Highland Medical Research Journal 2021-06-02T15:00:54+00:00 Professor Emmanuel I Agaba Open Journal Systems <p>The aim of the <em>Highland Medical Research Journal</em> is to publish scientific research in various fields of medical science and to communicate such research findings to the larger world community. It aims to promote cooperation and understanding amoungst workers in various fields of medical science.</p> Assessment of male partner involvement in prevention of mother to child transmission of HIV amongst HIV-positive women in Jos, Nigeria 2021-06-02T13:27:00+00:00 Henrietta C. Oyeocha Halima M. Sule Emeka U. Ejeliogu Rosemary K. Omoregie Cordelia Y. Agada Vivian Yuwa <p><strong>Background:</strong> Mother to child transmission (MTCT) of HIV is still a crucial problem in Nigeria. Due to sociocultural/economic factors, a woman's decision to access and adhere to PMTCT services may depend on her male partner as the key decision maker. Male partner involvement (MPI) may thus influence the uptake of PMTCT and ultimately impact on the HIV status of a baby born to the couple. This study assessed MPI in PMTCT and impact on HIV status of babies delivered by participants.<br><strong>Method:</strong> In a hospital-based cross sectional study, 123 HIVpositive women who had accessed PMTCT services were interviewed to determine their MPI in PMTCT and their babies' HIV status at 18 months. Data was analyzed using statistical package for social Science, Version 20.<br><strong>Results</strong>: Prevalence of MPI was 80.5%, with a mean score of 6.7 + 0.6 for positive responses/adherence to PMTCT parameters. There was a statistically significant difference between the mean scores of male partners involved in PMTCT and those who were not (p = &lt; 0.0001). All babies tested negative to HIV at 18 months.<br><strong>Conclusion:</strong> The study showed a high rate of male partner involvement and a high positive response/adherence to PMTCT parameters among the men who were involved. However, there was no MTCT of HIV among the babies. MPI may have some contribution to this but needs to be further investigated in future studies.</p> <p><br><strong>Keywords:</strong> Male partners, PMTCT, HIV-positive women, babies </p> 2021-06-02T00:00:00+00:00 Copyright (c) A comparison of the effect of two doses of propofol with sodium thiopentone in the prevention of suxamethonium induced fasciculation and myalgia 2021-06-02T13:32:52+00:00 Abey A. Omosanya Motunrayo A. Oladimeji Oyebola O. Adekola John O. Olatosi <p><strong>Background:</strong> The use of suxamethonium commonly results in fasciculation and myalgia. This could be distressing to the patient. We compared the efficacy of high dose propofol, 3.5mg/kg with standard dose propofol, 2mg/kg and thiopentone sodium, 5mg/kg in reducing the suxamethonium induced fasciculation and myalgia.<br><strong>Methods:</strong> A prospective double blind randomized study in 105 unpremedicated, ASA l or II patients, scheduled for elective general anaesthesia. They were randomized, and induced with propofol, 2mg/kg (Group P), thiopentone, 5mg/kg (Group STP) or high dose propofol, 3.5mg/kg (Group HP). Tracheal intubation was facilitated with IV suxamethonium (1mg/kg). The incidence and severity of fasciculation, 24 hours postoperative myalgia and creatine phosphokinase (CPK) levels were recorded.<br><strong>Results: </strong>The incidence (p &lt; 0.001) and severity (p =0.034) of fasciculation was significantly lower in Group HP than Groups P and STP. The incidence (p &lt;0.001), and severity (p =0.010)of myalgia followed a similar trend. The mean 24hours postoperative CPK level was significantly lower in Group HP than Groups P and STP, p &lt;0.001.<br><strong>Conclusion:</strong> It is concluded that high dose propofol is more efficient than standard dose propofol and thiopentone in minimizing suxamethonium-induced fasciculation and myalgia.</p> <p><strong>Key Words:</strong> suxamethonium, myalgia, fasciculation, creatinine kinase, propofol, sodium thiopentone </p> 2021-06-02T00:00:00+00:00 Copyright (c) Drug-related events in an emergency department of a tertiary health care facility in South- South Nigeria 2021-06-02T13:37:55+00:00 Abimbola O. Opadeyi Stephen A. Ayinbuomwan Ambrose O. Isah <p><strong>Background</strong>: Drug-related adverse events refer to any injury from a medical intervention relating to a drug. This study identified suspected drug-related events presenting to the accident and emergency (A&amp;E) unit of a teaching hospital.</p> <p><strong>Methods</strong>: The adult admission registers of the A&amp;E unit of the University of Benin Teaching Hospital, Benin-City, Nigeria were retrospectively reviewed over a four-year period (January 2015 –December 2018). Patients with diagnosis that may indicate a drug-related event were included in the study.</p> <p><strong>Results:</strong> A total of 24510 new patients were seen over the 4- year period, with 648(2.6%) presenting with a drug-related event (DRE). There were 353 (54.5%) males, and the mean age (SD) was 48.9(20.4) years. Main DRE identified were adverse drug reactions (n=465, 71.8%) and of these, Non-steroidal antiinflammatory drugs (NSAIDs)-induced upper gastrointestinal bleeding (n=145, 31.2%), drug-induced hypoglycaemia (n=79, 21.5%), herbal medicines related events(n=27, 4.2%), were the commonest. Other DREs were substance abuse/misuse (n=105, 16.2 %), causing substance (notably cannabis) - induced mental and behavioural disorders (n=60, 9.3%), and<br>lastly poisoning (n=78, 12%) which were mostly intentional poisoning (notably organophosphates) (n=43, 6.6%).</p> <p><strong>Conclusions</strong>: Drug-related events constitute a significant burden on the emergency system. Upper gastrointestinal bleeding following use of NSAIDs, drug induced hypoglycaemia, organophosphate poisoning were found to be notable life threatening causes of emergency admissions. require multifaceted public health interventional strategies to mitigate the burden.</p> <p><strong>Keywords:</strong> drug-related medical emergencies; adverse drug reactions; poisoning; anti-inflammatory agents non-steroidal; Nigeria</p> 2021-06-02T00:00:00+00:00 Copyright (c) Characteristics of Nasopharyngeal Cancer in Jos, Nigeria 2021-06-02T13:47:11+00:00 Daniel D. Kokong Adeyi A. Adoga Nuhu D. Ma'an Lohpon T. Nimkur Caleb J. Yabak John P. Yaro Nyam J. Chuwang Ayuba M. Dauda Abdullahi Adamu <p><strong>Background</strong>: Nasopharyngeal cancer (NPC) has been reported by scholars as the most lethal and emotionally traumatic malignancy globally, with the outlook even poorer in African Natives from late presentation. We therefore sought to study the characteristics of NPCs in our environment.<br><strong>Method:</strong> We retrospectively evaluated all histo-pathologically confirmed cases of NPC managed between May 1, 2009-April 30, 2017 from retrieved case files using the ICD-10 version 10 standard codes at the Jos University Teaching Hospital.<br><strong>Results:</strong> Thirty cases, accounting for 0.2% of new Ear, Nose and Throat(ENT) outpatients were analysed. This represents the&nbsp; commonest Head &amp; Neck Cancer and the 3rd general body squamous cancer with 9.3%. Age range was 18years-69years rd th with a bimodal distribution at the 3 and 7 decades of life. Alcohol consumption/Cigarette smoking was recorded in 73.3% with a maximum pack years of 31.5years. Predominant feature was neck masses in 66.7% where 65.0% had nodes&gt;6cm, 76.7% had T4 tumours and 56.7% anaemia while 76.7% presented late. The WHO type III predominated with 60.0%. Definitive therapy was administered in 16.7% with a<br>dismal follow-up visit as 70.0% never returned. Mortality was difficult to ascertain as all were referred.<br><strong>Conclusion:</strong> NPC remains infrequent in Africa with WHO type III the predominant form. It is associated with late presentation, advanced disease, inadequate cancer care infrastructure and poor access to chemo-radiation. Early detection strategy using EBV biomarkers is a priority to prevent the misery associated with NPC.</p> <p><strong>Key Words;</strong> Nasopharyngeal cancer, Characteristics, advanced disease, late presentation </p> 2021-06-02T00:00:00+00:00 Copyright (c) Pattern of bacterial colonization of health care personnel at a reference hospital in North- eastern Nigeria 2021-06-02T13:55:44+00:00 Iragbogie A. Imoudu Musa G. Zirami Abdu B. Zamo Igho E. Idiodemise Ladi M. Mahmoud Hassan Sambo brahim U. Abdul <p><strong>Background</strong>: Health care personnel (HCP) play a significant role in the spread of healthcare-associated infections. This study was conducted to determine the prevalence and pattern of bacterial colonization of HCP at the Federal Medical Centre (FMC), Azare.<br><strong>Methods:</strong> A cross sectional survey of health workers was st st conducted from 1 to 31 October, 2019. Swabs were taken from the hands and naso-pharynx of the subjects, processed and results analyzed.<br><strong>Results</strong>: Eighty-two HCP [64 (78%) males and 18(22%) females] were recruited. The prevalence of bacterial colonization of HCP was 70.7%. The naso-pharyngeal carriage rate was 52.4 per 100 HCP and isolates included <em>Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella spp, á-Streptococcus </em>and<em> Haemophilus influenza.</em> The carriage rate of hands was 10.1 per 100 HCP composed of<em> Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, </em>and<em> Klebsiella spp</em>. Doctors accounted for 20.0% of those without a positive swab culture and nurses accounted for 44.0% of this figure. The naso-pharynx was the most likely site 2 to be colonized by bacteria (÷ =112.4, df=24, P? 0.001). All the isolates were resistant to amoxicillin+ clavulanic acid, and all except 9.7% of Staphylococcus aureus isolates were resistant to both ceftriaxone and cefixime. Two (10.0%) of E<em>scherichia coli</em> isolates were sensitive to erythromycin.<br><strong>Conclusion</strong>: There was a high colonization rate by bacteria as well as a high hand carriage rate of Escherichia coli by HCP in FMC Azare. Resistance to commonly used antimicrobials was also prevalent among the isolates.</p> <p><strong>Keywords:</strong> Health care, Personnel, Bacterial colonization, Naso-pharynx, Hands, Azare</p> 2021-06-02T00:00:00+00:00 Copyright (c) In-Vitro Fertilization: Awareness and perception among infertile women at the Jos University Teaching Hospital 2021-06-02T14:01:11+00:00 Chinedu C. Ekwempu Amaka N. Ocheke Adaobi I. Ekwempu <p><strong>Background:</strong> The prevalence of infertility is high in the developing world, sub-Saharan Africa inclusive with its attendant medical and social consequences. Tubal factor and male factor are responsible for the majority of cases of infertility in this environment. In-Vitro fertilization (IVF) is the treatment of choice for these cases. Though the services are available in some parts of the country including Jos, the uptake appears to be low. We sought to assess the awareness and willingness to accept IVF services among infertile women in<br>Jos University Teaching Hospital.</p> <p><strong>Method:</strong> A cross-sectional descriptive study involving 149 patients from the Gynaecological clinic of the Jos University Teaching Hospital was carried out. Data were obtained using a pretested questionnaire and analyzed using SPSS version 21.0.</p> <p><strong>Results</strong>: The mean age of the respondents was 30+6 years. Only 45.6% had heard about IVF. The information they had on IVF was inaccurate in 52.9% of respondents. The majority (77.9%) of the respondents had no idea of the success rate of IVF but believed the process guaranteed pregnancy. Most respondents (74.5%) preferred to have multiple pregnancies if given a choice, however, the majority (72.7%) were unaware of the complications associated with multiple pregnancies.</p> <p><strong>Conclusion</strong>: Efforts to improve the awareness about IVF should be adopted to increase the uptake of the IVF services.</p> <p><strong>Keywords</strong>: IVF, awareness of IVF, infertility, Nigeria </p> 2021-06-02T00:00:00+00:00 Copyright (c) Breast Sonography: A Review of the indications and findings in Oghara, Nigeria 2021-06-02T14:07:55+00:00 Joyce E. Ikubor Oghenetejiri D. Ogholoh Nicholas Kogha Anthony O. Ogbeide Afeyodion Akhator <p><strong>Background:</strong> Breast sonography is the first line imaging tool for evaluating the symptoms and signs of breast disease. Different symptoms of breast disease will warrant the referral for a breast sonogram. Breast sonography is particularly useful as an imaging tool for young women with “mammographically” dense breast as the sensitivity of mammography for detection of breast cancer is reduced for such age groups. This study aims to review the indications for breast sonography and the pattern of sonographic diagnosis of breast lesions seen in Radiology Department, Delta State University Teaching Hospital, Oghara over a period of 5 years.<br><strong>Methods</strong>: The Radiology request forms and breast ultrasound scan reports of patients who presented to the Radiology department from 2012 to 2016 were retrieved and studied<br><strong>Results</strong>: A total of 240 patients with a mean age of 36.34 ±15.3 were examined during the study period. Females formed 95.2% of the study population while males were 4.8%. The patients were referred for breast sonogram due to varying complaints of lump or mass, pain and nipple discharge etc. Breast mass was the commonest complaint of 183 (68.0%) patients while the commonest provisional and radiological diagnosis of the patients who presented with breast lumps was fibroadenoma which was seen in 65 (27.1%) of the patients. Only one (0.4%) patient was referred for screening.<br><strong>Conclusion:</strong> Lumps in the breast are common symptoms in women warranting referral for breast sonography which should be the first line investigative imaging tool for various complaints of breast diseases in young women. </p> <p><strong>Key words</strong>: Breast, lump, sonography, mammographically dense </p> 2021-06-02T00:00:00+00:00 Copyright (c) Gestational age at booking for Antenatal Care and the pregnancy outcome at Faith Alive Hospital, Jos, Nigeria 2021-06-02T14:16:32+00:00 Charles U. Anyaka Tinuade A. Oyebode Uche A. Akunaeziri Chidozie F. Obi John Onyeji Chinedu A. Idoko Chinedu C. Ekwempu Christian O. Isichei <p><strong>Background:</strong> Early initiation of antenatal care is believed to improve maternal and foetal outcome. We sought to ascertain gestational age at booking and the outcome of these pregnancies at a faith based hospital in northern Nigeria.</p> <p><strong>Methods:</strong> A retrospective descriptive study of patients who booked for antenatal care at the Faith Alive Hospital, Jos, st st Nigeria between 1 January, 2010 to 31 December, 2017 was done. Information regarding demographics, gestational age at booking and outcome of these pregnancies were analyzed.</p> <p><strong>Result:</strong> During the study period, 3739 women registered for antenatal care. Majority of women were 20-24years (n= 1252 , 33.5 %) while The mean age was 28 ± 4years Of these women, 96.2% were married , 75.2% were Christians, 43.8% had secondary level of education and 41.2% were traders. st Furthermore, 23.2% of the clients booked in the 1 trimester in 2010, decreased to 17.3% in 2012 but progressively increased to 35.2% , 40.2% and 53.4% in 2014, 2015 and 2017 respectively. There was a significant statistical association between parity, marital status and educational status with late booking for antenatal care. Clients who booked late for antenatal care had poorer neonatal outcomes (low birth weight, still births and birth asphyxia) compared to those who booked early.</p> <p><br><strong>Conclusion</strong>: Late initiation of antenatal care is common in our environment and associated with poorer neonatal outcomes.&nbsp; Nonetheless, a progressive improvement in early bookings was noticed with improved pregnancy outcome.</p> <p><strong>Key Words:</strong> Gestational age, booking, pregnancy outcome, Faith Alive, Jos </p> 2021-06-02T00:00:00+00:00 Copyright (c) Hepatic Sonographic findings at the Jos University Teaching Hospital, Nigeria 2021-06-02T14:59:16+00:00 Abdul J. Salaam Kuleve O. Iyua Benjamin O. Egbo Samuel M. Danjem Adama A. Salaam Emmanuel O. Igoh Anthony E. Gabkwet Hadijat O. Kolade-Yunusa Yetunde F. Taiwo <p><strong>Background:</strong> Ultrasound examination is considered to be a very useful imaging modality for the diagnosis of hepatic diseases. Its major advantage is the avoidance of ionizing radiation exposure. However, it is operator dependent and less accurate when compared with Computed Tomography. The present study describes hepatic sonographic findings in patients referred to the radiology department for ultrasound examination based on clinical suspicion of liver disease.</p> <p><strong>Methods</strong>: This observational descriptive study was conducted between June 2019 and April 2020 at Department of Radiology, Jos University Teaching Hospital, Jos, Nigeria. Two hundred and twenty seven patients with clinical features suggestive of hepatic disease and referred to the department for ultrasound examination were enrolled. Ultrasonography was done using a LOGIQ V duplex Doppler ultrasound machine with 3.5-5 MHz curvilinear transducer</p> <p><strong>Results</strong>: The age of the patients ranged from 0 to above 60 years. Out of 227 patients studied, 48% were males and 52% were females. Decompensated chronic liver disease and chronic liver disease (CLD) dominated the indications for hepatic ultrasound scan with 23.3% and 19.4% respectively. The predominant pathological ultrasonic liver finding reported was chronic liver disease, accounting for up to 48% in frequency. This was followed by Hepatitis (16.3%) and Liver cirrhosis (13%).</p> <p><strong>Conclusions:</strong> The various indications and findings of liver ultrasonographic evaluation have been established by this study with chronic liver disease being the commonest indication for sonographic evaluation of the liver as well as the commonest finding.</p> <p><strong>Keywords:</strong> Hepatic, Jos, North-Central, Nigeria, ultrasound </p> 2021-06-02T00:00:00+00:00 Copyright (c) The value of dynamic (triphasic) computed tomography in differentiating malignant and benign portal vein thrombi using thrombus density 2021-06-02T14:28:41+00:00 Samuel M. Danjem Abdul S. Jimoh Gabkwet A. Epga Emmanuel O. Igoh Yetunde F. Taiwo Hadijat O. Kolade-Yunusa <p><strong>Background</strong>: Portal vein thrombosis (PVT) is the development of thrombus in the main trunk of a portal vein and its intrahepatic right and left branches. Malignant PVT typically arises from invasion of hepatocellular carcinoma into the portal vein of patients with liver cirrhosis. In contrast, bland PVT is attributed to sluggish portal venous flow in cirrhotic patients with portal hypertension. The study was to determine the diagnostic performance of Triphasic CT imaging using thrombus density in differentiating malignant from benign<br>portal vein thrombi.<br><strong>Methods</strong>: In this retrospective study, 46 patients with PVT who had contrast-enhanced Triphasic CT of the abdomen were evaluated for PVT. The assessment was performed by measuring the CT attenuation values of the thrombi in Hounsfield Units (HU). ROC (Receiver Operating Characteristic) curves were used to identify accuracy and optimal cutoff values.<br><strong>Results</strong>:Out of the 46 CT studies, 32 neoplastic thrombi and 14 bland thrombi were identified on the images. All patients with malignant thrombosis showed contrast enhancement while all patients with bland thrombi demonstrated no contrast enhancement. Contrast enhanced CT showed thrombi density sensitivity of 93.8%, specificity of 100% and accuracy of 95.7%. The AUCs was 0.539 in precontrast and 0.996 in portovenous phase for thrombus density. The optimal cut off in precontrast was 28.5 and in porto-venous phase was 59.0.<br><strong>Conclusion</strong>: Estimating thrombi density with triphasic dynamic CT may represent a vital tool for reliable differentiation of neoplastic from bland thrombi in patients with PVT.</p> <p><strong>Key Words</strong>: Dynamic CT, Differentiating Benign, Malignant, PVT. </p> 2021-06-02T00:00:00+00:00 Copyright (c) Knowledge and practice of Health Care Workers regarding radiographic imaging in women of reproductive age group at Aminu Kano Teaching Hospital, Kano 2021-06-02T14:35:25+00:00 Muktar A. Gadanya Amina Y. Ali Anas Ismail <p><strong>Background</strong>: Current clinical practice in many developing settings often requires the use of ionizing radiation for diagnosis. However, there are potential hazards when women of reproductive age are subjected to ioninzing radiation and healthcare workers should have safeguards to prevent unsafe exposures as they may relate to pregnancy. This study aimed at assessing the knowledge, perception of risk and safeguards involved in radiographic imaging of women of reproductive age group by healthcare workers at Aminu Kano Teaching Hospital, (AKTH), Kano, Nigeria.<br><strong>Methods</strong>: This was a cross sectional descriptive study of 202 doctors, radiographers and physiotherapists in AKTH using a pre-tested self-administred questionnaire. Additionally, 117 radiological investigations request forms were reviewed for women within the reproductive age group only for imaging modalities that utilize ionizing radiation taken in AKTH.<br><strong>Results</strong>: Majority of the respondents underestimated the fetal doses from conventional X-ray imaging modalities. Only 20% of respondents suggested that the risk to the fetus begins at radiation dose of 10mGy. Only 16% of the radiological forms reviewed had the column for last menstrual period completed with the required information on radiological request forms despite 97.9% of respondents indicating the use of last menstrual period as a means of screening for pregnancy. There was no relationship between the knowledge of guidelines on when/how to screen for pregnancy with respondents years of service (p= 0.475).<br><strong>Conclusion</strong>: The overall knowledge of healthcare workers regarding safe radiation fetal doses was inadequate. The level of compliance with guidelines stating when and how to screen for pregnancy was poor.</p> <p><strong>Key words</strong>: ionizing radiation, pregnancy, knowledge, safeguards, healthcare workers</p> 2021-06-02T00:00:00+00:00 Copyright (c) Intraorbital meningioma in a Young African Female: A case report 2021-06-02T14:40:35+00:00 Philip O. Akpa Barka V. Kwaghe Panshak E. Tenmang Alice A. Ramyil <p><strong>Background:</strong> Meningiomas are tumours that arise from arachnoid cap cells of the meningeal arachnoid villi. Intraorbital meningiomas account for a small percentage of all intraorbital tumours and can either arise primarily from within the orbit or secondarily invade the orbit from the intracranial cavity.<br><strong>Presenting Complaint/Investigations</strong>: We present a case of a 30 year old woman who presented with a 1 year history of gradual protrusion of the left eye, deteriorating vision and restriction of eye ball motility. A CT scan showed a soft tissue mass in the left lower orbit with a smooth outline, displacing the eyeball antero-superiorly and distinct from surrounding structures.<br><strong>Diagnosis/therapeutic intervention/outcome</strong>: Surgery was done with the removal of a well circumscribed mass from the lower quadrant of the orbit via a transverse incision in the inferior conjunctival fornix. Pathological examination revealed a well circumscribed encapsulated mass with grayish white cut surfaces. Histological examination revealed a meningothelial meningioma WHO grade 1. Patient did well postoperatively with marked improvement of vision and restoration of orbital anatomy.<br><strong>Conclusion:</strong> The diversity of subtypes and grades of meningioma encountered within central nervous system is not usually&nbsp; encountered in primary intra-orbital meningiomas, most cases of intra-orbital meningioma are benign. Surgical removal of intra-orbital meningiomas is difficult and recurrence is common if surgical excision is incomplete. The index case appears to be completely excised.</p> <p><strong>Keywords:</strong> Intra-orbital Meningioma, Meningothelial, Ectopic </p> 2021-06-02T00:00:00+00:00 Copyright (c) Accidental discovery of Unicornuate uterus during laparotomy for ruptured uterus: A case report 2021-06-02T14:45:55+00:00 Felix A. Elachi Olusesan S. Salam Victor C. Pam Amaka N. Ocheke Christopher O. Egbodo <p><strong>Background</strong>: Unicornuate uterus is one of the congenital anomalies that results from hypoplasia or agenesis of the Mullerian ducts. Its incidence is not well established due to varied classification systems. It is commonly diagnosed during evaluation for recurrent pregnancy losses and dysmenorrhoea. Some are diagnosed accidentally during Caesarean sections and laparotomies. This case is unique as she had previous recurrent pregnancy losses and a failed cervical cerclage in her th 4 pregnancy. She also had a Caesarean section in this facility in the past but proper diagnosis of her condition had not been made prior to the index pregnancy. Case&nbsp; presentation We report a unicornuate uterus accidentally diagnosed during laparotomy for a ruptured unicornuate +3 uterus in a 29 year ol3d G7P3 2A at a gestational age of 35weeks and 2days. She had laparotomy with delivery of a fresh still born. There was an oblique rupture in the lower segment of the unicornuate uterus involving part of the previous incision. She had repair of the&nbsp; unicornuate uterus because she insisted on her desire for future reproduction.<br><strong>Conclusion:</strong> Clinicians should always consider congenital uterine anomalies as one of the causes of recurrent pregnancy losses especially where cervical cerclage fails. Exhaustive evaluation of patients like this with 3D-ultrasonography and hysterosapingography in the preconception period will help to identify this anomaly. There is need for meticulous intraoperative examination of the pelvic and abdominal organs to forestall missing anomalies such as this.</p> <p><strong>Key words</strong>- Accidental discovery, Unicornuate uterus, Laparotomy, ruptured uterus </p> 2021-06-02T00:00:00+00:00 Copyright (c)