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Aboaja AM, Dewa LH, Perry AE, Carey JF, Steele R, Abdelsamie A, Alhasan GTA, Sharma IS, Watson F, Cairney SA. Sleep interventions for adults admitted to psychiatric inpatient settings: A systematic scoping review. Sleep Med Rev 2024; 76:101950. [PMID: 38788520 DOI: 10.1016/j.smrv.2024.101950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024]
Abstract
Sleep disturbances are common, affecting over half of adults with a mental disorder. For those admitted to a psychiatric ward, difficulties with sleep, particularly insomnia, are compounded by factors relating to the inpatient setting. We conducted a scoping review of sleep intervention studies involving adults admitted to psychiatric settings. We categorised the different types of sleep interventions and identified the effects on sleep and other mental and physical health outcomes. Instruments used to measure sleep were also examined. The search strategy yielded 4780 studies, of which 28 met the inclusion criteria. There was evidence of more non-pharmacological than pharmacological interventions having been tested in inpatient settings. Results indicated that non-pharmacological interventions based on cognitive behaviour therapy for insomnia improve sleep and may improve mental and physical health. Several distinct sleep measures were used in the studies. Gaps in the literature were identified, highlighting the importance of research into a wider range of sleep interventions tested against robust controls, using validated measures of sleep with evaluation of additional mental and physical health outcomes among a large sample size of adults in the psychiatric inpatient settings.
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Affiliation(s)
- Anne M Aboaja
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK; Mental Health and Addictions Research Group, University of York, York, UK.
| | - Lindsay H Dewa
- School of Public Health, Imperial College London, London, UK; NIHR Imperial Biomedical Research Centre, London, UK
| | - Amanda E Perry
- Mental Health and Addictions Research Group, University of York, York, UK
| | - Jon F Carey
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Rachel Steele
- Library and Information Services, Tees, Esk and Wear Valleys, NHS Foundation Trust, UK
| | - Ahmed Abdelsamie
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Gies T A Alhasan
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Ishwari S Sharma
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Florence Watson
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Scott A Cairney
- Department of Psychology, University of York, UK; York Biomedical Research Institute (YBRI), University of York, UK
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Goodman ML, Lee M, Springer A, Schick V, Vaughan E, Markham C, Gitari S, Mukiri F. Sleep disturbance as a precursor to anxiety, depression, and PTSD among rural Kenyans: A cross-lagged panel analysis from a rural Kenyan interventional cohort. J Sleep Res 2024; 33:e14119. [PMID: 38083983 PMCID: PMC11164828 DOI: 10.1111/jsr.14119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/06/2023] [Accepted: 11/22/2023] [Indexed: 05/01/2024]
Abstract
Sleep quality is essential to biopsychosocial functioning, yet there remains limited longitudinal research on sleep and mental or social well-being within low- or middle-income countries. This study utilised longitudinal cohort data from a community-based empowerment programme in Meru County, Kenya to assess cross-lagged correlations between sleep disturbance, social support, symptoms of depression, anxiety, and posttraumatic stress. Participants (n = 373; 92% women; age range 18-86 years) who reported more sleep disturbance at T1 reported significantly more symptoms of depression, anxiety, and PTSD, and significantly less social support at T2 (average 11 weeks later), controlling for all within-time correlations across measures, within-measure correlations across time, and sociodemographic background characteristics. The findings are consistent with research across high-income countries, underscoring the need for more contextualised research into sleep behaviours across low- and middle-income countries. The findings may inform interventions to increase mental and social well-being within Kenya.
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Affiliation(s)
| | - Miryoung Lee
- University of Texas School of Public Health in Houston, TX, USA
| | - Andrew Springer
- University of Texas School of Public Health in Houston, TX, USA
| | - Vanessa Schick
- University of Texas School of Public Health in Houston, TX, USA
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Yaria J, Olusakin T. Challenges in the Management of Narcolepsy in a Resource Limited Setting: A Case Report. Cureus 2024; 16:e58143. [PMID: 38738054 PMCID: PMC11088952 DOI: 10.7759/cureus.58143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 05/14/2024] Open
Abstract
The management of Narcolepsy, from the initial presentation to the long-term management and follow-up, remains a challenging endeavor, especially in developing climes. Worldwide, it has been recognized as a medical condition that is frequently associated with initial misdiagnoses, and delays in definitive management, further highlighted, in resource-limited settings like Nigeria where issues are further compounded by social, cultural, and political factors. In this report, we aim to shed some light on the peculiar challenges encountered by clinicians in Nigeria, and in other similar settings, in the process of diagnosis and management of narcolepsy. We present a case of a 17-year-old male teenager with Narcolepsy Type 1 (NT1) who had been previously managed as a case of Juvenile Absence Epilepsy in various centers prior to presentation at our facility. The symptoms began two years prior to presentation at our outpatient clinic, and they were excessive daytime sleepiness, cataplexy, and sleep paralysis. The symptoms were corroborated by laboratory parameters - reduced mean sleep latency (conducted in an improvised sleep laboratory), and a low cerebrospinal fluid (CSF) hypocretin level. The patient was initially placed on Modafinil for excessive daytime sleepiness and a trial of Fluoxetine for the Cataplexy. However, due to the scarcity of Modafinil, behavioral modifications - scheduled sleep naps and sleep hygiene - were eventually employed. Narcolepsy is a debilitating illness, and consequently, the far-reaching effects of these challenges must be understood. It is important that concerted efforts be made towards improving the overall quality of care received by patients from the early identification to the treatment of narcolepsy in the Nigerian healthcare system.
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Affiliation(s)
- Joseph Yaria
- Medicine, University College Hospital Ibadan, Ibadan, NGA
| | - Tobi Olusakin
- General Practice, Vine Branch Medical Center, Ibadan, NGA
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Nakie G, Takelle GM, Rtbey G, Andualem F, Tinsae T, Kassa MA, Tadesse G, Fentahun S, Wassie YA, Segon T, Kibralew G, Melkam M. Sleep quality and associated factors among university students in Africa: a systematic review and meta-analysis study. Front Psychiatry 2024; 15:1370757. [PMID: 38559402 PMCID: PMC10979362 DOI: 10.3389/fpsyt.2024.1370757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Background Poor sleep quality significantly impacts academic performance in university students. However, inconsistent and inconclusive results were found in a study on sleep among university students in several African nations. Therefore, this study aimed to estimate the pooled prevalence and associated factors of poor sleep quality among university students in Africa. Methods The databases PubMed, Scopus, Cochrane Library, Science Direct, African Journal Online, and Google Scholar were searched to identify articles. A total of 35 primary articles from 11 African countries were assessed and included in this systematic review and meta-analysis. Data were extracted by using a Microsoft Excel spreadsheet and exported to STATA version 14 for analysis. The I2 test was used to assess the statistical heterogeneity. A random effect meta-analysis model was employed with 95% confidence intervals. Funnel plots analysis and Egger regression tests were used to check the presence of publication bias. A subgroup analysis and a sensitivity analysis were done. Results A total of 16,275 study participants from 35 studies were included in this meta-analysis and systematic review. The overall pooled prevalence of poor sleep quality among university students in Africa was 63.31% (95% CI: 56.91-65.71) I2 = 97.2. The subgroup analysis shows that the combined prevalence of poor sleep quality in East, North, West, and South Africa were 61.31 (95% CI: 56.91-65.71), 62.23 (95% CI: 54.07-70.39), 54.43 (95% CI: 47.39-61.48), and 69.59 (95% CI: 50.39-88.80) respectively. Being stressed (AOR= 2.39; 95% CI: 1.63 to 3.51), second academic year (AOR= 3.10; 95% CI: 2.30 to 4.19), use of the electronic device at bedtime (AOR= 3.97 95% CI: 2.38 to 6.61)) and having a comorbid chronic illness (AOR = 2.71; 95% CI: 1.08, 6.82) were factors significantly associated with poor sleep quality. Conclusion This study shows that there is a high prevalence of poor sleep quality among university students in Africa. Being stressed, in the second year, using electronic devices at bedtime, and having chronic illness were factors associated with poor sleep quality. Therefore, addressing contributing factors and implementing routine screenings are essential to reduce the burden of poor sleep quality. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023493140.
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Affiliation(s)
- Girum Nakie
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Girmaw Medfu Takelle
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gidey Rtbey
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Techilo Tinsae
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mulat Awoke Kassa
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Gebresilassie Tadesse
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Setegn Fentahun
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yilkal Abebaw Wassie
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tesfaye Segon
- Department of Psychiatry, College of Health Science, Mettu University, Mettu, Ethiopia
| | - Getasew Kibralew
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Seck I, Ciss I, Diédhiou A, Baldé M, Ka S, Ba LA, Ndoye SF, Figadère B, Seon-Meniel B, Gomez G, Cojean S, Pomel S, Loiseau PM, Fall Y, Seck M. 1,2,3-triazenes and 1,2,3-triazoles as antileishmanial, antitrypanosomal, and antiplasmodial agents. Med Chem Res 2022. [DOI: 10.1007/s00044-022-02994-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Ozoh OB, Chakaya J. Awakening sleep disordered breathing in Africa. THE LANCET. RESPIRATORY MEDICINE 2022; 10:812-813. [PMID: 35405142 DOI: 10.1016/s2213-2600(22)00090-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Obianuju B Ozoh
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos Nigeria; Lagos University Teaching Hospital, Lagos, Nigeria.
| | - Jeremiah Chakaya
- Department of Medicine, Therapeutics and Dermatology, Kenyatta University, Nairobi, Kenya; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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Wachinou AP, Houehanou C, Ade S, Totah T, Berger M, Solelhac G, Amidou S, Fiogbe AA, Alovokpinhou F, Lacroix P, Preux PM, Marques-Vidal P, Agodokpessi G, Houinato D, Heinzer R. Prevalence of sleep-disordered breathing in an African general population: The Benin Society and Sleep (BeSAS) study. THE LANCET. RESPIRATORY MEDICINE 2022; 10:831-839. [PMID: 35405141 DOI: 10.1016/s2213-2600(22)00046-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Data on the prevalence of sleep-disordered breathing (SDB) in the African general population are scarce, and a better understanding is urgently needed. Our study aimed to objectively determine the prevalence of, and factors associated with, SDB in a large sample in Benin, west Africa. METHODS In the Benin Society and Sleep (BeSAS) cross-sectional study, participants aged 25 years and older were recruited from both urban and rural areas. Rural participants were recruited from Tanve, a village located 200 km north of Cotonou, and urban participants were recruited from Cotonou. The participants underwent respiratory polygraphy at home using a type-3 device that measures airflow through a nasal pressure sensor, respiratory effort (thoracic movement), and pulse oximetry. Clinical and morphometric data were also collected. SDB severity categories were defined according to the apnoea-hypopnoea index (AHI), with mild-to-severe SDB (AHI ≥5/h), moderate-to-severe SDB (AHI ≥15/h), and severe SDB (AHI ≥30/h). FINDINGS The study was completed from April 4, 2018 to Jan 15, 2021. Of 2909 participants recruited in the BeSAS study, 2168 (74·5%) underwent respiratory polygraphy. For the 1810 participants with complete polygraphic data (mean age 46 years, SD 15; 1163 [64·2%] women), the prevalence of mild-to-severe SDB (AHI ≥5/h) was 43·2% (95% CI 40·9-45·5), of moderate-to-severe SDB (AHI ≥15/h) was 11·6% (10·2-13·1), and of severe SDB (AHI ≥30/h) was 2·7% (2·0-3·5). Factors independently associated with SDB were advanced age, male sex, large neck circumference, abdominal obesity, overweight or obesity, and snoring. After multivariable adjustment, severe SDB was independently associated with hypertension in women (odds ratio 3·99, 95% CI 1·04-15·33; ptrend=0·044), but not in men (odds ratio 0·67, 0·22-2·05; Ptrend=0·63). INTERPRETATION The BeSAS study provides the first large-scale objective evaluation of SDB prevalence and associated factors in Africa. The high prevalence of SDB identified should stimulate the development of public health policies to prevent and treat this condition in African countries. FUNDING Ligue Pulmonaire Vaudoise, Switzerland.
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Affiliation(s)
- Ablo Prudence Wachinou
- Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin; Laboratory of Epidemiology of Chronic and Neurological Diseases, Cotonou, Benin; National Teaching Hospital for Tuberculosis and Pulmonary Diseases, Cotonou, Benin.
| | - Corinne Houehanou
- Laboratory of Epidemiology of Chronic and Neurological Diseases, Cotonou, Benin; National School of Public Health, University of Parakou, Parakou, Benin
| | - Serge Ade
- Faculty of Medicine, University of Parakou, Parakou, Benin
| | - Terence Totah
- Laboratory of Epidemiology of Chronic and Neurological Diseases, Cotonou, Benin
| | - Mathieu Berger
- Centre of Investigation and Research on Sleep, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Geoffroy Solelhac
- Centre of Investigation and Research on Sleep, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Salmane Amidou
- Laboratory of Epidemiology of Chronic and Neurological Diseases, Cotonou, Benin
| | | | | | - Philipe Lacroix
- Inserm U1094, University Hospital of Limoges-Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Pierre-Marie Preux
- Inserm U1094, University Hospital of Limoges-Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Pedro Marques-Vidal
- Department of Internal Medicine, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Gildas Agodokpessi
- Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin; National Teaching Hospital for Tuberculosis and Pulmonary Diseases, Cotonou, Benin
| | - Dismand Houinato
- Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin; Laboratory of Epidemiology of Chronic and Neurological Diseases, Cotonou, Benin
| | - Raphael Heinzer
- Centre of Investigation and Research on Sleep, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
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Balogun SA, Ubom AE, Adesunkanmi AO, Ugowe OJ, Idowu AO, Mogaji IK, Nwigwe NC, Kolawole OJ, Nwebo EE, Sanusi AA, Odedeyi AA, Ogunrinde OV, Adedayo OO, Ndegbu CU, Ojo AS, Anele CO, Ogunjide OE, Olasehinde O, Awowole IO, Ijarotimi OA, Komolafe EO. Nigerian resident doctors' work schedule: A national study. Niger J Clin Pract 2022; 25:548-556. [PMID: 35439917 DOI: 10.4103/njcp.njcp_1901_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background and Aim The deleterious effects of Resident Doctors' (RDs') long duty hours are well documented. Driven by concerns over the physician's well-being and patient safety, the RDs' duty hours in many developed countries have been capped. However, in Nigeria and many African countries, there are no official regulations on work hours of RDs. This study evaluated the work schedule of Nigerian RDs and its impact on their wellbeing and patient safety. Subjects and Methods A national survey of 1105 Nigerian RDs from all specialties in 59 training institutions was conducted. With an electronic questionnaire designed using Google Forms, data on the work activities of RDs were obtained and analyzed using the IBM SPSS software version 24. The associations were compared using Chi-squared test with the level of significance set at < 0.05. Results The mean weekly duty hours (h) of the RDs was 106.5 ± 50.4. Surgical residents worked significantly longer hours than non-surgical residents (122.7 ± 34.2 h vs 100.0 ± 43.9 h; P < 0.001). The modal on-call frequency was two weekday on-calls per week (474, 42.9%) and two weekend on-calls per month (495, 44.8%), with the majority of RDs working continuously for up to 24 hours during weekday on-calls (854, 77.3%) and 48-72 hours during weekend on-calls (568, 51.4%), sleeping for an average of only four hours during these on-calls. The majority of RDs had post-call clinical responsibilities (975, 88.2%) and desired official regulation of duty hours (1,031, 93.3%). Conclusion The duty hours of Nigerian RDs are currently long and unregulated. There is an urgent need to regulate them for patient and physician safety.
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Affiliation(s)
- S A Balogun
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - A E Ubom
- Department of Obstetrics, Gynecology and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - A O Adesunkanmi
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - O J Ugowe
- Department of Paediatrics, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - A O Idowu
- Department of Internal Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - I K Mogaji
- Department of Oral Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - N C Nwigwe
- Department of Anaesthesia, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - O J Kolawole
- Department of Internal Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - E E Nwebo
- Department of Morbid Anatomy and Forensic Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - A A Sanusi
- Department of Internal Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - A A Odedeyi
- Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - O V Ogunrinde
- Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - O O Adedayo
- Department of Community Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - C U Ndegbu
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria; Department of Colorectal Surgery, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, United Kingdom
| | - A S Ojo
- Department of Medicine, Howard University Hospital, Washington, DC, United States
| | - C O Anele
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - O E Ogunjide
- Department of Obstetrics, Gynaecology and Perinatology, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - O Olasehinde
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - I O Awowole
- Department of Obstetrics, Gynecology and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - O A Ijarotimi
- Department of Obstetrics, Gynecology and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - E O Komolafe
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
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