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Biomedical subjects

S Okolo

Publications and source records attributed to S Okolo.

12 recordsLinked to original sources
PubMed2006

An audit of gynaecological procedures in Jehovah's Witnesses in an inner city hospital.

A retrospective study of Jehovah Witness women between January 1994 and December 2003 was performed. Gynaecologists are concerned about operating on Jehovah's Witnesses because of the potential for haemorrhage during surgery. Jehovah's Witnesses do not accept donor blood but some will permit their own blood to be stored pre-operatively and administered during surgery if deemed necessary. Approximately 150,000 Jehovah's Witnesses live in the UK but little on gynaecological procedures in Jehovah's Witnesses has been published. There were 64 procedures (14 major, 18 intermediate and 32 minor) in 53 women with a median age of 42 years. There were no perioperative deaths, but postoperative anaemia was common. Our study showed that major, intermediate and minor gynaecological procedures can be performed without significant morbidity on Jehovah's Witnesses but a protocol should be available to outline management of those who refuse blood.

Adolescent↗
PubMed2001

Relationship between the production of prostaglandins and progesterone by luteinizing human granulosa cells.

Luteinizing granulosa cells synthesize high concentrations of progesterone, prostaglandin (PG) E(2) and PGF(2 alpha). The objective of this study was to explore the relationship between prostaglandin and progesterone output from human granulosa cells as they undergo functional luteinization in culture. Granulosa cells were partially purified from ovarian follicular aspirates and cultured at a density of 10(5) cells/ml in serum-supplemented DMEM:Ham's F(12) medium for 0, 1 or 2 days. Cells were then switched to serum-free medium for 24 h before measuring hormone concentrations in this spent medium by specific radioimmunoassays. Over the first 3 days in culture, PGF(2 alpha) and PGE(2) production declined progressively by up to 82+/-3% coincident with a 55+/-11% increase in progesterone output. In subsequent experiments, cells were treated for 24 h on the second day of culture with either 0.01 to 10 microM meclofenamic acid or with 10 microM and 100 microM aminoglutethimide. Meclofenamic acid inhibited synthesis of PGF(2 alpha) and PGE(2) by up to 70+/-9% and 64+/-7% respectively without affecting progesterone output. Likewise, 100 microM aminoglutethimide inhibited progesterone production by 62+/-6% without affecting concentrations of either PGF(2 alpha) or PGE(2). We have concluded that the progressive decline in prostaglandin production and the rise in progesterone output from luteinizing human granulosa cells occur independently of each other.

Aminoglutethimide↗
PubMed1996

Comparative effects on bone mineral density of tibolone, transdermal estrogen and oral estrogen/progestogen therapy in postmenopausal women.

The aim of the study was to assess the comparative effects on bone mineral density (BMD) in routine clinical practice of tibolone and estrogen (given either unopposed or combined with cyclical progestogen) in postmenopausal women who had not previously received estrogen or other menopausal therapy. BMD was measured in the spine and hip by dual energy X-ray absorptiometry (DEXA) at 12-month intervals over 3 years in 82 consecutive postmenopausal women referred for climacteric therapy. Of these, 35 women received tibolone, 24 transdermal estradiol alone and 12 conjugated equine estrogens together with cyclical progestogen; 11 received no therapy other than calcium. BMD increased significantly in the spine in those taking tibolone over 3 years (p < 0.0001 at 1 year; p < 0.0001 at 2 years; and p = 0.03 at 3 years). In those treated with conjugated equine estrogens and cyclical progestogen, BMD in the spine also increased significantly over the first 2 years (p = 0.03 at 1 year; p = 0.004 at 2 years), but not at 3 years. However, although BMD in the spine also rose over 3 years in the women treated with transdermal estradiol alone, the increase was not statistically significant. No significant change in the BMD of either the spine or the hip was observed in the control group. A significant difference in the increase of BMD in the spine between the different treatment groups was observed at 2 years (p = 0.004) in favor of those taking tibolone or conjugated equine estrogens, compared to women who received transdermal estradiol. The highest proportion of individual responders to therapy after 2 years' treatment was observed in those receiving tibolone or conjugated equine estrogens. There was no significant change in the BMD of the hip over 3 years, irrespective of the therapy taken, although there was a tendency towards a progressive increase in the women on tibolone. Neither the age of the women, their body mass index or pretreatment BMD had a significant effect on changes in bone density. Since tibolone effected a greater increase in spine BMD than did either conjugated equine estrogen with progestogen or transdermal estradiol alone, it is particularly suitable for older women who often have more advanced osteoporosis and who would not accept a return of cyclical bleeding.

Administration, Cutaneous↗
PubMed1995

Clinical experience with tibolone (Livial) over 8 years.

Tibolone (Livial), a synthetic steroid, relieves climacteric symptoms and maintains skeletal integrity in postmenopausal women. We have been using this compound for 8 years and have now reviewed our clinical experience in 301 postmenopausal women. The majority (65.12%) had not previously received climacteric therapy; 34.55% had previously received oestrogen/progestogen therapy. A significant proportion of those started on tibolone were specifically referred for consideration of non-oestrogenic therapy because of a past history of breast dysfunction--27 women with benign breast disease and 11 women who had undergone surgery for carcinoma of the breast. Overall tibolone was well tolerated and climacteric symptoms were relieved within 3-5 weeks. The major side effect was weight gain and/or a tendency to bloating and oedema which occurred in 11.28% of our women. Vaginal bleeding occurred in 33 women (12.69%) but in 17 of these women the bleeding was due to recent oestrogen therapy. Bleeding resulted from a polyp or fibroid in 11 women; no cause was found in the remaining five. Breast symptoms were reported by only 7.52% and no breast symptoms were reported in any of the 27 women referred because of benign breast disease. The total 'drop-out-rate' due to side effects was only 2.66% (eight women).

Aged↗
PubMed1995

The effects of the somatostatin analogue octreotide on ovulatory performance in women with polycystic ovaries.

The elevated luteinizing hormone (LH) and androgen concentrations characteristic of women with polycystic ovaries (PCO) are considered crucial factors in their infertility. The somatostatin analogue octreotide lowers LH and androgen concentrations in women with PCO. The effects of octreotide given concurrently with human menopausal gonadotrophin (HMG) were therefore compared with that of HMG alone in 28 infertile women with PCO resistant to clomiphene. In 56 cycles of combined HMG and octreotide therapy there was more orderly follicular growth compared with the multiple follicular development observed in 29 cycles in which HMG was given alone (mean number of follicles > 15 mm diameter on the day of human chorionic gonadotrophin (HCG) administration: 2.5 +/- 0.2 and 3.6 +/- 0.4 respectively; P = 0.026). There was a significantly reduced number of cycles abandoned (> 4 follicles > 15 mm diameter on day of HCG) in patients treated with octreotide+HMG, so that HCG had to be withheld in only 5.4% of cycles compared to 24.1% with HMG alone (P < 0.05). The incidence of hyperstimulation was also lower on combined treatment. Octreotide therapy resulted in a more 'appropriate' hormonal milieu at the time of HCG injection, with lower LH, oestradiol, androstenedione and insulin concentrations. Although growth hormone concentration was similar on both regimens, significantly higher insulin growth factor-I concentrations were observed on the day of HCG in women on combined therapy than on HMG alone.

Adult↗
PubMed1992

Effects of the somatostatin analogue, octreotide, in polycystic ovary syndrome.

In view of the association of hyperinsulinemia with elevated luteinizing hormone (LH) levels and hyperandrogenism in polycystic ovary syndrome (PCOS), the effect of octreotide was investigated in women with PCOS. Twelve amenorrheic women were treated with 100 micrograms octreotide twice a day for 7 days; 13 infertile women unresponsive to clomiphene citrate were treated either with octreotide (100 micrograms twice a day from day 1 of the menstrual cycle until corpus luteum formation) in addition to human menopausal gonadotropins (HMG) or with HMG alone. Octreotide significantly reduced the 4-hour integrated LH concentrations. LH pulse amplitude and nadir concentrations, and LH, testosterone, androstenedione, and estradiol responses to a gonadotropin-releasing hormone (GnRH) analogue in amenorrheic PCOS women. Octreotide treatment also resulted in a more "appropriate" hormonal milieu at the time of human chorionic gonadotropin (HCG) injection in the infertile women, with LH and testosterone levels being reduced while follicle-stimulating hormone (FSH) levels increased. Orderly follicular growth occurred, with one or two mature follicles being present at the time of HCG injection in cycles in which octreotide was given together with HMG. There were no cases of hyperstimulation, even in women who had previously hyperstimulated after HMG alone. Octreotide thus inhibits LH and androgen secretion and may improve ovulatory performance in infertile women with PCOS.

Adolescent↗
PubMedDate not supplied

The value of saline salpingosonography as a surrogate test of tubal patency in low-resource settings.

BACKGROUND: Tubal factor, which accounts for 15-30% of infertility in all women, is common in developing countries with high rates of pelvic inflammatory disease but limited resources. It is possible to outline the fallopian tubes by injecting isotonic saline transcervically during transvaginal ultrasound scanning of the pelvis, and both color flow Doppler and 3-dimensional scanning modes have been employed to improve visualization of the tubes, with varying success. METHOD: We investigated the value of saline salpingosonography (SSG), using 2-dimensional transvaginal ultrasound scanning, as a screening test of tubal patency in 113 women by comparing SSG findings to those at HSG or laparoscopy. RESULTS: The findings at SSG correlated well with the results of HSG or laparoscopy, with an overall concordance of 82.5%. SSG was more accurate at diagnosing patent tubes than blocked tubes and was well tolerated. The results are, however, unreliable when it is difficult to inject the saline and when the patient experiences severe pain during the procedure. CONCLUSION: SSG is a useful screening tool for investigating infertility, particularly in low-resource settings.

Adult↗