Braithwaite Memorial Specialist Hospital Research Articles

Evaluation of Total Protein in Malaria Parasitaemia

Malaria endemicity is most common in the tropical region, continuous transmission still occurs in about 85 countries and regions. The liver is very essential in overall body physiology and it plays a very important role in the life cycle of malaria and its function may be altered due to malaria parasitaemia. This cross sectional study was aimed at evaluating the level of total protein in malaria parasitaemia among children attending Braithwaite Memorial Specialist Hospital, Palmars, Omega Children Hospital, Early Breed Group of Schools, St Francis Nursery and Primary school and Staff Nursery and Primary school in Port Harcourt, Rivers state Nigeria. Of the 1000 subjects within 1-10 years, 694 subjects had malaria parasitaemia while 306 subjects had no malaria and thus made up the control group. Venipuncture technique was used to collect samples for estimation of malaria parasite density and total protein (TP) using biuret method. The results showed low (873.8±30.44), moderate (3248±109.31) and high malaria (24813.8±877.22) densities with TP values of 42.70±0.50g/l, 43.21±0.60g/l and 39.64±0.60g/l respectively. There was a significant difference (P-value<0.05) in total protein (TP) levels among various groups of malaria densities. This study has shown that the impact of malaria on the liver health vary depending on the level of the infestation.

Clinical Correlates of Type 2 Diabetic Patients with Erectile Dysfunction Attending the Family Medicine Clinic in a Southern State of Nigeria

Aims: This study aimed to provide evidence on the clinical correlates of type 2 diabetic patients with erectile dysfunction leading to improved quality of life. 
 Study Design: Cross-sectional study.
 Place and Duration of Study: Family Medicine Clinic of Braithwaite Memorial Specialist Hospital (BMSH) [now Rivers University Teaching Hospital] Port Harcourt. The data was collected from January 2012 to April 2012.
 Methodology: This hospital-based study was conducted on 324 male type 2 diabetic patients using systematic random sampling. The data were collected with a structured questionnaire; and the level of erectile dysfunction was measured using the international index of erectile function. Data was entered and analyzed using SPSS version 16. Logistic regression was employed to test associations between independent and outcome variables.
 Results: Three hundred and twenty-four patients enrolled for the study. Only 31 participants (9.5%) had normal erectile function while 273 (90.5%) had varying degree of erectile dysfunction. Majority of the participants 205(63.2%) had diabetes above 20 years, more than half (64.9%) had poor glucose control, 169(52.1%) were overweight, while 284(87.6%) had normal cholesterol level and 186(57.4%) with elevated diastolic blood pressure. Duration of diabetes and diastolic hypertension were the only factors associated with erectile dysfunction p<0.0001 and p<0.004 respectively.
 Conclusion: This study confirmed a high prevalence of ED in type 2 diabetic male patients especially among those with elevated blood pressure and those living with diabetes mellitus for many years.

Study on Malaria and Haemoglobin Interaction in Pregnant Women

Comparative observational study was carried out on the prevalence of malaria among pregnant women attending antenatal clinics in General Hospital, Bori (GHB) and Braithwaite Memorial Specialist Hospital, Port Harcourt (BMSH). Four hundred women were involved in this study of which two hundred per study location. Pregnant women with pyrexia of unknown origin, HIV and those on anti malarial drugs were excluded. Consents were obtained from participants and confidentiality upheld. Ethical approval was obtained from the ministry of health and from the selected health facilities. Sample collection was performed according to the recommended reference guideline for phlebotomy. Collected samples were used to assay for Haemoglobin using cyanomethamoglobin method, and malaria parasite using the Giemsa staining technique. Statistical analysis was performed for percentage, frequency, for descriptive statistics and inferences deduced at p-value=0.05. All statistical analyses were performed using Statistical Package for Social Sciences. Questionnaires were issued to obtain their demographic data. The prevalence of malaria was high among pregnant women with haemoglobin level 8.0–10.9g/dl from BMSH (17.9%) and GHB (35.9%). Infection was not dependent on locality at P-value < 0.05. Awareness of malaria in pregnancy should be supported. Anaemia in pregnancy should be treated and comorbidity of malaria and anaemia in pregnancy should be handled with urgency.

Impact of Malaria among Different Age Groups in Pregnancy in Rivers State

Studies have shown that pregnant women are vulnerable to malaria parasitemia. Unfortunately, less attention has been paid to the effect of age group on malaria parasitemia among this group of subjects. The aim of this study was to determine the most age vulnerable age group of malaria parasitemia among pregnant women. It was a hospital-based study carried out in two selected health institutions in Rivers State. A simple random sampling technique was used to select the areas of study as well as the 400 participants used for the study. A well-structured questionnaire was used to collect the socio-demographic data of the subjects within the age range of 21–40years. Venous blood samples of the subjects were collected from the subjects and examined for the presence of malaria parasites using standard procedures. The results obtained from the health institution located in urban region of Rivers State (Braithwaite Memorial Specialist Hospital) showed the prevalence rate of 36.4% in the group within the age of 21-25 years, 36.1% among age range of 26-30 years, 22.5% for 31-35 years and 23.1% for the pregnant women within the age of 36-40 years. The results obtained from the health institution located at semi-urban region of the state (General hospital Bori) showed prevalence of 44.2%, 23.0%, 35.7% and 41.7% respectively. There was a significant difference the prevalence of malaria among the age groups in both health facilities, P= 0.0001. This study has shown that younger pregnant women especially those in their 20s are more prone to malaria parasitemia than older women in the Rivers State.

The Impact of Malaria on Various Stages in Pregnancy in Rivers State

Malaria parasitaemia has remained an issue of public health concern. The coexistence of malaria and pregnancy is more burdensome with high mortality and other devastating effects on maternal and child health. This cross-sectional study carried out was focused on the impact of malaria among pregnant women attending antenatal clinics in General Hospital, Bori and Braithwaite Memorial Specialist Hospital, Port Harcourt. Four hundred women were involved in this study of which two hundred each from a facility. Pregnant women with pyrexia of unknown origin, HIV and those on anti-malarial drugs were excluded. Simple random sampling technique was used. Primary and secondary data sources were used including the use of a self-structured questionnaire comprising socio-demographic variables and items about gestation and pregnancy history. Statistical analysis involved the use of Statistical Package for Social Sciences version 25 for descriptive and inferential statistics – Chi Square at 0.05 level of significance. Laboratory investigation was according to the recommended standard analytical method for malaria parasite examination. Five milliliters (5mls) of blood was obtained from each subject by venepuncture into EDTA bottles. The samples were used to assay for malaria parasite determination using the Giemsa staining technique. Result revealed that pregnant women in the first trimester had the highest prevalence of malaria; BMSH (43.9%) and GHB (45.5%). Preventive safe practices are recommended including the use of insecticide treated nets, vector control methods and others. Diagnosis and treatment should be done timely especially in the first trimester.

Serum Hepcidin Level among Chronic Kidney Disease Subjects Accessing Healthcare in Braithwaite Memorial Specialist Hospital Port Harcourt

Hepcidin is the major controller of systemic iron homeostasis and the role of the kidney in regulating hepcidin level is vital in the whole process of iron and hepcidin relationship. This study was aimed at evaluating serum Hepcidin level among Chronic Kidney Disease subjects accessing Healthcare in BMSH Port Harcourt Metropolis. The study was conducted in Port Harcourt at Braithwaite Memorial Specialist Hospital among 55 CKD subjects and 33 normal individuals making up the control group. Subjects were selected randomly and 5mls of blood was collected in plain bottle using venipuncture technique for laboratory assessment of hepcidin. Hepcidin was assayed using competitive ELISA method. T-test was used to compare the mean difference oh hepcidin between both groups. Result showed that there was a significant difference in hepcidin level between CKD and control groups; 52.00±36.00ng/ml for CKD group and 16.00±13.00ng/ml for control group, p<0.05. This study has shown that CKD has a significant impact in hepcidin level blood and consequently on iron regulation.

B-RhD-Positive Blood Group Appears Relatively Less Susceptible to Anemia in Sickle Cell Disease Pregnant Women

▪Background: Sickle cell disease in pregnancy accounts for 0.14-0.2% of pregnant women seen in Antenatal clinic in Niger Delta Nigeria.1,2Chronic anemia in SCD during pregnancy could lead to a cascade of maternal and fetal complications. The aim of this study is to assess the various types of ABO blood groups of pregnant SCD women at booking and the severity of anemia. The outcome of this study will help in making recommendations of ABO blood types most suitable to improve the quality of life of SCD patients. This may contribute to guidelines for safe blood transfusion in SCD.Methodology: This was a-ten-year retrospective study of all registered SCD pregnant women seen at the antenatal clinic of Braithwaite Memorial Specialist Hospital (BMSH) Port Harcourt (January 2004- December 2013). Data on gestational age, Hemoglobin (Hb) electrophoretic pattern, Hb concentration and blood group were obtained at booking clinic. Data were analysed using Epi-info version 7.02 by WHO, Geneva Switzerland and CDC, USA.Result: A total of 52 Hb SS pregnant women were seen during the study period. The average booking trimester was the 2nd trimester. 94.2 % (49) were anemic (<11.0 g/dl)3 while 5.8% (3) were non anemic (≥ 11 g/dl). 27.0%, 9.6% and 61.5% were A, B and O rhesus D positive blood groups respectively. No AB blood group was recorded from this study [Table 1]. The O rhesus D positive blood group was significantly more prone to anemia [30 (61.2%)] than other ABO blood groups (X2=50.37; 0.001) [Table 2]. 20% (1/5) of B rhesus D positive and 6.3% (2/32) of O rhesus D positive patients were non-anemic. All A rhesus D positive blood were anemic. The highest prevalence of A rhesus D positive blood group (37.5%) was in 2nd trimester, that of B (20%) and O (66.7%) rhesus D positive blood groups were in 1st and 3rd trimesters respectively [Figure 1].Conclusion: Although most SCD pregnant women in this region are O rhesus D positive blood groups, B rhesus D positive blood group patients appear to be less susceptible to anemia. There is need to carry out more elaborate study on this group of blood.

CONFLICT MANAGEMENT STYLES AND CAREER SATISFACTION IN TERTIARY HEALTH INSTITUTIONS IN RIVERS STATE

This study examines the relationship between conflict management styles and career satisfaction of tertiary health institutions in Rivers State. Research design is cross-sectional survey. Target population for this study comprises of University of Port Harcourt Teaching Hospital and Braithwaite Memorial Specialist Hospital (BMSH). Purposive sampling technique was used. Total accessible population for this study consists of 608 medical doctors, nurses and administrative staffs. Sample size is 241 using Taro Yamane formular. Method of data collection is questionnaire. 241 copies of questionnaire were distributed but 200 copies were correctly filled and used for data analysis. Validity was determined using face validity. Cronbach alpha test was used to ascertain the reliability of the instrument. Spearman Rank Order Correlation Coefficient (rho) served as a statistical tool. Statistical Package for Social Sciences (22.0) was used to run the analysis. The study found that conflict management styles have significant relationship with career satisfaction. The study concluded that conflict management styles measured in terms of collaboration style, accommodation style and compromise style enhancecareer satisfaction of health workers in tertiary health institutions in Rivers state. One of the recommendations is that managers should adopt collaboration style of conflict management to resolve disagreement in the organization so as to improve career satisfaction of their employees.

Comparative Seroprevalence and Risk Factors of Toxoplasmosis among Four Subgroups in Port Harcourt, Nigeria

Aims: This study was carried out to investigate the comparative seroprevalence and associated risk factors of toxoplasmosis among four subgroups in Port Harcourt viz: immunocompromised persons (HIV), pregnant women (PTW) and schizophrenics (SZN), using immunocompetent persons (IP) as controls.&#x0D; Study Design: A descriptive cross-sectional study was adopted.&#x0D; Place and Duration of Study: The study was carried out in the University of Port Harcourt Teaching Hospital (UPTH), Braithwaite Memorial Specialist Hospital (BMSH) and Neuro Psychiatric Hospital (NPH) between March 2016 and February 2017.&#x0D; Methodology: A total of 800 (200 from each of the group) samples were collected from subjects from the three hospitals. Study participants of ≥20 years were used in this study. The detection of T. gondii antibodies in examined sera was carried out using ELISA –IgG and IgM assay using standard procedures. Structured questionnaires were used to collect data on social demographic risk factors associated with toxoplasmosis.&#x0D; Results: Out of the 800 (200 per group) examined, SZN recorded the highest seroprevalence of IgG 50%(100)(P.= .05) and IgM 4%(8) followed closely by HIV subjects with seroprevalence of IgG 32%(72) (P=.05) and IgM 2%(3). However, the seroprevalence were not significantly different from that of the immunocompetent control group which had the least seroprevalence. Schizophrenia subjects in age group 20-24 years recorded the highest seroprevalence with (P=.05) The unemployed recorded the highest seroprevalence for SZN with rates of 43% for IgG. More males were infected with the disease than females. Male Schizophrenics recorded a seroprevalence of 20.9%. There was no significant relationship between seroprevalence and demographic factors among subjects.&#x0D; Conclusion: Our findings indicated that toxoplasmosis was relatively prevalent (P=.05) among the studied population, with schizophrenics having the highest seroprevalence. Therefore, incorporating detection of anti-Toxoplasma antibodies in routine testing in our health care centers is recommended for monitoring and control of the disease.

Invivo Impact of Malaria and HIV Co-Infection on CD4 Cell Count of Infected Patients of Niger Delta Extraction

The study evaluated the impact of co-infection of malaria parasitaemia, and HIV positive indices on the CD4 cell count of 120 HIV infected subjects, who were already diagnosed and visiting Braithwaite Memorial Specialist Hospital Port Harcourt for routine Medical check-up. Also, a control group of 40 HIV negative were included as part of the study control group. The subjects were between the age ranges of ≤10–79 years respectively. A double check laboratory assay was conducted to detect the presence of antibody to HIV as confirmed using immunocomb 11 and Determine for HIV status. A thick Blood film stained with field stain (A and B) was used to detect the presence of malaria parasite in the subject’s blood. Furthermore, CD4 cell count was assayed using Partec cyflow counter (Partec, Germany). Excel and Graphpad statistical software were used for analysis of the data generated. The result among the HIV positive subjects and control subjects revealed that the highest positive for malaria infection was observed among ≤10 years age group as 2 (100%) and 11 (84.61%) respectively. In the HIV positive subjects, the distribution of malaria infection among sex revealed a high rate in male 42(77.78%) than in female 44 (66.67%). Similarly, the control recorded a high rate of malaria infection in male 11 (57.89%) than in female 7 (33.33%). However, 86 (71.67%) had malaria and HIV co-infection while 34 (65%) had only HIV mono infection. The positive HIV subjects who had CD4 cells count below 200 cells/mm3 were 15%, above 200-499cells/mm3 were 58.3% while 500 cells/mm3 and above had normal CD4 cells counts for 26%. Nonetheless, for the control subjects, no CD4 cells count of below 200cells/ mm was observed, 2.5% fell within the moderate category while 75% had normal CD4 cells count. Statistical analysis using ANOVA and t-test showed that there is significant difference between CD4 of seropositive and seronegative subjects infected with or without malaria (p=0.00). In addition, a t-test further demonstrated Comparison of Mean CD4 Cell Count among HIV and Malaria Infected and Non-Infected Subjects. MP/HIV Co-Infection and Mono Infection with No Infection showed strong mean difference (p=0.00) in the various CD4 counts while HIV Mono-Infection and others only had a non significant (p=0.44) mean difference between HIV Mono-Infection and No HIV or Malaria Infection. A robust and effective malaria and HIV control management programme should be strongly underpinned; so as to improve the quality of life of patients and HIV patients should be encouraged to live a healthy life style, through the provision of antiretroviral drugs and regular health education engagement, even as the provision of antimalarial treated net would be helpful to the subjects.

Vitamins E and C Concentrations in Anaemia Subjects Attending Braithwaite Memorial Specialist Hospital Port Harcourt

The study was carried out to determine Vitamins E and C concentrations in anaemic subjects attending Braithwaite memorial Specialist Hospital Port Harcourt. Three hundred (300) subjects made up of 150 anaemic patients (77 females and 73 males) age ranging between 15 – 67 years attending the Braithwaite Memorial Hospital (BMH) Port Harcourt and 150 apparently normal healthy individuals (78 females and 72 males) , age ranging between 15 – 67 years were used as controls for this study. The subjects had their Haemoglobin, Vitamins E and C concentrations determined. The results were subjected to statistical analysis using Statistical Package for Social Sciences (SPSS) 22. The result of the study showed that there was significant difference (P &lt;0.05) in haemoglobin concentrations (g/dl) of 13.51±1.14 in healthy subjects compared with 6.77±1.82 in anaemic subjects as shown in Table 1 below. Also the Vitamin E concentration (Mg/l) of 7.82±2.38 was significantly different from 5.33±1.90 in anaemic subjects (P &lt;0.05). The Vitamin C concentration (Mg/dl) of 0.61±0.29 was not significantly different from 0.28±0.16 in anaemic subjects (P &gt;0.05). This study showed that there was significant decrease in Vitamin E concentrations in anaemic subjects.

Lactose intolerance among under five children with malaria in Port Harcourt, Nigeria

This study assessed the occurrence of lactose intolerance among children under five years of age with malaria in Port Harcourt, south-southern Nigeria. One hundred and twenty-four (124) under five children attending paediatric clinics in Braithwaite Memorial Specialist Hospital, Port Harcourt, were selected for the study through purposive and systematic random sampling. Blood samples were collected from heel or thumb prick of the children to determine malaria parasite status while stool samples were collected for stool acidity test to determine lactose intolerance in the children. Data was analyzed on SPSS version 20.0. Results show that among the study children, there were more females (56.5%) and mostly those 2 years of age (26.6%) of which 54.8% were nourished. All the children tested positive for malaria with 53.3% having parasite density of 9000-50000 A–. About 69.4% of these children had acidic stool pH (< 5.5) indicative of lactose intolerance. The study found a significant relationship between malaria parasite density and lactose intolerance (p<0.05). A significant relationship (p<0.05) was also found between nutritional status and lactose intolerance among children with malaria. Malaria infection could predispose to lactose intolerance in children as observed in this study. It is therefore very important that prevention or early diagnosis and treatment of malaria among under-five children should be greatly encouraged to prevent lactose intolerance and its deleterious outcome in children.Keywords: Lactose Intolerance; malaria; under five children, Nigeria.

Changes in Plasma Haemoglobin Concentration in Citrate Phosphate Dextrose Adenine-1(CPDA-1) Stored Blood

Aim: This study assessed the level of plasma haemoglobin concentration in CPDA-1 stored blood with a view to determine the extent of haemolysis during the 35 days storage period.&#x0D; Study Design: This is an observational and comparative case-control study.&#x0D; Place and Duration of Study: The study was conducted using healthy male donors residing in Port Harcourt. Analysis was carried out at the Blood Bank of Rivers State University Teaching Hospital, formerly Braithwaite Memorial Specialist Hospital (BMSH), Port Harcourt, Nigeria, from February 1st to March 8th, 2017.&#x0D; Methodology: Blood for transfusion was collected from prospective male blood donor found to be in good health, aged between 18 and 52 years, with haemoglobin level within the range of 13.5 g/dl – 16 g/dl, body weight within 55 kg – 75 kg, and body temperature within 37.0 to 37.50C / 99.50F, into plastic bags containing anticoagulant CPDA-1, and handled under strict sterile condition to prevent bacterial contamination. The blood was stored in a blood bank refrigerator with a constant temperature of +2 to +60C under proper inspection at intervals for colour, turbidity, haemolysis and clot formation. Two milliliters of the sample was collected aseptically at different interval days of collection from the blood bag and analyzed using the HemoCue photometer.&#x0D; Results: Results showed no significant changes in plasma haemoglogin from day 1, 5, and 10, while significant increase in haemolysis occurred from day 15, 20, 25, 30, and 35 (p = 0.000), a significant increase (p&lt;0.05) in plasma haemoglobin was observed from day 15 to day 35 of storage.&#x0D; Conclusion: It is pertinent therefore to note that the use of CPDA-1 does not completely stop the changes that occur in RBC as there are several changes occurring in stored blood collectively called “storage lesions”. Therefore, it is advisable that blood should be transfused within 14 days of storage to avoid transfusion of blood products that has lost most of its benefits to recipients, and where possible whole blood should be processed and components separated before storage to reduce the level of non-viable red blood cells.

A Retrospective Review of Rifampicin-Resistant Mycobacterium tuberculosis between 2015 and 2017 in Port Harcourt, Nigeria

Background: The diagnosis and treatment of drug resistant tuberculosis (TB) is a significant challenge for the control of TB in Nigeria.&#x0D; Aim: The study was carried out to assess the prevalence of rifampicin-resistant TB at the point of initial diagnosis among subjects suspected of TB.&#x0D; Methods: A retrospective review of Mycobacterium tuberculosis (MTB) and rifampicin resistance detected by GeneXpert™ analysis between 2015 and 2017 in Braithwaite Memorial Specialist Hospital was carried out.&#x0D; Results: A total of 6733 samples were received and analyzed in the period under review, 1252 (19%) were positive for Mycobacterium tuberculosis and 5841 (81%) were negative. The prevalence of Mycobacterium tuberculosis was 24.56%, 20.11% and 16.86% from 2015 to 2017 respectively. There was a significant decline in the prevalence of MTB from 2015 to 2017 (c2 = 33.59, p = 0.0001). Rifampicin (RIF) resistance was 5.42%, 5.86% and 6.22% respectively from 2015 to 2017; but the trend was not statistically significant (c2 = 0.21; p = 0.6418).&#x0D; Conclusion: The study showed that despite a decrease in the prevalence of tuberculosis infection there was an increase in rifampicin resistance from 5.42% to 6.22% between 2015 and 2017. There is an urgent need to improve the management of TB in the Port Harcourt metropolis to improve treatment outcomes and to prevent the proliferation of drug resistant strains.

Distribution of Some Antibiotics Resistance Genes in Multi-drug Resistant E. coli Isolates from the Urogenitals of Women in Port Harcourt, Nigeria

Aim: The problem of antibiotics resistance has assumed a global emergency status. Whereas Multidrug Resistant (MDR) E. coli infection is common among human population in Port Harcourt metropolis of Nigeria, the genetic background of E. coli isolates in our locality is not well elucidated, hence this study.&#x0D; Study Design: This was a randomized study of women, with indications of Urogenital infections, attending Braithwaite Memorial Specialist Hospital (BMSH) Port Harcourt, Nigeria between July and December, 2017.&#x0D; Methodology: Ninety-Seven (97) samples comprising of urine, high vaginal swabs, end ocervical swabs were collected from patients to assess for the presence of some antibiotic resistance genes in multi-drug resistant E. coli. Samples were processed following standard microbiological protocols. Antimicrobial susceptibility test was performed on all E. coli isolates. Following this, all Multiple Drug Resistant E. coli were subjected to polymerase chain reaction (PCR) method for the detection of some antibiotic resistance-encoding genes- SHV, CTX-M, TEM. &#x0D; Results: Seventy-three (73) isolates, including 36 E. coli, were recovered from all the clinical specimens. Twenty-four (24) E. coli isolates were found to be multi-drug resistant. Sulphydryl Variable (SHV) was the most frequent resistant gene and was detected in 15 isolates. This was followed by Cefotaximase (CTX-M) in 10 isolates and Temoniera (TEM) in 5 isolates. Some isolates haboured more than one resistance gene. About 20% of the isolates haboured SHV/CTX-M; 2.5% haboured CTX-M/TEM, while no target was detected in one isolate.&#x0D; Conclusion: This present study revealed that most E. coli isolates from the urogenitals of women within our locality, possess the ESBL genes which confers on them the Multidrug resistant status and this is a major challenge to maternal health.

A 35-year standardized prediction estimates for gynecological lesions in oil and gas exploration and production city in the Niger Delta

Background: The impact of constant emission of hydrocarbons and contaminated water level through oil spillage in the oil and gas exploration and production areas of Niger Delta on women's health cannot be underestimated. We developed a 35-year standardized prediction estimates for gynecological lesions using data obtained from an integrated specialist hospital serving the residence of the oil and gas exploration and production City of Port Harcourt and the surrounding areas of Niger Delta, Nigeria. Methods: The study participants comprised of 697 females who received medical care at the Braithwaite Memorial Specialist Hospital (BMSH), Port Harcourt, Rivers State, Nigeria, between 2010 and 2014. Predictive modeling of the diseases was performed using JMP statistical discovery™ software, version 12.0 (SAS Institute, Cary, NC, USA). Results: The distribution of the gynecological lesions (n = 697) differed significantly (P Conclusion: The over 700% increased prediction of gynecological lesions by 2050 calls for urgent attention by both governmental and private agencies to fund awareness campaigns and screenings for women, especially for those residing in the oil- and gas-producing areas of Niger Delta.

The use of uterine artery doppler indices for prediction of pre-eclampsia in Port-Harcourt, Nigeria.

Pre-eclampsia (PrE), a clinical syndrome characterised by elevated blood pressure arising after 20 weeks of gestation, is a leading cause of maternal death worldwide. We evaluated the role of uterine artery Doppler (UtAD) in screening for PrE among unselected, pregnant women. This was a prospective cohort study of 170 healthy gravid women between 18 and 26 weeks of gestation recruited consecutively from the Antenatal Clinic of Braithwaite Memorial Specialist Hospital, Port-Harcourt, Nigeria, between July 2016 and June 2017. All had UtAD scans with an abnormal result defined as pulsatility index (PI), resistance index or systolic/diastolic (S/D) ratio >95th centile for gestational age or proto-diastolic notching. Outcome was obtained from antenatal records. Data were analysed using Statistical Package for Social Sciences, version 20 at statistical significance level of P < 0.05. The prevalence of PrE was 7.6%. There was significant association between an abnormal PI (χ2 = 16.29, P = 0.00), S/D ratio (χ2 = 8.55, P = 0.00) and the combined result (χ2 = 11.5, P = 0.007) with subsequent PrE. The highest sensitivity (53.8%) was obtained for the combined result with specificity, negative predictive value (NPV) and positive predictive value of 86.6%, 95.8% and 25%, respectively, area under the curve (AUC) of 0.71 (95% confidence interval [CI]: 0.534-0.871). A normal result had a very high NPV for all indices. The accuracy for the prediction of severe PrE was greater for all indices being highest for the combined result AUC of 0.830 (95% CI: 0.624-1.000; P = 0.01). Abnormal UtAD indices were associated with PrE and may be used in PrE screening.

English

The re-emergence and increase in the prevalence of tuberculosis cases and multidrug resistant strains is of public health concern. The conventional Acid Fast Bacilli detection tool is weak in the current disease trend especially in children, patients with human immunodeficiency virus (HIV) and low bacterial load. The aim of this research was to assess effectiveness of the Gene Xpert MTB/RIF assay and Microscopy in detectiing Mycobacterium tuberculosis (MTB) in sputum samples in Port Harcourt metropolis. A total of two hundred sputum samples were collected from tuberculosis (TB) suspected patients visiting the antiretroviral and directly observed short treatment clinics at Braithwaite Memorial Specialist Hospital, Port Harcourt and University of Port Harcourt Teaching Hospital, Choba. These samples were investigated to compare and evaluate the detection of M. tuberculosis using Gene Xpert MTB/RIF assay and microscopy. Results revealed that 20% (40/200) of the samples were positive for MTB. Ages 31 to 40 years had 55 samples with ten positive MTB while ages < 10 years had the least number of specimens and one MTB detected. Out of 200 samples analyzed, the percentage positive was 20% while 80% was negative for MTB. Ages < 10 years did not show any AFB positive smear whereas ages 31 to 40 years had 10 positive AFB smears. One hundred and four individuals were people living with HIV, ninety six were negative for HIV; fifteen individuals were positive for HIV as well as MTB (co-infection) and no individual that was co-infected had Rifampicin resistance. There is a significant difference in the detection of MTB across PLHIV and negative persons using AFB microscopy and Gene Xpert technique. It can be concluded that the gene xpert MTB/RIF assay is highly sensitive (98%) with a p-value of < 0.001 and specific in the detection of MTB and Rifampicin Resistance in sputum, and its use in health institutions should be encouraged to reduce exposure and spread of the disease as well correct treatment. Key words: Gene xpert, tuberculosis, Mycobacterium tuberculosis/Rifampicin (MTB/RIF), sputum, microscopy.

Relationship between ABO Blood Groups and Lipid Profile Level in Healthy Adult Residents in Port Harcourt Metropolis, Nigeria

A multitude of risk factors are responsible for development of cardiovascular diseases (CVDs) and association of cardiovascular disease risk factors with the ABO blood antigens is increasingly being reported. Thus, this study was designed to investigate the relationship between ABO blood groups and lipoprotein profiles of apparently 150 healthy adult patients attending Braithwaite Memorial Specialist Hospital, Port Harcourt, Nigeria following due consent to participate in the study. The serum TC, HDL-C, LDL-C and VLDL-C levels were determined by standard methods. ABO blood grouping was carried out by standard tile technique. Results show that the mean of the TC and LDL-C of most of the subjects in all the blood groups appeared desirable (&lt; 5.81 mmol/L and &lt; 3.37 mmol/L) respectively in both males and females. HDL-C was deficient in all blood groups both in males and females while the triglycerides level in the subjects was desirable (&lt; 2.83 mmol/L). While significant variation (p&lt;0.05) was observed between the means of the blood groups in the females, no such variation was seen the males. Strong positive correlations were observed between the lipoproteins in blood group B, AB and O females. As a result of the fact the rate of prevalence of CVD in our population is increasing, it is recommended that diagnosis, management and treatment of CVD in Nigeria should take into consideration the blood group status of the subjects.Key Words: Lipoproteins, Blood groups, cardiovascular diseases, triglycerides

The preponderance and dye-tissue receptive variability analyses of malignant and benign lesions of the female genitalia

Abstract Background Benign and malignant lesions of the female genitalia are of great concern worldwide. The roles of dyes to aid identification of diagnosis in these two classes of lesions are of importance. The aim of this research was to determine the prevalence of malignant and benign lesions in the female genitalia and their receptivities to seven histochemical dyes. Materials and Methods Six hundred and thirty two (n = 632) gynaecological malignant and benign lesions data collected from the archives of the Histopathology Laboratory of Braithwaite Memorial Specialist Hospital (BMSH), Port Harcourt, Nigeria between 2010 and 2014 were used for this study. The representative tissues were sectioned and stained with Haematoxylin and Eosin (H&E), Masson's Trichrome (MT), Periodic Acid Schiff (PAS), Phosphotungstic Acid Haematoxylin (PTAH), Southgate Mucincamine (SGM), Alcian Blue (AB) and Verhoeff Van Gieson (VVG) dyes. Results We identified 601 (95.1%) benign and 31 (4.9%) malignant lesions during the 5-year period. The mean and standard deviation (±SD) of patients' age associated with the malignant and benign tissues were 47.7 ± 16.7 and 37.3 ± 11.2 years. There were significant (p 0.05). Stain analyses revealed significant variations in the receptivity of the seven dye-tissues with the mean % area for benign lesions ranging from 38.94 ± 10.60% in SGM to 64.51 ± 12.04% in MT and those of malignant lesions ranging from 37.64 ± 17.71% in AB to 63.95 ± 8.94% in MT. Similarly, intensity measurements for benign lesions ranged from 81.76 ± 13.96 points (pts) in MT to 161.39 ± 17.23 pts in AB compared to malignant lesions, which ranged from 78.04 ± 25.73 pts in MT and 167.75 ± 12.62 pts in AB. Conclusion Our study reported the preponderance of benign lesions than malignant lesions in the sample population. Comparatively, MT exhibited the best dye-tissue receptivity in both benign and malignant lesions than the baseline dye (H&E) and remains a valuable tool for the diagnosis of gynecological lesions.