Preterm premature rupture of membranes (PPROM) complicates 3-8 percent of pregnancies and leads to one third of preterm deliveries. It results in increased risk of prematurity and leads to perinatal and neonatal complications with risk of fetal death. This article aims to determine the incidence and management outcome of PPROM in Enugu, Nigeria over a ten year period. This was a retrospective review of management outcome of PPROM at the UNTH Enugu from January 1 st 1999 to December 31 st , 2008. The frequency of 3.3% for PPROM and 7% perinatal death were recorded over the period. Preterm PROM is a major complication of pregnancies. Currently, there is no effective way of preventing spontaneous rupture of fetal membranes due to ignorance of its aetiology, with consequent inability to control its incidence. However, it is important that women be well informed regarding maternal, fetal and neonatal complications regardless of controversies of its management.

There has been a decline in operative vaginal delivery world-wide. Vacuum extraction has largely replaced forceps delivery in our low resource setting and in the developed countries, but the teaching and exposure of this procedure is still on the decline. There is a need for enhanced teaching and exposure of operative vaginal delivery and mastering of the procedure in our centers by the residents in training. Review of the pertinent literature and studies on operative vaginal delivery, selected references, internet services on operative vaginal delivery. Earlier studies on operative vaginal delivery showed that vacuum extraction has been the procedure of choice. The rates reported from developed countries were much higher than the rates reported from Nigeria. Vacuum extraction rates of 1.5% from Zaria, 1.7% from Maiduguri, 1.6% from Ilorin and 3.5% from Benin City all in Nigeria. At the University of Nigeria Teaching Hospital, Enugu-Nigeria, ventouse is popular with rates of 3.1% in 1980, 3.5% in 2001, and 1.5% in 2006, but still on the decline. Vacuum extraction is safe and effective practice in our poor resource setting. There is a need for enhanced teaching and exposure of residents in training because widely divergent situation can exist; facilities and adequate back up for caesarean section may not always be available in our poor resource setting.

Worldwide, vaginal route is the gynaecologist's route of surgery. However, abdominal route is the favoured route of hysterectomy in Nigeria inspite of the advantages of vaginal route. This descriptive review is to awaken interest in the teaching and surgical exposure of residents in obstetrics and gynaecology in the field of vaginal surgeries. The ratio of vaginal hysterectomy to abdominal hysterectomy in Nigeria ranges from 1:4 to 1:9. The frequency of vaginal hysterectomy in centres in Nigeria ranges from 10-23%. These rates are lower than the figures quoted from the United States (25%), France (50%), Australia (40-50%) and Saudi Arabia (28%). Vaginal hysterectomy is under-utilized in Nigeria. Most centres hardly do up to five vaginal hysterectomies in a year. Residents in training hardly perform vaginal hysterectomy and may not have watched or assisted in up to ten vaginal hysterectomies before the residency programme is completed. This is completely inadequate for acquisition of proficiency. There is inadequacy and under exposure of residents in the art of vaginal surgeries in Nigeria. There is need for workshops, training and retraining of residents in the field of vaginal surgeries to meet these challenges. This would ensure production of quality gynaecologists with skills and proficiency in vaginal surgery.

This study concerns the relationship between service quality dimensions and customer satisfaction with online/ebanking services of Nigerian banks. Seven service dimensions were included in the study and they are: reliability, assurance, responsiveness, perceived risk, tangibility, security, and price. The study was based on a sample 400 respondents out of which 258 responded to the questionnaire. The seven service quality variables and the dependent variable were all measured with a number of items each using seven-point Likert

The prevalence of uterovaginal prolapse was 3.4%. Thirty three (66%) of them were postmenopausal. Multiparity was a significant determinant as 74% of them were grandmultiparous. The commonest symptom was "something coming down the vagina" in 96% of the study subjects. Second degree prolapse was the commonest type of presentation (48%) and the definitive treatment modality was vaginal hysterectomy with pelvic floor repair (44%). Multiparity, prolonged labour and unsupervised deliveries are significant determinants. Uterovaginal prolapse is primarily a common gynaecological condition of the parous and elderly postmenopausal women associated with a decreased body image and quality of life. Education of women, women empowerment, effective antenatal care, supervised hospital deliveries, and limiting the family size by efficient contraception deserve priority attention to prevent this social malady.