Browsing by Author "Olatinwo, Abdulwaheed O."
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Item Assisted Reproduction Technology: Comparison of Anesthetic Techniques for Oocyte Retrieval in a Tertiary Health Facility in Ilorin(2017) Omokanye, Lukman O.; Olatinwo, Abdulwaheed O.; Saadu, L.O.; Biliaminu, S.A.; Durowade, K A.; Salaudeen, A.GBackground: Transvaginal ultrasound‑guided oocyte retrieval (TUGOR) technique is minimally invasive and requires shorter time compared to previous techniques. Yet, it is a potentially stressful and painful procedure and thus requires some form of analgesia with or without sedation. The effects of various anesthetic techniques used for TUGOR on reproductive outcomes remain controversial. Aims and Objectives: This study aimed at comparing the efficacy of paracervical block (PCB) and conscious sedation for pain relief and pregnancy outcomes during TUGOR. Materials and Methods: This is a cross‑sectional comparative study of 137 eligible clients that underwent assisted reproduction program in our facility. All clients were treated with antagonist protocol for controlled ovarian hyperstimulation. The choice of analgesia for TUGOR was influenced by clients’ and/or clinicians’ preference. PCB and conscious sedation were administered for TUGOR in 66 and 71 clients, respectively. Pain was assessed using a 10‑cm Visual Analog Scale (VAS), while clients’ overall satisfaction was rated using Likert scoring system. Results: There was no statistically significant difference in the clinical pregnancy, miscarriage, and live birth rates between the two groups. The mean VAS 10‑point scores at 1, 6, and 24 h postretrieval and on the day of embryo transfer were significantly higher for paracervical group. The mean Likert score for conscious sedation group was significantly higher than that of paracervical group. Conclusion: Conscious sedation is superior to PCB as anesthetic/analgesic agent for pain relief and clients’ satisfaction for TUGOR. However, a multimodal approach to anesthesia/analgesia for TUGOR is suggested to further improve overall clients’ satisfaction.Item Assisted Reproduction Technology: Comparison of Clinical outcomes between day 3 and day 5 embryo transfer(College of Medicine KLE University, Belgaum, India, 2018) Omokanye, Lukman O.; Saadu, L.O.; Olatinwo, Abdulwaheed O.; Biliaminu, S.A.; Durowade, K A.; Panti, Abubakar A.; Salaudeen, A.G.BACKGROUND: Embryo transfer (ET) is a critical step in in vitro fertilization (IVF). Selecting the day of transfer for achieving the desired outcomes has been a great challenge. AIMS AND OBJECTIVES: The aim of this study was to compare the pregnancy rates of day 3 and day 5 ET in assisted conception. MATERIALS AND METHODS: This is a longitudinal prospective study of 122 eligible patients that underwent assisted reproduction program in our facility. All patients had controlled ovarian hyperstimulation using antagonist protocol. Patients with four or more zygotes were randomly allocated on day 1 to either day 3 or 5 transfers (58 vs. 64 patients). Fertilization was achieved through conventional IVF. Zygotes were kept in a single‑step medium (Global total®) for day 3 and 5 transfers, respectively. The morphologically best two or three embryos or blastocysts were chosen for transfer in both groups. RESULTS: The overall clinical pregnancy and live birth rates for both groups were 40.2% and 33.6%. There was no statistically significant difference between day 3 and day 5 transfer regarding clinical pregnancy rates (36.2% vs. 43.8% [P = 0.51]), live birth rates (27.6% vs. 9.1% [P = 1.0]), twinning rates (18.8% vs. 20% [P = 1.0]), and rates of early pregnancy loss (8.6% versus 4.7% P = [0.2]). CONCLUSION: In this study, the clinical outcomes of blastocyst transfer are similar to day 3 ET. This underscores the need for patient selection for the choice of days of ET. Further controlled randomized prospective studies with larger sample sizes are recommended.Item Assisted Reproduction Technology: Perceptions among infertile couples in Ilorin, Nigeria.(A taif University Saudi, 2017) Omokanye, Lukman O.; Olatinwo, Abdulwaheed O.; Durowade, K A.; Raji, S.T.; Biliaminu, S.A.; Salaudeen, A.GBackground: Infertility is a global health problem and a socially destabilizing condition for couples carrying several stigmas and a cause of marital disharmony. Assisted reproduction technologies (ARTs) offers a chance at parenthood to couples, who until recently would have had no hope of having a “biologically related” child. Aims and Objectives: This study aimed to determine the awareness and perception of ART services among infertile couples at a public health facility in Ilorin, Nigeria. Materials and Methods: This is a cross‑sectional descriptive study of consecutively consenting infertile couples seen at the ART unit of the Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, Ilorin, between January 1, 2012, and December 31, 2015. Results: The patients aged 22–52 years with a mean age of 36.1 ± 6.6 years and mean duration of infertility of 7.3 ± 5.8 years. Most (60.8%) belonged to middle social class. Of the 559 infertile couples interviewed, 87.3% were aware of ART services. Less than half (48.8%) were aware of surrogacy while majority (85.7%) rejected the use of surrogate mother. Reasons to decline surrogacy were desire to carry one’s own child (51.7%) and “do not like the idea” (22.3%). Female partner age, duration of infertility, and religion had a significant influence on acceptance of donor egg (P < 0.05). Conclusion: Despite the high level of awareness of ART, its low utilization remains a gap in the delivery of these services. Government and nongovernmental agencies need to institute interventions to stem the trend.Item Assisted Reproductive Technology: Experience from a Public Tertiary Institution in North Central Nigeria(Association of Fertility and Reproductive Health, 2016) Omokanye, Lukman O.; Olatinwo, Abdulwaheed O.; Saadu, L.O.; Biliaminu, S.A.; Durowade, K A.; Panti, Abubakar A.Background: According to the World Health Organization, more than 180 million couples globally suffer from infertility, the majority being residents of developing countries. Assisted reproductive technologies (ARTs) offer a chance at parenthood to couples, who until recently would have had no hope of having a “biologically related” child. Objectives: This study aimed to determine pregnancy outcomes following assisted conception. Materials and Methods: This is a prospective study of 104 clients who underwent the procedure of ART between January 1, 2012 and December 31, 2016 at the ART unit of University of Ilorin Teaching Hospital, Ilorin, Nigeria. Results: Of the 510 clients who had infertility consultation at the ART clinic, 104 (20.4%) underwent ART procedures. The patients aged 27–46 years with a mean age of 33 ± 4.0 years. More than half (58.7%) had primary infertility. Their duration of infertility ranged from 1 to 20 years (4.6 ± 2.9 years). Majority (81.7%) had conventional in vitro fertilization while 19 (18.3%) had intracytoplasmic sperm injection. Thirteen (12.5%) cases of cycle cancellation and 11 (11.7%) cases of mild‑to‑moderate ovarian hyperstimulation syndrome were recorded. The clinical pregnancy rate per cycle started was 39.4%. However, 9/41 (22%) resulted in spontaneous miscarriages and 32 (6 sets of twin, 25 singleton, and 1 high‑order multiple births) were successfully delivered, giving a live birth rate per cycle started of 30.8%. Pregnancy outcomes were not significantly affected by age of the women, types of infertility, and duration of infertility (P > 0.05). Conclusion: The outcomes of ART procedures in a resource‑limited country like ours are encouraging. This underscores the need to encourage ART in public tertiary institutions in Nigeria through the support of government and nongovernmental organizations for the benefit of infertile couples who were hitherto hopeless.Item Biochemical Infertility Among Prospective Oocyte Donors at the University of Ilorin Teaching Hospital Assisted Reproductive Unit, Nigeria(College of Health Sciences, University of Ilorin, 2018) Biliaminu, S.A.; Abdul Azeez, I.M.; Akande, A.A.; Okesina, A.B.; Olatinwo, Abdulwaheed O.; Omokanye, Lukman O.Item Clomiphene Resistant Polycystic Ovarian Syndrome: Analysis of Outcomes following Laparoscopic Ovarian Drilling in Infertile Women in Ilorin, North-Central, Nigeria.(African Health Research Organization, 2017) Omokanye, Lukman O.; Olatinwo, Abdulwaheed O.; Panti, Abubakar A.; Ibrahim, S.; Oyedepo, O.O.; Ige, O.A.; Adegboye, M.B.Background: Laparoscopic ovarian drilling (LOD) is one‑off treatment modality for clomiphene citrate (CC)‑resistant polycystic ovarian syndrome (PCOS) avoiding the need of medical therapy and its attendant complications. Aims and Objectives: This study aimed at determining the efficacy of LOD in women with anovulatory infertility secondary to CC‑resistant PCOS and factors influencing reproductive outcomes. Materials and Methods: A cross‑sectional study of infertile women who underwent LOD on account of CC‑resistant PCOS between January 2012 and December 2015 at a tertiary institution. Results: Patients aged 24–38 years (29.7 ± 3.6 years) and their body mass index (BMI) ranges from 20 to 35 (26.3 ± 4.3). The majority (90.5%) were nulliparous. Most (61.3%) had primary infertility. Their duration of infertility ranges from 1 to 13 years (4.3 ± 2.7) and ovarian volume ranges from 10 to 24 cm3 (mean, right ovary = 15.2 ± 3.2; left ovary = 16.3 ± 3.2). The number of drills per ovary ranged from 4 to 14 (mean, right ovary = 7.4 ± 2.1; left ovary = 7.3 ± 2.1) and the luteinizing hormone/follicle stimulating hormone (LH)/FSH ratio ranges from 2 to 6 (3.2 ± 1.4). All achieved spontaneous resumption of menses and ovulation with mean durations of 4.0 ± 1.8 days and 5.3 ± 3.2 weeks, respectively. Eighty‑three (60.6%) clinical pregnancies were recorded, of which 68 (49.6%) resulted to live births (61 singletons and 7 twin births) and 14 (10.2%) early first trimester miscarriages. The mean time interval from LOD to pregnancy was 4.4 ± 1.1 months. There was a significant association between BMI, duration of infertility, FSH/LH ratio, and pregnancy outcomes (P < 0.05). Conclusion: LOD is the most preferred treatment modality for CC‑resistant PCOS as it resulted in higher pregnancy rate.Item Controlled ovarian stimulation protocols in assisted conception: agonist versus antagonist in normal responders(African Journal of Infertility and Assisted Conception, 2017) Omokanye, Lukman O.; Olatinwo, Abdulwaheed O.; Saadu, L.O.; Biliaminu, S.A.; Durowade, K A.; Panti, Abubakar A.; Salaudeen, A.G.Item Determinants of infertility in male partners of infertile couples at a public health facility in Ilorin, Nigeria(Regional Institute of Medical Sciences, Imphal, India, 2016) Omokanye, Lukman O.; Olatinwo, Abdulwaheed O.; Durowade, K.A; Abdul, I.F; Biliaminu, S.ABackground: Infertility is the most important reproductive health and social issue confronting married couples in our environment. The contribution of male factor is assuming a tremendous proportion. Seminal fluid analysis (SFA) remains an indispensable tool in the evaluation of the fertility potential of these male partners. Aim and Objectives: This study aimed to determine the pattern of seminal fluid parameters and its impact on infertility among male partners of infertile couple at a public health facility in Ilorin. Materials and Methods: A cross‑sectional study of the seminal fluid indices of consecutively consenting male partners of infertile couple seen at the Assisted Reproductive Technology (ART) Unit of the Department of Obstetrics Gynecology, University of Ilorin Teaching Hospital, Ilorin, between January 1, 2012 and December 31, 2014. Results: All male partners of infertile couple who had infertility consultation at the ART unit consented to SFA during the study period. The patients were aged 27–67 years. One hundred and seventy‑five (56.1%) patients had normal parameters. There was a high level of leukocytospermia and bacterial infections in both normospermic and oligospermic semen. The predominant organism was Staphylococcus aureus. Of the sociodemographic and reproductive/hormonal variables, only the age was found to have statistically significant association with types of infertility. Conclusion: Male factor is increasingly assuming a significant role in the etiology of infertility in Ilorin. The practitioners should, therefore, endeavor to involve them early in the overall management to reduce stigmatization and ostracizing of women for infertility.Item Determinants of Utilization of Assisted Reproductive Technology services in Ilorin, Nigeria(Regional Institute of Medical Sciences, Imphal, India, 2017) Omokanye, Lukman O.; Olatinwo, Abdulwaheed O.; Durowade, K A.; Raji, H.O.; Raji, S.T.; Biliaminu, S.A.; Salaudeen, A.G.Background: Infertility is the most important reproductive health and social issue confronting married couples in developing countries. Assisted Reproductive Technology (ART) offer a chance at parenthood to couples, who until recently would have had no hope of having a “biologically related” child. Aims and Objectives: This study aimed at determining the factors influencing the utilization of ART services at a public health facility in Ilorin, Nigeria. Materials and Methods: A cross‑sectional descriptive study of consecutively consenting infertile couples seen at the ART unit of the Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, Ilorin, between January 1, 2012, and December 31, 2015. Results: The patients aged 22–52 years with a mean age of 36.1 ± 6.6 years and mean duration of infertility of 7.3 ± 5.8 years. Majority (87.3%) was aware of ART services; only a few (15.6%) had ever used it. Most (63.3%) were of the opinion that ART is financially accessible. Reasons for nonutilization of ART were high cost (44.3%) and nonavailability (29.4%). Measures to enhance the utilization of ART were cost reduction (61.2%) and awareness creation (27.2%). Knowledge on ART practices showed that 56.7% were aware that the procedure could fail and 35.1% knew that it could address male infertility. Female partner age and parity had a significant influence on awareness and utilization of ART services. Conclusion: Awareness of ART services is high; however, utilization is abysmally low. Efforts should be made to make the procedure more affordable and accessible to the masses.Item The Determinants of Utilization of Insecticide Treated Nets Among Pregnant Women Attending Antenatal Clinic at University of Ilorin Teaching Hospital, Ilorin, Nigeria(Biomedical Science Direct Publication, 2012) Omokanye, Lukman O.; Saidu, R.; Olatinwo, Abdulwaheed O.; Jimoh, A.A.G.; Salaudeen, A.G.; Balogun, O.R; Ijaiya, M.A.; Panti, Abubakar A.Background and Objective: Malaria remains a disease of public health importance in the developing countries. The purpose of this study was to determine factors influencing the utilization of ITNs among pregnant women attending antenatal clinic at the UITH, Ilorin. Materials and Methods: This study was a cross-sectional survey of pregnant women carried out in the antenatal clinic of UITH. The subjects were selected at booking and administered questionnaire. Data were analyzed using Epi-Info software version 3.4.1 of computer. Results: The findings were that 85.2% knew about ITNs and 29.6% did not know where to obtain ITNs. About 74% did not know the cost of ITNs, and 81.5% and 79.8% were of the opinion that ITNs are used to protect against mosquito bites and effective in prevention of malaria respectively. One third (33.7%) of respondents had ever used ITNs. The reasons for non-utilization of ITNs were among others, lack of knowledge, lack of interest, unavailability and use of other methods of prevention. About half of ITNs users used it every day and only 7.9% have been using it for over three years. Statistical analysis showed that marital status, parity, and education had significant influence on utilization of ITNs, where as age and gestational age at booking did not. Conclusion: ITNs coverage is abysmally low among the most vulnerable group. There is need for government to increase enlightenment campaign and intensify advertisement on media that would inform and educate individuals about the usefulness of ITNsItem Ectopic Pregnancy in Ilorin, Nigeria(National Postgraduate Medical College of Nigeria, 2013) Omokanye, Lukman O.; Balogun, O.R.; Salaudeen, A.G.; Olatinwo, Abdulwaheed O.; Saidu, R.Aims and Objectives: This is to study the incidence, predisposing factors, clinical presentation and management of ectopic pregnancy that presented over a four year period. Patients, Materials and Methods: This is a retrospective study of 98 ectopic pregnancies managed at the gynaecological unit of University of Ilorin Teaching Hospital, Ilorin from 1st January 2004 to 31st December 2007. Information was obtained from the case notes, theatre and labour ward registers. Results: A total of 10,054 deliveries were recorded while 1,430 gynaecological patients were admitted. Ninety eight patients had ectopic gestation accounting for 1% of all deliveries and 6.9% of all gynaecological admissions. The peak age group was 25-29 years (33%); 70 (74.5%) were married and 16 (17%) were students mostly undergraduates. Previous pelvic inflammatory disease 78 (83%), previous pelvic surgery 7 (7.4%) and previous history of ectopic pregnancy 2 (2.1%) were the most common risk factors in the patients. Lower abdominal pain 90 (95.7%), missed period 82 (87.2%), dizziness/fainting attack 57( 60.6%) and vaginal bleeding 50 (53.2%) were the predominant symptoms at presentation. There were 2 (2.1%) bilateral ampullary tubal ectopic with one unruptured ectopic which was treated with linear salpingostomy. Only one (1.1%) case of heterotrophic pregnancy. Open abdominal surgery was the treatment employed in all the patients. No Mortality was recorded. Conclusion: The incidence of ectopic pregnancy can be reduced by putting in place measures to reduce induced abortion and pelvic inflammatory disease. In addition, early presentation, prompt diagnosis and efficient blood transfusion services will decrease the morbidity and mortality associated with ectopic pregnancy.Item Evaluation of Ovarian Reserve in Assisted Reproductive Facilities; Biochemical and Other Alternatives: Pros and Cons-A Review Article(Faculty of Medical Laboratory sciences, Usmanu Danfodiyo University, Sokoto, Nigeria, 2017) Biliaminu, S.A.; Abdul Azeez, I.M.; Okesina, A.B.; Olatinwo, Abdulwaheed O.; Omokanye, Lukman O.; Adunmo, G.O.The precarious rate of infertility has become a global issue. The social and psychological stresses attached to the problem of not having a fruit of womb have necessitated the establishment of assisted reproductive facilities within and outside Nigeria. Most of these Centers are privately owned while very few of them belonging to government. The need for the knowledge or idea of ovarian reserve in female clients of fertility centers is very crucial as it will not only tell the suitability of the client for the procedure but also assist in determining the drugs required for stimulation and the protocol required in a particular client. Various methods are being used in evaluation of ovarian reserve in assisted reproductive facilities some of which are biochemical, ultrasonographic, histopathologic and combined in nature and form. This review article is on evaluation of ovarian reserve in assisted reproductive facilities; biochemical and other alternatives as well as their pros and cons. It was essentially based on literatures and research works written in EnglishItem Female factor infertility: Laparoscopic evaluation at a public health facility in Ilorin, Nigeria.(College of Medicine KLE University, Belgaum, India, 2017) Omokanye, Lukman O.; Ibrahim, S.; Olatinwo, Abdulwaheed O.; Durowade, K.A.; Raji, S.T.; Biliaminu, S.A.; Salaudeen, A.G.BACKGROUND: Infertility is a problem of global proportions, the majority being the residents of developing countries. The contribution of female factor is assuming a tremendous proportion. Laparoscopy remains an indispensable tool in the evaluation of the fertility potential of these female partners. AIMS: This study was aimed at determining the various causes of female factor infertility among female partners of infertile couple in a tertiary health facility. METHODS: A cross-sectional observational study of ninety seven (97) eligible infertile women who underwent diagnostic laparoscopy between 1st January 2012 and 31st December 2015 were enrolled for the study. The data were analyzed using SPSS/PC version 16.0 and p value was preset at <0.05. RESULTS: The patients aged 21-50 years with a mean age of 33.2 ± 6.6 years. Majority (79.4%) were nulliparous. Fifty (51.5%) had primary infertility. Their duration of infertility ranged from 1to 33years (5.7 ± 5.5 years). Most (63.9%) belong to middle social class and their spouse age ranges between 28-60 years (39.0 ± 7.5). More than a quarter had clomiphene resistant Polycystic Ovarian Syndrome, 19 (19.6%) tubal blockage, 13 (13.4%) uterine fibroid and 10 (10.3%) each had endometriosis, peritubal and ovarian adhesions, ovarian cyst and normal findings respectively. There was significant association between patients’ age, intra-operative findings and tubal patency evaluation on laparoscopy (P < 0.05). CONCLUSION: Laparoscopic procedures are less invasive, more convenient and more precise for diagnosis of infertility in women. The common causes responsible for infertility were polycystic ovarian syndrome, tubal occlusion, uterine fibroid, endometriosis, peri-tubovarian adhesions and ovarian cyst.Item A five year review pattern of placenta previa in Ilorin, Nigeria(2017) Omokanye, Lukman O.; Olatinwo, Abdulwaheed O.; Salaudeen, A.G.; Ajiboye, A.D.; Durowade, K A.Background: Placenta previa, a major cause of obstetric hemorrhage, is potentially life-threatening to the mother and frequently results in high perinatal morbidity and mortality. Methodology: This is a retrospective study of all cases of placenta previa managed at the University of Ilorin Teaching Hospital over a 5-year from January 2011 to December 2015. A pro forma template was used to harvest information from case notes of patients involved in the study. Results: There were a total of 10,250 deliveries over the 5-year study and 164 cases of placenta previa were managed during this period; giving an incidence of 1.6% of the total deliveries. Of these patients, 65.9% were unbooked while 34.1% were booked. 110 (67%) were above 30 years of age and 51.2% were grand multiparous women. The majority (81.7%) of the patients belonged to the low socioeconomic class. Painless vaginal bleeding (62.2%), intrapartum hemorrhage (22.6%), and abnormal lie presentation (8.5%) were the most common mode of presentation. Vaginal delivery occurred in (29.3%) of patients while 70. 7% were delivered through cesarean section. There was a significant association between patients’ age, parity, booking status, and types of placenta previa (P < 0.05). Similarly, there was a significant association between gestational age at delivery, mode of delivery, intraoperative blood loss, and birth weight at delivery and types of placenta previa (P < 0.05). Perinatal mortality was 12.2%, 15.6% of babies had severe birth asphyxia, and there was no maternal mortality. Conclusion: From this study, the risk factors for placenta previa are advanced maternal age above 35 years, grand multiparity, and booking status. Early recognition, appropriate referral of these patients and availability of ultrasound facilities, blood transfusion facilities, improvement in neonatal facilities and trained personnel will go a long way in reducing the perinatal mortality from placenta previa.Item Gynaecological Laparoscopic Surgeries: A 4- Year audit at the University of Ilorin Teaching Hospital, Nigeria(Society of Gynaecology and Obstetrics of Nigeria, 2017) Omokanye, Lukman O.; Olatinwo, Abdulwaheed O.; Ibrahim, S; Durowade, K.A.; Biliaminu, S.A.; Abdul, I.F.Background: In addition to a shorter hospital stay and better cosmetic results, laparoscopic surgery also offers patients fewer postoperative complications compared to conventional open gynecological surgeries. With expertise and better facilities, it has come to stay as an alternative surgical approach to gynecological diagnosis and treatment. Aims and Objectives: The aim of this study was to assess the indications, intraoperative findings, and types of laparoscopic surgeries performed at the University of Ilorin Teaching Hospital, Ilorin. Materials and Methods: A retrospective observational study of 150 patients who underwent laparoscopic procedures between January 1, 2012 and December 31, 2015, at the Assisted Reproduction Technology (ART) unit of the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria. Results: Within the period of our review, there were 1,256 gynecological operations and 150 laparoscopies, thus giving a period prevalence of 11.2%. The patients were aged 20–59 years with a mean age of 32.1 ± 3.9 years. Of the 150 laparoscopies, 30 (20%) had diagnostic laparoscopies while 120 (80%) had therapeutic laparoscopies. Of the 30 patients who had diagnostic laparoscopies, 5 (16.7%) presented with primary infertility and 12 (40%) with secondary infertility. The commonest indication for therapeutic laparoscopy was clomiphene‑resistant polycystic ovary syndrome (PCOS) and was found in 81 (67.5%). One (0.7%) was converted to open surgery due to technical difficulties. There was a case of iatrogenic sigmoid colon injury and no mortality recorded. Conclusion: Laparoscopic surgery offers patients a novel choice of intervention that affords establishing definitive diagnosis, shorter hospital stay, better cosmetics, and reduced morbidities/mortalities compared to open gynecological surgeries.Item An improvised endotrainer for low resource settings(African Journal of Infertility and Assisted Conception, 2017) Omokanye, Lukman O.; Olatinwo, Abdulwaheed O.; Shehu, F.I; Afolabi, G.M.; Balogun, Z.B.; Ayeni, O.M.; Afolayan, S.T.; Orhue, M.O.Item An improvised endotrainer for low resource settings(African Journal of Infertility and Assisted Conception, 2017) Omokanye, Lukman O.; Olatinwo, Abdulwaheed O.; Shehu, F.I.; Afolabi, G.M.; Balogun, Z.B.; Ayeni, O.M.; Afolayan, S.T.; Orhue, M.O.Training in minimal access surgery has always been difficult in developing countries with limited resources, paucity of animal laboratories, unaffordability/unaffordable conventional endotrainer and limited number of trained endoscopic surgeons to help the trainee. Objective: To design an endotrainer for use in resource- poor settings with the aim of domestication of laparoscopic surgery. Materials and Methods: A fabricated endotrainer box with a camera, a bulb for adequate illumination powered by electricity connected to a television was designed at affordable price to improvise for the conventional endotrainer for low resource settings. Results: The fabricated endotrainer model was found to be an effective training tool for improving psychomotor skills and dexterity of movement, especially for suturing in difficult areas. This is comparable to the sophisticated virtual reality simulator. Also, it is far less expensive compared to the expensive virtual reality simulator, thus affordable. Conclusion: It is concluded that this model should be employed by other low resource setting to improve the skills of surgeons in endoscopy surgery and facilitate the training of new hands.Item An improvised endotrainer for low resource settings(College of Health Sciences, Osun state University, NIgeria, 2013) Omokanye, Lukman O.; Olatinwo, Abdulwaheed O.; Salaudeen, A.G.; Balogun, O.R; Saidu, R.Training in minimal access surgery has always been difficult in developing countries with limited resources, paucity of animal laboratories, unaffordability/unaffordable conventional endotrainer and limited number of trained endoscopic surgeons to help the trainee. Objective: To design an endotrainer for use in resource- poor settings with the aim of domestication of laparoscopic surgery. Materials and Methods: A fabricated endotrainer box with a camera, a bulb for adequate illumination powered by electricity connected to a television was designed at affordable price to improvise for the conventional endotrainer for low resource settings. Results: The fabricated endotrainer model was found to be an effective training tool for improving psychomotor skills and dexterity of movement, especially for suturing in difficult areas. This is comparable to the sophisticated virtual reality simulator. Also, it is far less expensive compared to the expensive virtual reality simulator, thus affordable. Conclusion: It is concluded that this model should be employed by other low resource setting to improve the skills of surgeons in endoscopy surgery and facilitate the training of new hands.Item Lipid Profile as a Biomarker of Atherogenicity in Subfertile client with Hyperprolactinemia: A North- Central Nigerian University Teaching Hospital Experience.(Faculty of Medical Laboratory sciences, Usmanu Danfodiyo University, Sokoto, Nigeria, 2017) Abdul Azeez, I.M.; Biliaminu, S.A.; Okesina, A.B.; Olatinwo, Abdulwaheed O.; Omokanye, Lukman O.; Adunmo, G.O.Hyperprolactinaemia is associated with amenorrhoea and decreased estrogen concentration which may lead to the elevation in total cholesterol and low density lipoprotein cholesterol (LDL-C) and decrease in high density lipoprotein cholesterol (HDL-C). The aim of this present study was to evaluate lipid profile as an artherogenic biomarker in hyperprolactinaemic sub-set of subfertile individuals. This cross-sectional study was carried among clients with hyperprolactinaemia at the Assisted Reproductive Unit of University of Ilorin Teaching Hospital, Ilorin between January and June 2015. Serum fasting total cholesterol (TC), triglycerides (TGs), high density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were measured in 51 women with hyperprolactinaemia who were non-pregnant and not breastfeeding and 40 age-matched non- pregnant and non-breastfeeding women of child bearing age. Comparisons between serum hormonal profiles as well as lipids profiles as biomarkers of artherogenic index were assessed. Women with hyperprolactinaemia present with significantly lower serum level of FSH, progesterone and oestradiol than those of controls, while there was insignificant elevation in mean LH. There was a significant elevation in the levels of prolactin, testosterone, total cholesterol, triglycerides, HDL-C, LDL-C, mean coronary heart disease risk ratio and Castelli ratio IIin hyperprolactinaemic subjects when compared with controls. In contrast, there was no significant difference when mean values of artherogenic index and Castelli II in hyperprolactinaemic subjects were compared with those of controls. This study revealed an association between hyperprolactinaemia and dyslipidaemia with higher atherogenicity than the controls. We concluded that dyslipidaemia is common in hyperprolactinaemia and as such early lipid profile is advised as well as holistic interpretation of lipid profile as prompt treatment may prevent cardiovascular events in hyperprolactinaemic patientsItem Lipid profile in subfertile clients with premature ovarian failure: University of Ilorin Teaching Hospital(Krishna Institute of Medical Sciences, 2018) Abdul Azeez, I.M.; Biliaminu, S.A.; Okesina, A.B.; Olatinwo, Abdulwaheed O.; Omokanye, Lukman O.Background: Premature Ovarian Failure (POF) is associated with a higher incidence of cardiovascular events later in life. Concurrent with the ages of menopausal transition, a shift in lipid profile takes place. The increased burden may be mediated by a worsening of cardiovascular risk factors, such as lipids, corresponding with the loss of ovarian function. Aim and Objectives: To investigate serum lipid and hormonal levels in women with premature ovarian failure and compare with those of apparently healthy women of similar age. Material and Methods: The study was a cross-sectional one in which serum fasting Total Cholesterol (TC), Triglycerides (TG), High Density Lipoprotein Cholesterol (HDL-C) and Low Density Lipoprotein Cholesterol (LDL-C) levels were measured in 50 women with POF and compared with 40 age matched control. Serum hormonal profiles were compared with lipid profiles and biomarkers of atherogenic index were assessed. Results:Women with POF present with statistically significant elevations in the mean values of serum FSH and LH, when compared with those of controls (p<0.001), while there were significant decrease in mean levels of serum prolactin, progesterone, testosterone and oestradiol when subjects were compared with controls (p<0.001). There were statistically significant elevations in serum total cholesterol, triglycerides, HDL-C and LDL-C, in premature ovarian failure subjects when compared with controls (p<0.001). There was statistically significantly difference when mean values of artherogenic index and Castelli ratio II of subjects were compared with those of controls. Conclusion: Loss of ovarian function at a very young age (POF) was characterized with subtle changesin the serum lipid profile (higher TC, TG, HDL-C, and LDL-C levels). It also shows that atherogenic index and Castelli ratio II are better tools for assessment of atherogenicity than CHD risk ratio and Castelli ratio I in patients with POF.