Irrua Specialist Teaching Hospital Research Articles

Using motivational interviewing to improve sleep quality among patients with hypertension attending a tertiary hospital in southern Nigeria: a randomized controlled trial

IntroductionRestorative sleep is essential for the maintenance of overall health and for the prevention of chronic diseases, including hypertension. The aim of this study was to determine the effect of motivational interviewing (MI) on sleep quality in patients with hypertension.MethodsThe study was a randomised controlled trial (PACTR202301917477205) of 250 adult patients aged 18 to 65 years (125 in each group) with hypertension presenting to the Family Medicine Clinics of Irrua Specialist Teaching Hospital, Irrua, Nigeria from April to December 2023. Patients were selected through systematic random sampling and randomised into intervention and control group with the intervention group having monthly sessions of motivational interviewing in addition to standard care for hypertension and the control group having standard care only. Data were analysed with Stata with level of significance set at p < 0.05.ResultsThe participants had a mean age of 51.5 ± 10.0 years, were mostly females 156 (62.4%), married 135 (54.0%), and Christians 134 (53.6%). There was no significant difference in the sleep pattern of both the intervention and control groups (χ2 = 1.111 and p = 0.292) at baseline. Post-intervention with MI, there was a significant improvement in sleep quality (p = 0.002) and a corresponding improvement in blood pressure control (p < 0.001) of patients in the intervention group compared to controls.ConclusionThe use of motivational interviewing led to a significant improvement in sleep quality and a corresponding improvement in blood pressure control. Motivational interviewing should be employed by physicians and other health workers during sleep prescription counselling.

Electroencephalography in emerging viral infections: Lessons learned from implementing an EEG unit in a Lassa fever isolation ward in Nigeria.

Electroencephalography (EEG) has been used for almost a century in well-equipped medical centers to facilitate the diagnosis of epilepsy and other brain disorders. Lassa fever (LF) and other emerging viral infections (EVI) are known to cause neurological complications, including meningitis, seizures, and encephalopathy, though to date it remains unclear whether these are secondary to metabolic disturbances caused by the disease or by direct involvement of the central nervous system (CNS). To better characterize how Lassa virus (LASV) affects the CNS, we established an EEG diagnostic unit in the LF isolation ward at Irrua Specialist Teaching Hospital in Edo State, Nigeria. Here, we report on the specific difficulties to successful implementation of EEG in this highly challenging setting. Technical artefacts due to electrical interferences and interrupted power supply, artefacts deriving from a partly improvised EEG setup within a high consequence pathogen isolation ward, and environmental factors, such as heat in the endemic West African setting are among the main difficulties encountered when setting up this diagnostic facility. It takes experienced neurophysiologists to distinguish such artefacts from actual EEG abnormalities as many of them are not commonly encountered to this extent in well-equipped EEG laboratories and can easily be confused with pathologies. The EEG recording process is further complicated by biosafety considerations and the necessity of wearing extensive personal protective equipment. Nevertheless, with the help of experienced neurophysiologists, it is possible to correctly set up the facility and interpret recordings. Taking the above into consideration, EEG is valuable in identifying CNS involvement in emerging infections, particularly regarding assessment of encephalitis, differential diagnosis of impaired consciousness and treatment adjustment in patients with symptomatic seizures. Although highly challenging under these circumstances, EEG can be an important, noninvasive diagnostic tool for neurological complications in EVI where other more advanced imaging modalities are not available.

Modern Technology in Nursing, its Impact and Role in Improving Maternal and Child Health among Nurses in Irrua Specialist Teaching Hospital, Esan Southeast, Edo State, Nigeria

Modern Technology in Nursing, its Impact and Role in Improving Maternal and Child Health among Nurses in Irrua Specialist Teaching Hospital, Esan Southeast, Edo State, Nigeria

Influence of health education and physiotherapy on functional independence among Nigerian stroke survivors

This study was carried out to compare the effectiveness of physiotherapy and combined health education and physiotherapy intervention on functional independence among Nigerian stroke survivors. A total of 50 stroke survivors in University of Benin Teaching Hospital (UBTH) and Irrua Specialist Teaching Hospital (ISTH) were divided into the control (ISTH) and experimental group (UBTH) which were made up of 25 participants each. The experimental group were administered a combination of health education and structured physiotherapy programme while the control group were administered only structured physiotherapy programme. Analysis of co-variance (ANCOVA) was used to test the hypothesis. Bonferroni post-hoc test was used to identify the source of the difference between the groups. Statistical significance was accepted for p value of &lt;0.05. Findings showed that there was improvement in the Functional Independence Measure (FIM) following combined health education and physiotherapy from 32.08 ± 1.10 to 112 ± 1.75. Also, there was improvement in FIM following only physiotherapy from 33.20 ± 1.15 to 55.64 ± 1.81. However, there was an adjusted mean difference of 57.031 ± 2.53 in FIM between the experimental and control group. A variance of 91.5% in FIM was accounted for health education. It is therefore concluded that a combination of physiotherapy with health education is the best approach to substantially optimize the functional independence of Nigerian stroke survivors.

Aesthetic Surgery &amp; the Indications at A Sub-Urban Tertiary Hospital in Edo State, Nigeria

Background: Aesthetic surgery though growing at an exponential rate in developed countries is still not well developed in Nigeria. Though lately, there has been an increasing demand for cosmetic procedures in Nigeria but still, the practice is still slow growing. Objective: Few reports of the scope of aesthetic surgery are available from the sub region and Nigeria as a whole. In this study we seek to determine the aesthetic procedures and its indications in our centre, a sub urban teaching hospital in Irrua, Edo State, Southern Nigeria. Methods: A retrospective study of all aesthetic surgery cases carried out over a 5-year period – Jan 2019 to December 2023 at Irrua Specialist Teaching Hospital. Data from theatre records and case notes were analysed with respect to age, sex, procedure and indications for surgery done. Descriptive analysis of variables, means and percentages were considered. Results: In the period of study, 1,066 plastic surgery procedures were documented: 34 (3.19%) were for aesthetic indications. Sixteen of the patients (47.1%) were male and 18 (52.9%) female. Age range of patients that had aesthetic surgery was 1 - 60 years and the mean age was 24.1 + 18.08 years. The commonest aesthetic procedure was cleft repair 14 (41.17%) following cleft lip/palate, the rest were scar revisions 6 (17.65%) with the commonest indication being unsightly scar, otoplasties 5 (14.70%) following traumatic injury to the ear, liposuction 3 (8.82%) indicated by lipodystrophy, rhinoplasties 3 (8.82%) post traumatic injury to the nose, mammoplasties 2 (5.88%) which were done post mastectomy, and one (2.94%) cranioplasty following gun-shot orbital injury. Conclusion: There is paucity in the volume of cosmetic procedures in Irrua and the pattern of requests here differs in many respects from western centres. With the current reduced pool of aesthetic surgery, it is advisable to establish an aesthetic surgery sub-unit in most tertiary institutions. This sub-unit should be fully functional including special clinic days, as this could help attract future clients and develop this branch of Plastic Surgery.

Abdominal wound closure in the presence of sepsis: our experience with the use of subcutaneous drain.

Patients requiring surgery for secondary peritonitis demonstrate a significantly increased risk for incisional surgical site infection. This study aimed to evaluate the efficacy of subcutaneous wound drain post-laparotomy for contaminated surgical wounds. This was a prospective comparative hospital-based study. Patients who had surgery for secondary peritonitis in Irrua Specialist Teaching Hospital were studied. Fifty patients aged 16 years and above who presented with secondary peritonitis. Patients who met the inclusion criteria were randomized into two equal groups. Group A had a suction drain placed in the subcutaneous space after laparotomy while Group B did not. Development of incisional surgical site infection, wound dehiscence, and duration of post-operative hospital stay. The incidence of incisional surgical site infection was significantly less in Group A (20%) than in Group B (68%). There was no case of wound dehiscence in Group A as against 3 (12%) in Group B. The difference was not statistically significant. The mean duration of hospital stay was significantly less with subcutaneous suction drain (8.96+2.81 Vs 14.04+8.05; p = 0.005). Subcutaneous suction drainage is beneficial in abdominal wall closure in cases of peritonitis as it significantly reduces the incidence of incisional surgical site infection and the duration of postoperative hospital stay. The reduction in surgical wound dehiscence observed in this study was, however, not statistically significant. None declared.

Buildability Issues in Building Construction Projects in Nigeria

Buildability terminology is adopted for the effect of design on construction and as an essential professional input of a builder during the design stage in project execution. Thus, this research determined buildability issues on building projects. The objectives assessed the factors responsible for buildability issues and examined mitigation strategies on selected construction projects. Primary data were collected through the distribution of sixty questionnaires to construction professionals in fifteen ongoing construction projects handled by Ambrose Alli University, Ekpoma; Irrua Specialist Teaching Hospital; Esan West Local Government and Esan Central Local Government purposively sampled. The return rate of questionnaires administered was 83.3%. The data obtained were analyzed using mean item score and relative importance index. Results revealed the prevalence of buildability issues in the study area; especially inadequate cash flow from client, poor information flow between designers and contractors and omitted drawing details. The most prominent factor responsible for buildability issues being improper planning and poor site layout (RII = 0.884) while the most predominant strategy to mitigate buildability issues was producing detailed working drawings (RUI = 0.904).

IDF23-0347 Prevalence of Hyperglycaemia among Obese Hypertensive Individuals Attending Irrua Specialist Teaching Hospital Nigeria

IDF23-0347 Prevalence of Hyperglycaemia among Obese Hypertensive Individuals Attending Irrua Specialist Teaching Hospital Nigeria

Barriers and Facilitators to Dietary Salt Reduction Among Patients With Hypertension in Southern Nigeria: A Hospital-based Qualitative Study.

Reduction in salt intake improves blood pressure control and reduces the risk of hypertension and other noncommunicable diseases (NCDs). However, salt intake remains high among Nigerians. This study aimed to identify barriers and facilitators to salt reduction among hypertensive patients attending a family medicine clinic in southern Nigeria. A focussed group discussion (FGD) exploring patients' perceptions of the barriers and facilitators to salt reduction was conducted with 8 groups of purposefully selected 74 hypertensives who consumed excess dietary salt, stratified by age and sex, using an FGD guide. Thematic analysis was then performed using Nvivo® version 12 pro. Ethical approval was obtained from Irrua Specialist Teaching Hospital (ISTH), and written informed consent was obtained from the patients before the FGD. Respondents had a mean age of 51.96 ± 8.98 years. The majority were females (47, 63.5%) and had uncontrolled blood pressure (66, 89.2%). Five major themes were identified, from which several minor themes emerged. Respondents rated their overall health as good but expressed concerns about their poor blood pressure control. Identified barriers to salt reduction included family pressure, ignorance, ready availability and affordability of salt and lack of affordable alternatives. Facilitators of salt reduction were measuring the amount of cooking salt, removing salt from the dining table and providing substitutes. Respondents, however, expressed willingness to reduce their salt consumption. The study identified barriers and facilitators to salt reduction. There is a need to create awareness of the safe amount of salt to be consumed and provide safe and readily available alternatives.

Physical activity, obesity and risk of atherosclerotic cardiovascular diseases among patients with hypertension and diabetes attending a teaching hospital in Edo State, Nigeria.

Preventing Atherosclerotic Cardiovascular Diseases (ASCVD) can best be achieved by promoting a healthy lifestyle through improvements in diet, physical activity, and avoidance of tobacco use and exposure to second-hand smoke. The study aimed to determine the association between physical activity as well as obesity and the risk of atherosclerotic cardiovascular diseases among patients with hypertension and diabetes attending Irrua Specialist Teaching Hospital (ISTH), Irrua, Nigeria. The research was a descriptive, cross-sectional study of 394 systematically selected consenting patients with hypertension and diabetes presenting to a teaching hospital in Irrua, Edo State, Nigeria. The Cardiovascular risk assessment was determined using the Framingham 10year Risk of General Cardiovascular Disease. Anthropometric assessment, blood pressure and blood glucose were determined. Data was collected with a semi-structured questionnaire and analysed with Stata version 16. Chi square and logistic regression was used to test for association and significance level was set at p = 0.05. The study included 394 participants with a mean age of 54±15.47years. Respondents were mostly females (55.3%), physically inactive (70.3%), overweight (42.4%) and had a high risk (41.8%) of developing CVD in 10 years using Framingham categorisation. There was a significant association between physical activity (P<0.01; OR 2.45; CI: 1.53-3.92), obesity (P<0.01; OR 2.52; CI: 1.64-3.86) and risk of developing CVD. The study found a statistically significant relationship between physical inactivity, obesity, and the risk of atherosclerotic cardiovascular diseases. Increasing physical activity levels need to be a top priority at all levels of healthcare as well as the general population.

Maternal Seroprevalence and Placental Transfer of COVID-19 Antibodies in Pregnancy: A Hospital-Based Study.

Coronavirus disease 2019 (COVID-19) is a relatively new disease with high morbidity and mortality.Information about the prevalence of infections in pregnancy could help identify herd immunity, project epidemics, and decide policy guidelines. The aim of this study was to determine the infection susceptibility risk of COVID-19 in pregnancy, to determine the prevalence of COVID-19 antibodies (IgG & IgM), and to evaluate the determinants of COVID-19 antibody positivity in pregnancy. This was an analytical cross-sectional study involving 258 consenting pregnant women recruited at Irrua Specialist Teaching Hospital, Edo State, Nigeria. Of these, 179 participants were recruited from the antenatal clinic, and 79 from the gynecology emergency unit. A structured questionnaire was administered at baseline. Venous blood was obtained at enrolment to test for total antibodies using ELISA. A nasopharyngeal swab was simultaneously obtained for COVID-19 PCR for all participants. Umbilical cord blood was taken after delivery in those who had positive serology. Socio-demographic variables and clinical presentation of respondents were considered as exposure variables, and this was cross-tabulated with outcome variables in bivariate analysis using chi-square with a level of significance at a P-value less than 0.05. Variables in bivariate analysis of chi-square that have a P-value less than 0.2 were entered into a logistic regression using multivariate logistic models. The study detected active COVID-19 infections among 7.4% (19/258) of the study participants. The study demonstrated a seroprevalence of COVID-19 antibodies in 62.4% (161/258) of the participants at recruitment and showed a strong correlation between working in the healthcare setting and living in an urban environment. Our study also reported 5.3% (8/152) of cord blood antibody positivity among study participants. The concentration of maternal immunoglobulin strongly and positively correlated with cord blood seropositivity. Prevalence estimates are an underestimate of the actual proportion of pregnant women with prior COVID-19 exposure as observed in the study discrepancy of confirmed PCR infection and evidence of previous infection from serology. The study also highlighted a low efficiency of placental transfer of COVID-19 antibodies at birth among those who were seropositive at baseline and showed that maternal antibody levels play an important role in determining the efficiency of placenta transfer of COVID-19 antibodies in pregnancy.

Atypical presentation of mpox in Irrua environs: a case report

BackgroundMpox, previously known as monkeypox, -is an orthopoxvirus infection of the skin and previously a public health emergency of international concern. It reemerged in Nigeria over 5 years ago and has since spread to other parts of the world. This is a case report of a confirmed patient who was managed at Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria before the global surge. This report shows peculiar differences from previous patients managed at the same center in terms of the relatively prolonged eruptive phase, possible seasonal occurrence of mpox in the community, and some traditional care for mpox and skin rashes. It also corroborates previous reports of possible sexual transmission of mpox in Nigeria before the report from the global outbreak.Case presentationThe patient is a 30-year-old Nigerian male artisan with a 2-month history of raised rashes on the body that started on the genitals then involved other parts of the body. There was history of sore throat and unprotected sex with a female partner with similar rash whose other sexual history could not be ascertained. There was also history of “seasonal” rash in his village for about 7 years prior to his symptoms. Examination showed multiple vesicles and some nodules (ulcerating, healing, and healed) on the face, trunk, limbs, gluteal region, scrotum, palms, and sole, an almost circumferential penile ulcer, and lymphadenopathy. Polymerase chain reaction skin samples sent for mpox returned positive, while retroviral and coronavirus disease 2019 screenings were negative. He was managed in isolation while contact tracing in the affected community was initiated.ConclusionAtypical presentations of mpox, as managed in Irrua before the global surge, emphasize the varied spectrum of presentations (typical and atypical) in Nigeria. Therefore, there is a need for a higher index of suspicion for the uncommon presentations which will strengthen case recognition, case management, and community-based interventions as well as surveillance in the prevention and control of mpox in Irrua, its environs, Nigeria, and the world.

Early outcome of surgery, triamcinolone and silicone gel combination therapy for earlobe keloid: our local experience

Background: Earlobe keloids cause facial disfigurement, physical, emotional and psychological burden to patients, while posing an intriguing treatment challenge to the plastic surgeon. Different options of combination therapy have been used in the treatment of earlobe keloids with varied success rates. Methods: This interventional prospective hospital-based study was carried out in Irrua Specialist Teaching Hospital, Irrua, Edo State, over a 15-month period (October 2017 to December 2018). Forty-two patients with earlobe keloids who met the inclusion criteria were serially recruited into the study. Forty-eight earlobe keloids in 41 patients had the intralesional excision biopsy, intralesional triamcinolone injection and silicone gel combination therapy. A modified Sharquie et al’s scar grading system was applied pre-intervention to record the baseline scores and post-intervention to evaluate the patients’ rate of response. Post treatment complications were identified, and the patients were followed up for six months. Results: Most of the patients with earlobe keloids fell in the age group 21-30 years and the male-female ratio was 1:19.5. Multiple earlobe piercing had significant association with the development of earlobe keloids. 95.8% of treated lesions had complete response to therapy. Two (4.2%) patients had dyschromia following treatment. Conclusions: The triple therapy combination of intralesional excision biopsy, postoperative intralesional triamcinolone injection and topical silicone gel application is a readily available, safe and efficacious treatment modality for earlobe keloids. Thus, it can be used as a first-line treatment modality.

Lassa Fever Infection among Healthcare Workers during the 2018 Outbreak in Nigeria

Introduction: Healthcare workers (HCWs) are potentially exposed to infection during viral hemorrhagic fever outbreaks. In the wake of 2018, Nigeria experienced an unprecedented surge in cases of Lassa fever (LF), which affected HCWs. To guide infection prevention and control (IPC) strategies in similar settings, we characterize HCWs' infection and describe the gaps in IPC standards and practices during the outbreak. Methods: Data was collected using a structured questionnaire, interview, and review of case notes of 21 HCW with laboratory-confirmed Lassa fever who were treated at the Irrua Specialist Teaching Hospital (ISTH) Irrua and the Alex-Ekwemen Federal Teaching Hospital, Abakaliki (AEFETHA), between 1st January and 27th May 2018. Information collected was the patients' socio-demographic characteristics, date of potential exposure and onset of illness, nature, and type of exposure, clinical features, outcome, use of personal protective equipment (PPE), and personnel IPC training and were analyzed using descriptive statistics with Microsoft Excel. Results: The study included 21 HCWs, and 12 (57.14%) were doctors. The case fatality rate was 23%. Nearly two-thirds (62%) of the HCWs could describe a likely procedure leading to their exposure and infection. Among 13 HCWs, 85% had multiple blood and body fluids exposure, while 15% had needle stick injury or scalpel cut. About one-fifth of the participants had received some IPC training. Conclusion: Limited IPC adherence and inappropriate risk assessment were identified as factors leading to Lassa fever exposure and infection among HCWs. There is an urgent need to provide IPC training for all HCWs and to ensure an adequate supply of IPC materials to all healthcare facilities as part of emergency preparedness, especially in LF endemic areas.

Intake of Fruits and Vegetables as Self Prescribed Weight Reducing and DASH Diets among Obese-Hypertensive Individuals Attending Irrua Specialist Teaching Hospital Irrua, Edo State, Nigeria

Background: Five servings of fruits and vegetables each day, along with relatively unprocessed whole grains or legumes with each meal, are essential for reducing the risk of obesity, hypertension and other related non communicable diseases. While being low or relatively low in calories, fruits and vegetables include a large amount of dietary fiber and a range of micronutrients, antioxidants and phytochemicals which are all essential for health.&#x0D; Aims: To investigate the intake of fruits and vegetables as self prescribed weight reducing and DASH (Dietary Approach to Stop Hypertension) diets among obese - hypertensive individuals attending Irrua Specialist Teaching Hospital Irrua, Edo State.&#x0D; Methods: A descriptive cross sectional study design was used with a sample size of 440 obese hypertensive individuals (with body mass index of = or &gt; 30Kg/m2 and blood pressure of = or &gt; 140/90mmHg). Questionnaires, personal interviews and anthropometric measurements were used to collect data using purposive sampling technique. Data collected were analyzed using Statistical Package for the Social Sciences (IBM SPSS) 22 Version.&#x0D; Results: A total of 440 respondents were used in the study and data were elicited from all of this number giving a 100% response rate. A total of 242 (55.0%) and 215 (48.9%) of the respondents consumed fruits and vegetables only one to two days per week with only 36 (8.2%) and 26 (5.9%) consuming fruits and vegetables every day.&#x0D; Conclusion: It can be concluded based on the key findings of this study that there is statistically significant mean difference in fruits and vegetables consumption amongst obese - hypertensive individuals attending Irrua Specialist Teaching Hospital, Edo State, Nigeria (p&lt;0.05).

Focussed Assessment with Sonography in acute Lassa Fever (FASLa): Development of a point-of-care protocol and description of common ultrasound findings

Managing Lassa fever (LF) patients is challenging because of the complexity of this life-threatening infectious disease, the necessary isolation measures, and the limited resources in countries where it is endemic. Point-of-care ultrasonography (POCUS) is a promising low-cost imaging technique that may help in guiding the management of patients. We conducted this observational study at the Irrua Specialist Teaching Hospital in Nigeria. We developed a POCUS protocol, trained local physicians who applied the protocol to LF patients and recorded and interpreted the clips. These were then independently re-evaluated by an external expert, and associations with clinical, laboratory and virological data were analyzed. We developed the POCUS protocol based on existing literature and expert opinion and trained two clinicians, who then used POCUS to examine 46 patients. We observed at least one pathological finding in 29 (63%) patients. Ascites was found in 14 (30%), pericardial effusion in 10 (22%), pleural effusion in 5 (11%), and polyserositis in 7 (15%) patients, respectively. Eight patients (17%) showed hyperechoic kidneys. Seven patients succumbed to the disease while 39 patients survived, resulting in a fatality rate of 15%. Pleural effusions and hyper-echoic kidneys were associated with increased mortality. In acute LF, a newly established POCUS protocol readily identified a high prevalence of clinically relevant pathological findings. The assessment by POCUS required minimal resources and training; the detected pathologies such as pleural effusions and kidney injury may help to guide the clinical management of the most at-risk LF patients.

A Six Year Review of the Outcome of Pregnancy in Diabetic Patients in Irrua Specialist Teaching Hospital, Irrua, Nigeria

Diabetes mellitus is a common medical condition complicating pregnancy with poor outcome. Early diagnosis and proper blood glucose control may reduce complications. The incidence and outcomes of the disease in Irrua is not known. The aim of this study is to determine the incidence and outcomes of diabetes mellitus complicating pregnancy in Irrua. We carried out a six year retrospective review of the demographic characteristics of the patients, parity, clinical and booking status, number of hospital admissions for blood sugar control and pregnancy outcome of diabetes mellitus complicating pregnancy in Irrua Specialist Teaching Hospital, Irrua between January 1, 2000 and December 31, 2005. Data collected were analysed using SPSS window version 20.0 statistical package. In the study period, there were 5,460 pregnant women who booked for antenatal care in the hospital, out of these, 2,765 attended the antenatal carefully and eventually delivered in the hospital and 30 of them whose pregnancies were complicated with diabetes mellitus were studied. The incidence of diabetes mellitus complicating pregnancy in this study is 10.85 pregnancies per 1000 births. The mean age of the patients was 33 years. Multipara were affected in 62% of cases. Gestational diabetes predominated in 66.7% of cases. There were family history of diabetes in 73.3% of cases. All patients had both dietary and insulin therapy throughout antenatal period. Majority of the patients were admitted for blood glucose control once. Majority of the patients (76.6%) had vaginal deliveries while 23.3% had caesarian deliveries due to fetal and maternal complications. Over 73% of the patients delivered at term. The outcome of pregnancy was poor. The incidence of diabetes mellitus complicating pregnancy in Irrua is 10.85 pregnancies per 1000 births, this is high with relatively poor outcome. Preconceptional counseling, deliberate blood glucose tolerance testing and adequate blood glucose control in pregnancy is recommended.

Gestational Trophoblastic Disease In Irrua Specialist Teaching Hospital, Nigeria: A 5-year Review

Background: Gestational Trophoblastic Diseases (GTD) is a group of interrelated heterogeneous disease of trophoblastic tissue resulting from abnormal fertilization, characterized by abnormal tissue proliferation. Characteristically, prognosis positively correlates with early diagnosis and treatment.&#x0D; Objective: The objective was to determine the burden, clinical presentation, management and outcomesof GTD at Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.&#x0D; Methodology: A five-year descriptive (retrospective) study of histologically confirmed cases of st th GTD managed in ISTH between 1 July, 2016 and 30 June, 2021 was undertaken. Inclusion criteria: patient that were management at the study site, histology confirmation and availability of the case-file for review. Women managed for other gynaecological disorders or those with suspected GTD but no histologic confirmation were excluded from the study. Statistical analysis was done using SPSS version 20.0 and the results were presented in tables.&#x0D; Results: There were 21 cases of GTD and 4703 deliveries with an incidence of 4.5 per 1000 deliveries. The mean age of participants was 32.9±7.5 years. Partial mole was the commonest histologic type (47.4%), choriocarcinoma (31.6%), complete mole (10.5%), invasive mole and placenta site trophoblastic tumor-PSTT (5.3%) respectively. Abnormal vaginal bleeding was the commonest presenting symptom 89.5% (17/19); others were excessive vomiting 52.6% (10/19) and abdominal pain 36.8% (7/19 ). The treatment modalities included suction curettage (42.1%) , suction curettage and chemotherapy (36.8%), total abdominal hysterectomy and cytotoxic chemotherapy only (15.8%).Serum Beta hCG returned to normal within 4 weeks for molar pregnancy and an average of 6 months for choriocarinoma. Default rate from surveillance was 10/19 (52.6%) while two participants (10.5%) died as cases of choriocarcinoma with advanced disease from late presentation.&#x0D; Conclusion: Abnormal vaginal bleeding was the commonest presentation of GTD with high default and mortality rates. Therefore, efforts should be geared towards education and awareness to improve early presentation, surveillance and prompt treatment.

Determinants of blood pressure control among hypertensive patients attending a rural teaching hospital in Southern Nigeria.

Hypertension (HTN) is the commonest cardiovascular risk factor in sub-Saharan Africa. It is a global public health threat, often associated with significant morbidities and mortality with rising prevalence both in rural and semi-urban areas of economically disadvantaged countries. This study aimed to assess the determinants of blood pressure control among patients with hypertension receiving care at the Irrua Specialist Teaching Hospital in Southern Nigeria. A cross-sectional study of 502 consenting hypertensive adults receiving care at the Irrua Specialist Teaching Hospital, Irrua in Edo State, South-south Nigeria. A pre-tested semi-structured interviewer-administered questionnaire was used to collect data which was analyzed using SPSS version 21 and the level of significance was set at P < 0.05. Five hundred and two participants (226 males, 276 females) completed the study with a mean age of 52.98 ± 12.82 years. Optimal blood pressure control was found in 15.5% of the study participants. Blood pressure control was significantly associated with being married (OR 1.549, CI: 1.040-2.309), having a monthly household income of over N50,000 (OR 1.691, CI: 0.999-2.863), engaging in physical activity (OR = 1.537, CI: 0.989-2.388), and not being obese evidenced by a normal Waist Hip Ratio (OR = 2.276, CI: 1.555-3.332). Blood pressure control to target goal was low in the study population and achieved only in less than one-fifth of respondents on antihypertensive therapy. Numerous socio-demographic and lifestyle variables were shown to be associated with blood pressure control. Physicians should emphasize medication adherence and lifestyle modification approaches in hypertensive adults.

Finger and palmar dermatoglyphics in diabetic subjects: a study in a Nigeria teaching hospital

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;: The aim of this study is to evaluate digito-palmer print among diabetic patients visiting Irrua specialist teaching hospital (ISTH), Irrua Edo State, Nigeria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt;: Using standard procedures of the ink method, the finger prints of both hands were obtained and palm photographed were taken from clinically diagnosed diabetic patients. The data were analyzed using SPSS (version 21) and results presented in tables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results&lt;/strong&gt;: The mean age of the patients was 59.64±9.73 years with 64% females. In the right hand the arch finger print was prevalent on the thumb and loop on the little, middle and ring fingers. In the left hand, the arch print was prevalent on the thumb, index and middle fingers. There was no significance between gender on the distribution of the various finger print patterns except in the right middle finger where females were significantly more likely (p&amp;lt;0.05) to present the loop finger print. The 310-palm print was prevalent in the right and left hands of the diabetic patients with 60% chances of symmetric. Female subjects were more likely to present the 310-palm print compare with male in both hands. The 311 point of origin, intercept and cross (PIC) was absent in the right palm of the male and absent on the left palm of the female.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions&lt;/strong&gt;: It appears that there exists a variation in the dermatoglyphic patterns in diabetic patients. However, there is a need for larger population-based studies to standardize the parameters and translate the findings into clinical and public health practice.&lt;/p&gt;