Clinicopathologic Features of Uterine Fibroids in a Private Gynecologic Setting in Calabar, Nigeria

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S138-S138
Author(s):  
Ima-Obong Ekanem ◽  
Ima-Obong Ekanem ◽  
Odudu Ekanem ◽  
Chinweoke Ekanem
Keyword(s):  
Abdominal Mass ◽  
Uterine Fibroids ◽  
Abdominal Hysterectomy ◽  
Medical Centre ◽  
Medical Attention ◽  
Traditional Health ◽  
Clinical Presentations ◽  
Pathologic Features ◽  
Health Practitioners ◽  
Microscopic Findings

Abstract Introduction Uterine fibroid is a common gynecologic problem among adult females in Nigeria with variable clinical presentations. Unfortunately, these patients often seek medical attention very late after having consulted nonorthodox and/or traditional health practitioners. Objectives To assess the clinical outcome of patients diagnosed with uterine fibroids and review the pathologic features of specimens obtained from such patients managed over a 48-months period at Davis Medical Centre, a specialist gynecologic private health facility in Calabar, Nigeria. Methods This retrospective study was conducted at Davis Medical Centre, located in a semirural community in Calabar Municipality. It involved the extraction of data from case notes of patients and review of laboratory reports and H&E-stained histopathologic slides of surgical specimens removed from patients who presented with abdominal mass/swelling, heavy menstrual bleeding, abdominal pain, and inability to get pregnant having excluded other causes of infertility and ultrasonographic features suggestive of leiomyoma. Results A total of 82 patients aged between 26 and 54 years (mean age 36 ± 2 SD) were seen, giving an annual rate of about 20 cases yearly in the 4-year period (2015-2018) studied. Forty-eight (58.5%) had giant uterine fibroids with uterine size between 16 and 28 weeks. Myomectomy was the mainstay of treatment in 93.9% while 6.1% had abdominal hysterectomy. Histologically, the number of fibroid nodules ranged from 1 to 60 nodules with the largest weighing 4,097 g. All had the typical whorled grayish-tan gross appearance of leiomyoma uteri with a large proportion histologically showing degenerative changes of the hyaline type (39%) and few having features suggestive of adenomyosis. Conclusion Despite the grotesque, unusual macroscopic and characteristic microscopic findings, timely and careful surgical intervention can remedy the reproductive outcome and save lives of the affected patients when seen and managed by an experienced specialist gynecologist.

scholarly journals TREACHEROUS OVARIAN TUMOURS

2009 ◽  
Vol 16 (03) ◽  
pp. 463-465
Author(s):  
FARHAT RASHID ◽  
NAZIA AMJAD
Keyword(s):  
Ct Scan ◽  
Endometrial Hyperplasia ◽  
Abdominal Mass ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ovarian Tumours ◽  
History Of ◽  
Peritoneal Washings ◽  
Mucinous Cyst

A 47 years old P7 AO presented with history of gradually increasing abdominal mass and menorrhagia for the last six months.Pelvic ultrasound showed enlarged uterus with multiple fibroids of varying sizes with bilateral, large ovarian tumours with solid elements andhypoehoic thick fluid with septations. CT scan also confirmed same findings. Staging Laparotomy was performed which confirmed the findingsof ultrasound and CT scan. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was done along with peritoneal washings forcytology. Histopathology showed uterine fibroids, simple endometrial hyperplasia and Bilateral Mucinous cyst Adenomas of ovary with noevidence of malignancy.

scholarly journals Perceptions of Ghanaian traditional health practitioners, primary health care workers, service users and caregivers regarding collaboration for mental health care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Solomon Nyame ◽  
Edward Adiibokah ◽  
Yasmin Mohammed ◽  
Victor C. Doku ◽  
Caleb Othieno ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Human Rights ◽  
Primary Health Care ◽  
Service Users ◽  
Traditional Health ◽  
Healthcare Needs ◽  
Primary Health ◽  
Traditional Health Practitioners ◽  
Health Practitioners

Abstract Background In low- and middle-income countries, the paucity of conventional health services means that many people with mental health problems rely on traditional health practitioners (THPs). This paper examines the possibility of forging partnerships at the Primary Health Care (PHC) level in two geopolitical regions of Ghana, to maximize the benefits to both health systems. Methods The study was a qualitative cross-sectional survey. Eight (8) focus group discussions (FGDs) were conducted between February and April 2014. The views of THPs, PHC providers, service users (i.e. patients) and their caregivers, on the perceived benefits, barriers and facilitators of forging partnerships were examined. A thematic framework approach was employed for analysis. Results The study revealed that underlying the widespread approval of forging partnerships, there were mutual undertones of suspicion. While PHC providers were mainly concerned that THPs may incur harms to service users (e.g., through delays in care pathways and human rights abuses), service users and their caregivers highlighted the failure of conventional medical care to meet their healthcare needs. There are practical challenges to these collaborations, including the lack of options to adequately deal with human rights issues such as some patients being chained and exposed to the vagaries of the weather at THPs. There is also the issue of the frequent shortage of psychotropic medication at PHCs. Conclusion Addressing these barriers could enhance partnerships. There is also a need to educate all providers, which should include sessions clarifying the potential value of such partnerships.

scholarly journals Large cervical fibroid: a rare case report

2019 ◽  
Vol 8 (8) ◽  
pp. 3414
Author(s):  
Sunanda N.
Keyword(s):  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Large Mass ◽  
Abdominal Hysterectomy ◽  
Reproductive Age ◽  
Pelvic Tumors ◽  
Rare Case Report ◽  
Tender Mass ◽  
Restricted Mobility ◽  
Reproductive Age Group

Although leiomyomas are the most common pelvic tumors presenting in the reproductive age group, cervical fibroids are rare accounting for 2% of all uterine fibroids. We report a case of 40 year old lady presenting with a firm, non-tender mass of 22-24 weeks size pregnant uterus with restricted mobility. Laparotomy showed a large mass arising from the anterior lip of cervix, with a small uterus pushed posteriorly. Enucleation followed by total abdominal hysterectomy was done. Large cervical fibroids are rare, presenting with surgical difficulties. Careful dissection by expert hands is needed in the management of such cases. 

Painless spontaneous haemoperitoneum secondary to a uterine leiomyoma/fibroid: unusual presentation of a life-threatening differential

2021 ◽  
Vol 14 (10) ◽  
pp. e243465
Author(s):  
Chiamaka Maduanusi ◽  
Sathiyaa Balachandran ◽  
Sahathevan Sathiyathasan ◽  
Kazal Omar
Keyword(s):  
Uterine Leiomyoma ◽  
Rare Complication ◽  
Abdominal Mass ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Haemodynamic Instability ◽  
Hypovolaemic Shock ◽  
Important Differential Diagnosis ◽  
Life Threatening ◽  
Definitive Management

This is a case of a 47-year-old woman with a spontaneous haemoperitoneum secondary to uterine leiomyomas (fibroids), an important differential diagnosis in patients with uterine fibroids and hypovolaemic shock. Uterine fibroids are very common in women of reproductive age, yet little is taught about their potential to cause hypovolaemic shock. Although it is a rare complication, given the prevalence of fibroids, it is important to bear this life-threatening differential in mind to optimise the care for these women. Presentation typically involves abdominal pain, syncope, haemodynamic instability and an intra-abdominal mass. CT of the abdomen and pelvis can be helpful in identifying the source of the haemoperitoneum, but should not delay surgery, which is the definitive management.

scholarly journals Pharmacological and Ethnomedicinal Overview of Heritiera fomes: Future Prospects

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Imran Mahmud ◽  
Md Khirul Islam ◽  
Sanjib Saha ◽  
Apurba Kumar Barman ◽  
Md Mustafizur Rahman ◽  
...  
Keyword(s):  
Skin Diseases ◽  
Chemical Constituents ◽  
Folk Medicine ◽  
Anticancer Activities ◽  
Mangrove Plant ◽  
River Deltas ◽  
Traditional Health ◽  
Heritiera Fomes ◽  
Health Practitioners ◽  
Important Medicinal Plant

Mangrove plants are specialized woody plants growing in the swamps of tidal-coastal areas and river deltas of tropical and subtropical parts of the world. They have been utilized for medicinal and other purposes by the coastal people over the years. Heritiera fomes Buch. Ham. (family: Sterculiaceae) commonly known as Sundari (Bengali) is a preeminent mangrove plant occurring in the Sundarbans forest located in the southern part of Bangladesh and adjoining West Bengal province of India. The plant has applications in traditional folk medicine as evidenced by its extensive use for treating diabetes, hepatic disorders, gastrointestinal disorders, goiter, and skin diseases by the local people and traditional health practitioners. A number of investigations indicated that the plant possesses significant antioxidant, antinociceptive, antihyperglycemic, antimicrobial, and anticancer activities. Phytochemical analyses have revealed the presence of important chemical constituents like saponins, alkaloids, glycosides, tannins, steroids, flavonoids, gums, phytosterols, and reducing sugars. The present study is aimed at compiling information on phytochemical, biological, pharmacological, and ethnobotanical properties of this important medicinal plant, with a view to critically assess the legitimacy of the use of this plant in the aforementioned disorders as well as providing directions for further research.

scholarly journals Perceptions of traditional health practitioners on violence in the Helderberg Municipal Area, Western Cape

2013 ◽  
Vol 18 (1) ◽  
Author(s):  
Diana Gibson
Keyword(s):  
Urban Setting ◽  
Western Cape ◽  
Gender Based Violence ◽  
Traditional Health ◽  
Traditional Health Practitioners ◽  
Parents And Children ◽  
Health Practitioners ◽  
High Concentrations ◽  
Gender Based ◽  
And Gender

This study on perceptions of violence was conducted with 56 traditional health practitioners (diviners: amagrirha) in the Helderberg Municipal Area of Cape Town Metro. It forms a subsection of a larger study on African medicine. This particular research focuses on how traditional health practitioners perceive violence, including gender-related violence. Individual, in-depth interviews were done with 21 traditional health practitioners and focus group discussions were held with 35 participants. The paper reports on their understanding of, as well as the meanings attached to, community and gender-based violence in an urban setting. The traditional health practitioners related violence to a range of disconnections in society, ranging from not adhering to traditional norms and practices, to breaks in relations between parents and children, within families and in marital- and sexual relations. They referred to a general sense of disjuncture between the living and the ancestral worlds. The accumulative effect of this sense of not being connected was seen as damaging and a precursor to violence. In two sites where there were high concentrations of violence, ceremonies were held to purify the areas by ritual. In addition to attending to the physical manifestations of illness, distress and violence, these traditional health practitioners attempted to enhance and restore proper social relationships between the living, as well as between the living and the dead.Hierdie studie oor persepsies van geweld is gedoen met 56 tradisionele gesondheidspraktisyns (waarsêers: amagrirha) in die Helderberg Munisipale gebied van Kaapstad Metro. Dit vorm deel van ’n groter studie gerig op Afrika-medisyne. Hierdie spesifieke navorsing fokus op hoe tradisionele gesondheidspraktisyns geweld beskou, insluitende geslags-gebaseerde geweld. individuele, in-diepte onderhoude is gevoer met 21 tradisionele gesondheidspraktisyns en fokusgroepbesprekings is gehou met 35 deelnemers. Die artikel doen verslag oor hoe tradisionele gesondheidspraktisyns gemeenskaps- en geslags-gebaseerde geweld verstaan en daaran betekenis heg in ’n stedelike opset. Die tradisionele gesondheidspraktisyns verbind geweld met ’n reeks diskonneksies in die gemeenskap, wat wissel van ’n gebrek aan gehoor ten opsigte van tradisionale norme en praktyke tot verbrokkeling van verhoudings tussen ouers en kinders, binne families en in huweliks- en geslagsverhoudings. Hulle het verwys na ’n algemene persepsie van ontwrigting tussen die lewendes en die wêreld van die voorouers. Die akkumulatiewe effek van hierdie gevoel van verbrokkeling word gesien as afbrekend en ’n voorspel tot geweld. In twee plekke waar daar hoë konsentrasies van geweld was, is seremonies gehou om die areas ritueel te reining. Bykomend tot die aandag aan fisiese manifestasies van siekte, nood en geweld, het hierdie tradisionale gesondheidspraktisyns gepoog om behoorlike sosiale verhoudings tussen die lewendes te verbeter en te herstel, sowel as tussen die lewendes en die gestorwenes.

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