booked mothers to deliver by spontaneous vaginal delivery (OR 0.45, 95 percent CI 0.29-0.71, p-value is less than 0.001) but were twice as likely to deliver preterm babies (OR 2.03, 95 percent CI 1.14-3.59, p-value is less than 0.009) and three times more likely to have babies with birth asphyxia. Perinatal and maternal mortalities were higher in unbooked mothers. CONCLUSIONS: The study showed a positive correlation between unbooked mothers and an increased risk of maternal and foetal adverse outcomes.

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INTRODUCTION: This study aimed to determine the incidence of, and identify independent risk factors to retained placenta in Ile-Ife, southwestern Nigeria. METHODS: This was a prospective case-control study involving 120 women with retained placenta after vaginal birth at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, southwestern Nigeria over a period of seven years. Two consecutive normal deliveries after each retained placenta served as controls. Following a bivariate analysis, a multivariate logistic regression model was constructed in order to define independent risk factors for retained placenta while controlling for confounding variables. RESULTS: During the study period, there were 120 cases of retained placenta, and the total number of deliveries was 6,160, making the incidence 1.9 percent. Independent risk factors associated with retained placenta include non-use of antenatal care (odds-ratio [OR] 22.71, 95 percent confidence interval [CI] 10.5-49.12, p-value is less than 0.000), previous retained placenta (OR 15.22, 95 percent CI 3.30-70.19, p-value is less than 0.000), previous caesarean section (OR 12.00, 95 percent CI 2.05-70.19, p-value is less than 0.006), maternal age 35 years or more (OR 7.10, 95 percent CI 1.5-32.40, p-values is less than 0.012), grand multiparity (OR 6.63, 95 percent CI 1.88-23.40, p-value is less than 0.003), previous dilatation and curettage (OR 4.44, 95 percent CI 1.69-11.63, p-value is less than 0.002), preterm delivery (OR 3.12, 95 percent CI 1.12-8.68, p-value is less than 0.029) and placenta weight less than 501 g (OR 2.91, 95 percent CI 1.34-6.32, p-value is less than 0.007). CONCLUSION: Women with identifiable risk factors should be targeted for the prevention of retained placenta. There is a need for the training of birth attendants in the proper conduct of delivery and third stage of labour to prevent placenta retention and postpartum haemorrhage.

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The aims of this study were to compare anxiety and depressive symptoms between a sample of Nigerian women and their husbands on treatment for infertility, and to identify factors, which are associated with emotional burden in their families. In total, 82 women and their spouses completed the two subscales of the Hospital Anxiety and Depression Scale (HADS) at the gynaecology clinics of a Nigerian teaching hospital. The women had a significantly higher mean anxiety score (p<0.001) and higher mean depression score (p <0,001) than their husbands. On both anxiety and depression subscales of the HADS, the scores of the women were positively correlated with their husbands' scores (p<00.1). Emotional burden in the family was significantly associated with low religious inclination of husband and wife; strained relationship of couple; extended family pressure on husband; husbands' negative attitude towards child adoption; and lower age group of wife. Women with infertility in this subregion experience higher emotional burden than their husbands. Psychological couple counselling is required to ameliorate the emotional burden of infertility imposed by these factors.

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The purpose of this study was to determine the relationship between socio-cultural factors and infertility-related stress among a sample of Nigerian women. The subscales of the Hospital Anxiety and Depression Scale and a schedule detailing socio-demographic and infertility-related variables were administered on women with infertility and a matched control group. The rates of significant anxiety symptoms (39.4) and depressive symptoms (40.4) among the women with infertility were higher than the corresponding rates of 11.1 and 10.1 in the control group. Their mean anxiety and depression scores were also higher (P0.001). Low religiosity; friction with husband's family; polygamous relationship and family pressure on husband predicted symptoms among the women with infertility. Public campaign to improve attitude towards women with infertility is advocated. Therapeutic mental health services are important for these women

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The study investigated postpartum emotional distress including depression among 47 Nigerian women who had a caesarean section by comparing them at 6-8 weeks following childbirth with 47 matched controls who had normal vaginal delivery. Analysis of scores on the General Health Questionnaire (GHQ-30) and the Beck Depression Inventory (BDI) showed that women that delivered by caesarean section were significantly different from the controls on the GHQ and BDI scores in the postpartum period. Apart from marital status, other sociodemographic variables did not significantly contribute to psychopathology in this group of women. This observation is in support of the view that caesarean childbirth may predispose Nigerian women to adverse psychological sequelae.

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Although variable clinicopathological entities have been documented in sickle cell trait in pregnancy, such information is absent in this environment. This study therefore was aimed at examining the outcome of pregnancy in a population of Nigerian women with sickle cell trait. A prospective analytical study was carried at Ile-Ife, Nigeria comparing morbidities and mortalities between 210 pregnant women with sickle cell trait and 210 women with HbAA. Data were processed using SPSS 11.0 and PEPI packages, and the p value was set at =0.05. There were no significant differences between mothers with sickle cell trait and HbAA in terms of sociodemographic characteristics, the course of labour, deliveries and morbidity patterns. However, mothers with sickle cell trait had significantly fewer attacks of malaria in pregnancy (25.7% compared with 34.8%) and faster recovery of their newborn from birth asphyxia at 1 min (0.9% compared with 4.9%). Sickle cell trait may confer greater resistance to malaria in pregnancy and carries no extra risk to the outcome of pregnancy.

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Induction of labour may be indicated despite an unripe cervix. The purpose of this study was to compare the safety and efficacy of intravaginal misoprostol and an intracervical Foley's balloon catheter for preinduction cervical ripening and labour induction. A total of 120 patients requiring indicated induction of labour with an unfavourable cervix (Bishop's score < or =4) were randomised prospectively to receive either 50 mug intravaginal misoprostol every 6 h for a maximum of two doses, or an intracervical Foley balloon catheter for 12 h followed by an intravenous oxytocin infusion. The two arms of the study were comparable with respect to maternal age, parity, gestational age, indication for induction, and initial Bishop's scores. There were significant change in the Bishop's score in the two groups (5.9 +/- 0.2 and 4.0 +/- 0.2, respectively, p < 0.001) but no inter group differences. Oxytocin induction or augmentation of labour occurred more in the catheter group (95%) than in the misoprostol group (43.3%) (p < 0.0001). Induction to delivery interval was significantly shorter in the misoprostol group than in the catheter group (8.7 +/- 2.4 vs 11.9 +/- 2.7 h p < 0.0001). There was no significant difference noted in the caesarean or other operative delivery rates among patients in the two treatment groups. There was a higher incidence of tachysystole and hyperstimulation in the misoprostol group than in the catheter group (p < 0.03). No differences were observed between groups for meconium passage, 1- or 5-min Apgar scores < 7 and admission into the neonatal intensive care unit. In conclusion, the maternal and perinatal outcomes in this study have shown no difference confirming the efficacy and safety of both methods, however we observe a decrease in the induction-to-delivery interval when misoprostol is used for this purpose.

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This research examined the sexual behaviour and perception of the risk of HIV/AIDS and other sexually transmitted infections (STIs) among adolescents in Nigerian secondary schools. Quantitative data was collected from 450 senior secondary school 1 and 2 students who were selected from 5 of the 22 co-educational secondary schools in Ilesa using a multistage sampling technique. In addition qualitative data was collected by focus group discussion (FGD) with 8 groups (4 for each of the sexes) of ten randomly selected respondents from 4 other secondary schools. Sixty three per cent had had sexual intercourse. There was no statistically significant (p>0.05) difference between the genders [females (52.3%) males (77.8%)], although males appeared to be more sexually active. The median age at first intercourse was 12 years with a range of 6-19 years. Many of the respondents had multiple sexual partners. There is poor perception of the risk of sexually transmitted infections (STIs) including that of human immune deficiency virus (HIV). It was concluded that there is a high risk of the spread of STIs, including HIV/AIDS in the study population. In view of the high prevalence of sexual intercourse and the reproductive health problems associated with STI, HIV/AIDS, it is recommended that a structured family life education (FLE) curriculum should be instituted for all schools starting at an early age.

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Fifty-five women who presented at Wesley Guild Hospital, Ilesa, Nigeria, for either elective or emergency caesarean section during a 5-month period (1 December 2003 - 30 April 2004) were recruited consecutively and assessed for psychiatric morbidity using the General Health Questionnaire (GHQ-30), the Beck Depression Inventory (BDI) and the State Version of the State-Trait Anxiety Inventory (STAI). Twenty-two women (40%), were cases on the GHQ, and the BDI was able to pick 11 women with depression in the study sample. The mean anxiety score for the entire study population was 41.7, which was higher than the usually accepted threshold of 40 for clinical disorder on the scale. Thirty-three women (60%) were initially reluctant to give consent for the operation and they had higher mean STAI scores than those who willingly consented to the procedure, and the difference in scores was statistically significant. The implications of these findings are discussed.

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Female genital mutilation, despite efforts to abolish it, is still widely practised in Nigeria. The risk of female genital mutilation to a female child in southwest Nigeria was investigated by interviewing 430 consecutive pregnant women attending the antenatal clinic of Wesley Guild Hospital Ilesa, Nigeria between July 2001 to October 2001. The results show that 60% of the pregnant women studied had a type of genital mutilation. The decision to mutilate a female child is taken before she is born. Seventy-four (17.2%) of the women and 146 (34%) of their husbands would circumcise their female child. The decision to circumcise a female child is made between the husband and wife but the final decision comes mainly from the husband. Because the majority of the women (58.4%) were yet to decide whether or not to circumcise their female children, they could sway the decision either way before the husband makes up his mind. Therefore, every effort should be taken to involve men in the struggle to eradicate this unwholesome practice.

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A virus inducing mosaic and severe leaf malformation, isolated from Senna hirsuta in Nigeria, was studied. The virus had a rather narrow host range, infecting a few species in Caesalpinaceae, Chenopodiaceae and Fabaceae families. The virus was widespread in southern Nigeria with prevalence ranging from 74% to 86.4% in some locations. It was transmitted mechanically and in a non-persistent manner by Myzuspersicae, Aphis craccivora and A. spiraecola. There was no evidence of transmission by seeds. Electron microscopy of leaf dip preparations revealed flexuous rod-shaped particles. The viral coat protein had Mr of 32.5 K. The virus reacted positively with a monoclonal antibody (MAb) to peanut stripe virus specific for potyviruses (members of the Potvvirus genus) and with antisera to turnip mosaic virus (TuMV), potato virus Y (PVY), TuMV, potato virus A (PVA), potato virus V (PVV) and bean yellow mosaic virus (BYMV), but it failed to react with antisera to celery mosaic virrus (CeMV), bean common mosaic virus (BCMV), soybean mosaic virus (SMV), and clover yellow mosaic virus (ClYMV) in plate-trapped ELISA (PTA-ELISA). No positive reaction was obtained when the virus was tested against any of the antisera in double-antibody sandwich ELISA (DAS-ELISA). This is the first report of natural infection of Senna species in Nigeria. The virus, tentatively designated as Senna mosaic virus (SeMV), seems to differ from other viruses previously described from Senna species in the literature and indeed other legume potyviruses in Nigeria.

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AIDS constitutes a major public health problem in developed and developing countries. The experience at Obafemi Awolowo University Teaching Hospitals Complex (O.A.U.T.H.C.), Ile-Ife, Nigeria has shown that HIV/AIDS is not uncommon. Screening of pregnant women with symptoms and signs suggestive of HIV/AIDS revealed 5 cases in three years (1996-1998). Four of these cases were reviewed to highlight the socio-economic implications and the burden of the disease on maternal and child health in our environment. It was shown that the socio-economic status of the women could not support adequate management of their conditions resulting in poor outcomes namely abortion, increased risk of infection to the baby and debts from hospital bills among others. Improvement in the socio-economic conditions of the populace and community health education on HIV/AIDS will enhance the outcome of management in pregnancy. In addition to emphasising preventive measures, research into appropriate mode of management of HIV/AIDS in pregnancy is urgently needed in our environment.

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An unusual presentation of a ruptured uterus with extrusion of twin fetuses into the urinary bladder is described. A routine pelvic ultrasound to confirm pelvic collection from a suspended criminally induced abortion revealed a rupture of the anterior wall of the uterus with communication to the urinary bladder and this finding was confirmed at laparatomy. While a high index of suspicion is important in the diagnosis of ruptured uterus, a subtle place for pelvic ultrasound in patients with vaginal bleeding, suprapubic pain and haematuria may be of help.

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An attempt was made to distinguish between celosia mosaic virus (CIMV) and asparagus virus 1 (AV-1) based on biological properties, which hitherto was obscured from serological data from previous work. The host range of AV-1 was found to be a subset of that of CIMV and AV-1 was transmitted by the aphid Myzus persicae which, on the other hand, did not transmit CIMV. No evidence of cross-protection was obtained between these two viruses.

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The incidence of umbilical cord prolapse at Obafemi Awolowo University teaching hospital complex, Ile-Ife over a ten year period was 0.42% (one in 240 deliveries). The incidence was observed to be higher among the unbooked patients (76.7%). Analysis of the 60 cases reveals that multiparity, unengaged presenting part from cephalo-pelvic disproportion, prematurity, prelabour spontaneous rupture of membranes, breech presentation, and multiple pregnancy were the major contributory factors. The perinatal mortality (36.7%) was significantly higher than that of the hospital which was 8% (P < 0.05). The perinatal mortality rate was higher among the unbooked patients (86.4%). Caesarean section gave better results except when the cervix was fully dilated. Early resort to Caesarean section, proper and adequate antenatal care and properly supervised hospital delivery is recommended.

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Thirty-three cases of ruptured ectopic pregnancies treated by emergency autologous blood transfusion were compared with 85 cases treated by homologous blood. The postoperative outcome was satisfactory and the duration of hospital stay was similar in both groups. However, the quantity of blood transfused in those who received autologous blood was significantly higher than in those transfused with homologous blood ( P 0.02). Because of this experience we advocate greater use of intra-operative blood salvage and autotransfusion, even when banked homologous blood is available, in the management of ruptured ectopic pregnancy.