This work was carried out to study the association between lifestyle, health-care practices and incidence of recurrent vulvovaginal candidosis (RVVC) among young women in south eastern Nigeria. It was a multicentre case-control study of 176 women aged between 20 and 35 years recruited from the designated health facilities. Lifestyle and health-care practice structured questionnaires were used to survey the participants. Clinical examination was performed and vaginal swabs were taken from participants for microscopy, culture and sensitivity. The germ tube test was performed for identification of Candida albicans. The results of this study showed that frequent douching with water or other fluids (odds ratio [OR](adjusted) = 2.41, 95% confidence interval [CI] = 1.25-4.66, P = 0.000), wearing tight nylon/synthetic underwear (OR(adjusted) = 4.76, 95% CI = 2.28-9.95, P = 0.000), alternative medical treatment for repeated or recalcitrant cases (OR(adjusted) = 4.84, 95% CI = 2.94-15.91, P = 0.000), were significantly associated with higher odds for RVVC and self-diagnosis and use of over-the-counter antifungal medications (OR(adjusted) = 4.61, 95% CI = 2.29-9.32, P = 0.000) were associated with RVVC. Results of the fungal cultures showed that C. albicans and non-C. albicans were isolated from 83.7% and 16.3% of participants, respectively. Our results supported the association between some of the hypothesized risk factors and the occurrence of RVVC.

The use of phosphodiesterase-5 inhibitors (PDE5i) and tramadol in the absence of erectile and ejaculatory dysfunctions in Nigeria has become a norm. In this study, we comparatively assess the effects of chronic use of these drugs on hepatotoxicity. Fifty male albino wistar rats weighing 180-200g were randomly assigned into 5 groups (n=10) as follows; control, sildenafil (1mg/100g b.w), tadalafil (1mg/100g b.w), tramadol (2mg/100g b.w) and sildenafil+tramadol treated group (1mg/100g and 2mg/100g b.w, respectively). Drugs were orally administered, once, every two days for 8weeks, at the end of which five animals were sacrificed per group (batch 1), while the remaining five animals per group were allowed for another 8weeks without drug administration (batch 2). Serum concentration of liver enzymes (AST, ALT and ALP) and bilirubin were assessed in both batches. Serum concentrations of AST, ALT, ALP, total bilirubin and unconjugated bilirubin were significantly (p<0.001) increased in all treated groups (batch 1), while conjugated bilirubin concentration was significantly (p<0.001) reduced in all treated groups, compared with control. Serum concentrations of AST and ALT were significantly reduced in sildenafil (p<0.01), tadalafil (p<0.05), tramadol (p<0.001) and sildenafil+tramadol (p<0.001) recovery groups, compared with their treated groups. Total and unconjugated bilirubin fractions were significantly (p<0.05 and p<0.01, respectively) reduced in tadalafil recovery group, compared with the treated group. Sildenafil+tramadol recovery group showed significantly (p<0.001) reduced total and unconjugated bilirubin concentrations, compared with the treated group. Chronic administration of PDE5i and tramadol reversibly altered liver functions.

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Several undesired effects following chronic use of phosphodiesterase-5 inhibitors (particularly, sildenafil and tadalafil) and opioid (tramadol) have been reported. This study assessed the effect of chronic administration of sildenafil, tadalafil, tramadol and sildenafil+tramadol (as used in Nigeria today), on serum lipid profile (cardiovascular risk assessment), since alterations may not be easily discernable by their users. Fifty male albino wistar rats weighing 180-200 g were randomly divided into 5 groups (n = 10), thus; control (0.2 mL normal saline), sildenafil treated (10 mg kgG 1

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