Medicine is a fast evolving even if inexact science. Built in ancient times upon insightful observations of Egyptian, Greek and Arabic physicians [1], its progress was spearheaded by European (mainly British, French, German and Austrian) scientists after the middle ages. If the assignment of Nobel prizes is a guideline is this regard,in the last century the leadership was taken over by the United States. Both physicians and lay persons may be inclined to assume therefore, that the achievements of medical research are utilized in America in everyday practice and that progress runs parallel in all branches of medicine. As far as obstetrics is concerned these assumptions have limited validity at best. During the last century maternal and perinatal mortality rates (recognized indices of the quality of clinical care) were markedly less favorable in the USA than in Scandinavia [2] and some other developed countries. They still lag behind many others at the time of this writing.

Objective: To determine the prevalence and laparoscopic features of endometriosis in women investigated for infertility using laparoscopy and dye test. Methods: This was a retrospective survey at Life Institute for Endoscopy, Limited, Nnewi, Nigeria between January 2006 and December 2008. Data was collected with a pre-designed proforma which included the socio-demographic characteristics and laparoscopic findings in various abdomino-pelvic organs. The data was analyzed using SPSS software version 16 (SPSS for windows, Version 16.0 Chicago: SPSS Inc.).

Introduction: Due to strong religious faith and beliefs against blood transfusions, Jehovah’s Witness patients often pose tight spot for obstetrician-gynecologists. Myelosuppressive effects of chemotherapy in gynecology-oncology settings are additional source of worry. Case Presentation: A 25-year-old P0+1 Nigerian woman presented with subcostal pains, dyspnea and cough productive of bloody sputum of one month duration. There was no vaginal bleeding. She had spontaneous miscarriage and evacuation of retained products of conception twice at another health facility with histology confirming choriocarcinoma. She was anemic and had a Durable- Power-of-Attorney card forbidding blood transfusion. She received Iron dextran and erythropoietin prior to each of three courses of olychemotherapy. Beta-Human Chorionic Gonadotrophin returned to normal 456 days later and had normal pregnancy sixteen months later.

Background:Ovarian granulosa cell tumours are low-grade malignant sex cord-stromal tumours. They represent 2 to 3% of all ovarian cancers and occur mainly within the adult population. Aim: to provide an updated overview on ovarian adult granulosa cell tumours.Patients Methods:in our retrospective study, we reviewed seven cases of adult granulosa cell tumours that were diagnosed at the pathology department of Mongi Slim hospital over a fourteen-year period (2002- 2015). Clinical and pathRIiological characteristics were retrospectively analyzed. Results: The patients of our series ranged in age between 39 and 64 years (mean = 53 years). The most common presenting symptom was abnormal uterine bleeding (n=5) followed by pelvic pain (n=4). All patients underwent surgical treatment including total hysterectomy with bilateral salpingo-oophorectomy (n=4), hysterectomy with right salpingo-oophorectomy (n=1) and salpingo-oophorectomy (n=2). Histopathological examination of the surgical specimen confirmed the diagnosis of adult granulosa cell tumour in all cases.

The December 2, 2015 issue of the “American Medical Association Morning Rounds” reminded me to this old dictum. It announced that as a result of coordinated efforts by several national health care agencies, the rate of hospital acquired conditions diminished by 17% during the years of 2010 - 2014. With the exception of side effects of drugs, the “hospital acquired conditions” were invariably infections: “Urinary tract infection, central line associated blood stream infection, pressure ulcer and surgical site infection”. It was calculated that this endeavor saved 87,000 lives and $ 20 billion in healthcare costs. My calculation is slightly different. In my mind this ambitious project failed to prevent almost 400,000 lives and allowed $100 billion taxpayers’ money to be wasted. The pamphlet cites the comment of Dr. Richard Kromik, director of one the participating organizations. It seems to reveal that deep down in their souls the investigators felt that something was missing from their announcement: “We are still trying to understand all the factors involved.”