Nnamdi Azikiwe University Teaching Hospital Research Articles

Prevalence of Malaria Infection among Pregnant Women Attending Antenatal Clinic in Nnamdi Azikiwe University Teaching Hospital, Nnewi

Malaria is a major health problem affecting people in the tropics and sub-tropical regions of the world. This cross-sectional hospital-based study was carried out to determine the prevalence of malaria infection among pregnant women attending a tertiary hospital in Nnewi, Anambra State, Nigeria. A total of 100 venous blood samples were collected from pregnant women into EDTA tubes and examined using field-stained thick and thin films for identification of malaria parasites. Demographic information such as age, trimester and insecticide-treated nets usage was obtained using a structured questionnaire. Data was analyzed using Statistical Package for the Social Sciences version 22. The chi-square test was used to determine the difference among the variables studied and P≤ 0.05 were considered significant. Out of the 100 blood samples examined, 27 were infected and had an overall prevalence of 27%. Women within the age bracket of 31-35 years had the highest prevalence rate 11(36.7%) while no infection was recorded in the 41-45 years age group 0(0.0%). Pregnant women in their first trimester had the highest infection prevalence of 13(35.1%) while those in their third trimester had the least prevalence of 5(17.9%). In relation to ITN’s usage, pregnant women who don’t normally sleep under ITNs had the highest infection prevalence 23(31.5%) while those who usually sleep under ITNS had the least prevalence rate 4(14.8%). It is pertinent to periodically check the malaria infection status of pregnant women attending antenatal services. Prophylactic treatment should be routinely administered to avoid pregnancy complications due to malaria infection.

Intimate partner violence among pregnant women in Anambra State, Nigeria: Prevalence, pattern, determinants and coping strategies

ABSTRACT Background: Intimate partner violence (IPV) has emerged as a global phenomenon, with pregnant women being particularly vulnerable, especially in developing countries. Despite its diverse manifestations and severe impacts, IPV is sometimes perceived as culturally acceptable or as a means of controlling women. Aims: This study aimed to assess the prevalence, patterns and determinants of IPV amongst pregnant women attending antenatal care (ANC) at a tertiary hospital in Anambra State, Nigeria. Materials and Methods: This cross-sectional survey enrolled 400 pregnant women receiving ANC at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State. Data collection utilised semi-structured, self-administered questionnaires. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 26. Results: In this study we found a 21.8% prevalence of IPV. Psychological violence was the most common form, followed by sexual and physical violence at rates of 72.4%, 35.6%, and 32.2% respectively. Risk factors associated with IPV included low educational attainment, maternal unemployment, average monthly income of <50,000 naira, partner unemployment and substance abuse, increased maternal age, having family members choose their partner and marital conflicts. Various coping strategies were identified amongst victims, including help-seeking, spiritual recourse, substance abuse, retaliation and divorce. Alarmingly, 75.9% of the participants took no action when faced with IPV. Conclusion: This study underscores the prevalence of IPV among pregnant women, with approximately one in five reporting victimisation during pregnancy. Psychological, sexual, and physical forms of violence occurred in decreasing order of prevalence. We found that a range of factors, including individual and relationship-related factors, correlated with increased odds of IPV. Women who experience IPV adopt different strategies, including help-seeking, spiritual recourse, substance abuse, retaliation, divorce and in some cases, passivity.

Assessment of plasma levels of D-dimer and lipid profile in women with breast cancer on chemotherapy at Nnamdi Azikiwe university teaching hospital, Nnewi

Assessment of plasma levels of D-dimer and lipid profile in women with breast cancer on chemotherapy at Nnamdi Azikiwe university teaching hospital, Nnewi

Epidemiological trends and treatment abandonment of paediatric solid tumours in a nigerian tertiary hospital: a seven-year review (2016–2022)

BackgroundPaediatric solid tumours, both benign and malignant, present significant health challenges, particularly in Sub-Saharan Africa where comprehensive data is limited. This study aims to elucidate the prevalence, distribution, and treatment outcomes of paediatric solid neoplasms in a tertiary hospital in South-East Nigeria over a seven-year period.MethodsA retrospective cohort study was conducted at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. Clinical details and histological slides of confirmed cases from January 2016 to December 2022 were reviewed. Data extraction focused on socio-demographic variables and treatment outcomes, analysed using statistical methods.ResultsThe study included 293 children diagnosed with solid tumours (58.1% malignant, 41.9% benign), with a female predominance (61.8%). The median age at diagnosis was 12 years. Fibroadenoma was the most common benign tumour (61.8% of benign cases), while non-Hodgkin lymphoma was the predominant malignant tumour (18.2% of malignant cases). Treatment abandonment rates differed significantly between benign (13.8%) and malignant (51.2%) tumours. Significant associations were found between treatment outcomes and factors such as gender (p = 0.0001 for benign tumours), age category (p = 0.0001 for benign tumours), and specific diagnoses (p = 0.0001 for both benign and malignant tumours).ConclusionThis study underscores the substantial burden of paediatric solid tumours in South-East Nigeria and highlights the critical need for improved treatment adherence strategies, particularly for malignant cases. The findings emphasize the importance of tailored interventions based on tumour type, age, and gender. These insights can inform future research, policy formulation, and healthcare strategies aimed at enhancing the management and outcomes of paediatric solid neoplasms in resource-limited settings.

Possible alteration in serum ferritin level in malaria infected HIV seropositive individuals in Nauth, Nnewi, Nigeria

The role of Ferritin in monitoring disease progression in immune compromised HIV individuals with an underlying active infection like malaria is a subject of growing research. Ferritin being an acute phase protein, plays important role in assessing the range of damage due to inflammation in immunosuppressed patients leaving in highly endemic malaria regions. The levels of serum ferritin in malaria infected HIV positive individuals in Nnamdi Azikiwe University teaching hospital (NAUTH), Nnewi, Anambra State, Nigeria, was assessed. Questionnaire was used to obtain the demographic details of the participants, and to rule out other inflammatory infections. 88 participants of the age group 18 - 65 years, comprising 24 with HIV infection, 22 with HIV and Malaria co-infection, 22 with Malaria infection, and a control group of 22 individuals with neither HIV nor malaria infection were randomly recruited. Ferritin level was determined using enzyme linked immunosorbent assay technique and a cross sectional prospective study design was used. A significantly high mean serum ferritin level was observed in HIV infected individuals with and/ or without malaria co-infection than in malaria positive and control group (p<0.05 respectively). Serum ferritin level was significantly higher in female participants than in male counterparts (p < 0.05). Serum ferritin level was significantly higher in individuals with CD4 count >500 than in CD4 count ≤ 500 (p < 0.05). Blood pressure was significantly higher in HIV infected and malaria positive individuals when compared with controls. The increased serum ferritin level and higher blood pressure in HIV infected participants suggests active inflammatory process, reduced immunity and hypertension which may have worsened by malaria co-infection. This may subsequently lead to vascular and endothelia damage causing disease severity.

Antiretroviral adverse drug events reported among adult HIV patients in a Nigerian tertiary hospital: A retrospective study

Background: The use of Highly Active Antiretroviral Therapy (HAART) has changed HIV/AIDS from a near-certainly fatal illness to one that can be managed chronically. A significant constraint of HAART is the high prevalence of adverse drug events (ADE) among HIV patients taking them. Objectives: The study determined the frequency and severity of reported antiretroviral adverse events among HIV-infected adults (≥16 years) at the Institute of Human Virology (IHV) Clinic of Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria, within five years. Antiretroviral therapies implicated in the reported adverse drug events were also determined. Method: Information on reported ADEs was extracted from the NAFDAC Pharmacovigilance forms in the Pharmacovigilance section of the IHV Clinic Pharmacy. The severity of ADEs was classified using the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index for categorizing errors. Results: A hundred and nineteen (119) patients reported 161 ADEs within the 5-year study period (2017-2021). Most ADE reports came from females (74.53%) and patients 36-55 years old. Dizziness (31.1%), Rashes (14.3%), and Fatigue (13.0%) were prominent among all the ADE reports documented. TDF/3TC/EFV (57.8%) and AZT/3TC/NVP (11.8 %) combinations were the frequently implicated antiretroviral regimen. All the ADEs reported were mild (Category ‘E’). ADE reports appreciated in the second year and progressively declined afterwards. Conclusion: There is a need to improve the system for antiretroviral ADE reporting through sensitization and developing a specific tool that enhances ADE reports from patients and healthcare providers.

Evaluation of Some Hormones Total Antioxidant Capacity and Malondialdehyde Levels in Polycystic Ovarian Syndrome Women attending the gynecology Clinic at Nnewi

Polycystic ovarian syndrome (PCOS), marked by oxidative stress and hormonal imbalances, causes infertility, insulin resistance, and diverse health problems. It not only affects physical health but also can strain marriages and lead to divorce, posing a notable societal issue. The levels of hormones (Estradiol (E2), Dihydroepiandrosterone sulfate (DHEA), luteinizing hormone (LH), follicle-stimulating hormone (FSH), progesterone (PROG) Testosterone (TEST)), total antioxidant capacity (TAC) and Malondialdehyde (MDA) in PCOS Women attending the gynecology Clinic at Nnewi were investigated. This cross-sectional study had 45 participants with PCOS as a test group and 45 participants without PCOS as the control group between the ages of 18-50 recruited. All the biochemical parameters were determined by enzyme-linked immunoassay technique. Data was expressed as Mean ± standard deviation. The differences in parameters studied between the PCOS group (test) and the control group were evaluated using an independent t-test. Statistical significance was set at p-value < 0.05. Result showed significant higher differences in the mean serum levels of DHEA (87.40±65.90), LH (34.7±36.1), FSH (19.61±14.73) and Testosterone (3.04±1.36) in women with PCOS compared with the control (1.035±0.54),( 20.76±18.1), (13.2±10.19), and (3.04±1.36)(p< 0.05) respectively. A higher significant difference exists in the mean serum MDA values of the test group (women with PCOS compared with the control group(p<0.05). This study concluded that oxidative stress and hormone imbalance occurred among participants with PCOS attending the gynecology clinic of Nnamdi Azikiwe University Teaching Hospital in Nnewi. Keywords: PCOS, Estradiol, DHEA, luteinizing hormone, FSH, progesterone, Testosterone, TAC

Electrocardiographic Abnormalities in Adult Homozygous Sickle Cell Disease Patients in Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-Eastern Nigeria

Background; Sickle cell anaemia is the most common monogenic hematologic disorder in Nigeria. Cardiovascular pathology, resulting in electrocardiographic abnormalities are a common finding in adult sickle cell patients.
 Objective; This study investigated the pattern of electrocardiographic (ECG) abnormalities in steady state adult sickle cell anaemia (HbSS) patients and compared the findings with that of age and sex matched Haemoglobin AA(HbAA) controls.
 Methodology; Fifty steady state adult HbSS participants were recruited from the haematology clinic at Nnamdi Azikiwe University Teaching Hospital while fifty age and sex matched HbAA controls were recruited from the hospital community. Participants underwent resting 12 lead ECG using a Schiller CARDIOVIT AT-1 ECG machine. Data was analyzed using Statistical Package for Social Sciences version 21.
 Results; The prevalence of ECG abnormalities amongst the adult sickle cell participants and controls was 70% and 10% respectively. ECG abnormalities were more common amongst male sickle cell participants and left ventricle hypertrophy was the most frequent ECG abnormality detected.
 Conclusion; There is a high prevalence of ECG abnormalities amongst adult sickle cell anaemia patients. Regular Electrocardiography is recommended for early detection of these abnormalities for early treatment and improved quality of life.
 Keywords: Electrocardiographic Abnormalities, Sickle Cell Disease Patients, Nnamdi Azikiwe University, Haemoglobin AA

Correlation of Glasgow Coma Scale with Head Computed Tomographic Findings in Patients with Traumatic Brain Injury in a Tertiary Hospital in Nnewi

Background: Traumatic brain injury is an injury that causes anatomical or functional damage to the cranium, meninges and the brain. It is a major health challenge that causes increased mortality among trauma patients. This creates the serious need to find ways of elucidating the seriousness and prognostic possibility of every head injury patients. This study will help classify the patients in such a way as to affect management and also predict outcome early in the treatment of patients with traumatic head injury. Aim of the Study: Aim of this study is to correlate the clinical assessment of head injury patients with Glasgow Coma Scale (GCS) and CT findings as classified with Rotterdam scoring system. Subjects and Methods: This prospective study of 170 patients with head injury presenting for CT scan, was carried out from October, 2017 to September, 2019, in the Radiology department of the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi. All stable patients that were referred for head CT within this period were included in the study. Prior to the commencement of the study, informed consent, relevant clinical history and necessary physical examination are usually carried out on the patient or obtained from the care giver to ascertain the level of consciousness by Glasgow coma scale. The GCS grading used was as follows; a score of 3 - 8 (severe head injury), 9 - 12 (moderate head injury) and 13 - 15 (mild head injury). Patients were scanned using a 4 slice/gantry rotation capacity CT (General Electric (GE), HANGWEI MEDICAL SYSTEMS CO. LTD. Data obtained from the study pro-forma and the cranial CT findings of subjects, was entered and analysed using IBM SPSS (Statistical Package for Social Sciences), version 20.0. Armonk, NY, U.S.A, 2011. Results: A total of 170 patients were involved in the study which showed a high prevalence of traumatic head injury. More males were involved than females and the predominant age in the study is 21-30. There was a significant correlation between the GCS and the Rotterdam scoring system. Discussion: The findings that more males and the younger age group are more involved and that the Rotterdam scores are good indicators of the outcome are similar to the findings in other studies. Conclusion: This study showed that Rotterdam CT score system is a good prognostic tool in patients with traumatic brain injury.

Assessment of Vitamin D status of patients with human immunodeficiency virus

ABSTRACT Background: Vitamin D regulates calcium and phosphorus homeostasis. Vitamin D deficiency (VDD) commonly occurs in people living with human immunodeficiency virus (HIV) (PLWHIV) and is linked to bone disorders and metabolic and infectious diseases. HIV seropositivity and VDD may worsen the consequences on the individual. Methods: A cross-sectional analytical study was conducted using 90 serum samples from 42 HIV-positive and 48 HIV-negative patients attending the Nnamdi Azikiwe University Teaching Hospital (NAUTH). This study was approved by the NAUTH Ethics Committee. Serum Vitamin D levels were analyzed using enzyme-linked immunosorbent assay. Sociodemographic data were obtained using a questionnaire. Data analysis was performed using IBM SPSS Windows version 27, and P < 0.05 was considered statistically significant. Results: Overall, 13.3% of the population had suboptimal Vitamin D levels, with 2.2% having VDD and 11.1% having Vitamin D insufficiency. VDD was found in 2.2% and 2.1% of the HIV-positive group and HIV-negative groups, respectively. No significant difference was observed in mean serum Vitamin D levels between the two groups (P > 0.05). Within the HIV-positive group, education, place of living, and skin coloration were associated with suboptimal Vitamin D levels, and only skin coloration was associated with HIV-negative subjects. Conclusion: VDD is relatively low in the region; however, it may contribute to poor bone health in PLWHIV. Interventions should target individuals with poor educational attainment, living in rural domains, or dark skin coloration. Studies with large sample size are needed to determine the effects of Vitamin D supplementation or exposure to sunlight on HIV infection.

Risk factors for Undiagnosed Kidney Disease among Stable First-Degree Relatives of Chronic Kidney Disease Patients at Nnamdi Azikiwe University Teaching Hospital, Nnewi, South Eastern Nigeria

Background: Chronic kidney disease (CKD) is a global public health problem and has a major impact on health and cost of health care. In Nigeria, renal replacement therapy (RRT) is funded out of pockets by patients and their relatives unlike in most developed countries. There is a high clustering of the risk factors for CKD in FDRs of CKD patients, making then an ideal population for the screening for and the reversal of the modifiable risk factors that predispose to CKD.
 Objective: This study determined the risk factors for CKD in the FDRs of patients
 Methodology: This study involving 300 subjects: 150 FDRs of CKD patients and 150 control subjects without personal or family history of CKD. The study and control subjects were screened for CKD using urine albumin creatinine ratio (uACR) and estimated glomerular filtration rate (eGFR). Prevalence rate of the risk factors for CKD such as hypertension, diabetes mellitus, obesity, dyslipidaemia, hyperuricaemia and life style practices like significant smoking and heavy alcohol consumption were determined for both the FDRs and the control subjects. Data was analyzed with SPSS version 21.0. Mann-Whitney U test was used for comparing the variables between the two study groups for continuous variables that were not normally distributed and Chi square tests for categorical variables.
 Results: The prevalence rate of dyslipidaemia and hyperuricaemia was significantly higher among the FDRs of CKD patients compared with the control subjects (26% versus 12%; P = 0.003) and (20.7% versus 7.3%; P = 0.001) respectively. The other risk factors for CKD that included hypertension, diabetes mellitus, obesity, significant cigarette smoking, heavy alcohol consumption and herbal medication use were equally more among the FDRs of CKD patients compared with the controls, although not statistically significant.
 Conclusion: The risk factors for CKD were common among FDRs of CKD patients. Screening for these risk factors at the earliest possible contact with the FDRs of CKD patients and taking appropriate actions to tackle the modifiable ones will prevent the development of CKD and retard the progression of the already existing disease, reduce the alarming global burden of CKD.

Associations of asymptomatic coronary heart disease in a cohort of stable type 2 diabetic subjects in a tertiary health center in south eastern Nigeria: A cross sectional study

Background: Coronary heart disease (CHD) is a type of heart disease where the lumina of the major arteries of the heart (coronary arteries) are narrowed by a build-up of plaque with a resultant limitation of blood flow to and oxygenation of the heart. Coronary heart disease can pose a diagnostic challenge in diabetic subjects due to the fact that it is often asymptomatic with a resultant lack of overt clinical complaint by the patients. It is an important cause of diabetes-associated morbidity and mortality and also a huge contributor to the cost of diabetes care. Objective: To determine the association between CHD and age, sex, cigarette smoking, duration of diabetes, central obesity, glycaemic control, hypertension, chronic kidney disease (CKD), stroke, transient ischaemic attack (TIA), dyslipidaemia, lack of exercise and metabolic syndrome in type 2 diabetic subjects attending the diabetes outpatient clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi in South Eastern Nigeria. Materials and Methods: This was a cross-sectional, observational study comprising 136 clinically stable T2DM subjects that were asymptomatic of coronary heart disease. The participants had two contacts with the researcher. Firstly, all the participants were evaluated with resting ECG for the diagnosis of CHD, 30 subjects had CHD while 106 had not. Next, the 30 subjects that had CHD and 98 of the 106 that had not, were met a second time on another clinic visit where medical history was extracted and anthropometric measurements were done. Next, biochemical tests, which included fasting blood glucose (FBG), glycated haemoglobin (HbA1c), fasting lipid profile (FLP) and serum creatinine were done and the glomerular filtration rate estimated using the Modification of Diet in Renal Disease (MDRD) calculator. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 25 (Chicago, IL, USA). The level of significance was set at p < 0.05. Results: A total of 128 subjects completed the study and had their data analyzed. 30 subjects had CHD while 98 had not. There was significant association between CHD and TIA (p = 0.040), but no significant association between CHD and age (p = 0.959), sex (p = 0.679), educational status (p = 0.094), cigarette smoking (p = 1.000), duration of diabetes (p = 0.335), central obesity (p = 0.726), glycaemic control (p = 1.000), hypertension (p = 1.000), CKD (p = 0.570), stroke (p = 0.141), dyslipidaemia (p = 0.290), exercise (p = 0.641) and metabolic syndrome (p = 0.633) respectively among the subjects. Conclusion: There was a high prevalence of asymptomatic CHD among stable type 2 diabetic subject and with the exception of TIA, there was no significant association between CHD and all the other risk factors for CHD that were studied, although these risk factors were found more among the subjects that had CHD compared with those that had not.

Histopathological Pattern and Audit of Skin Tumors Seen in Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East Nigeria: A 10-year Retrospective Study

Abstract Background: Skin tumors consist of neoplastic lesions that affect the integumentary system which includes skin, hair, nails, and related muscles and glands. Diagnosis of these lesions can be a dilemma for both physicians and pathologists. Tumors of the skin are more heterogeneous than those of any other organ in the body, and this is a result of varying types of cells which can give rise to both benign and malignant skin lesions. Aim and Objectives: The aim of this is to audit the histopathological patterns of skin tumors seen in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South-East Nigeria. Materials and Methods: All cases of skin tumors diagnosed in the center within the study period of January 2013 to December 2022 were retrieved from the archives of the Anatomic Pathology Laboratory, NAUTH. Histology slides of the cases that met the inclusion criteria were carefully reviewed. Then, tissue blocks for those diagnosed as malignant skin tumors, were sent for immunohistochemistry. The data obtained were analyzed using the Statistical Package for the Social Sciences version 20.0. Results: There were a total of 206 cases that met the inclusion criteria, 103 males (50.0%) and 103 females (50.0%). The most common tumor as seen in the study is squamous cell carcinoma (SCC) (19%), with the least common being cylindroma, sebaceoma, and trichoepithelioma (1% each). The peak age incidence is in the third decade. The anatomic site most affected by the tumors is the head-and-neck region (78%) followed by the lower-limb region (66%) and the least affected is the anogenital region (25%). Immunohistochemistry showed a 100% correlation for the malignant skin tumors. Conclusion: The overall most common skin tumor is SCC followed by hemangioma, whereas trichoepithelioma, sebaceoma, and cylindroma are the least common. The most common benign tumor is hemangioma, whereas the least common benign tumors are trichoepithelioma and cylindroma. The most common and least common malignant tumors are SCC and Paget’s disease respectively. This study served to generate baseline data for the histopathologic pattern of both benign and malignant skin tumors in NAUTH, Nnewi.

Assessment of Metabolic, Cardiovascular, and Anthropometric Parameters in PCOS Women Attending Gynecology Clinic at Nnewi, Anambra state, Nigeria.

Polycystic ovarian syndrome (PCOS) is a common hormonal disorder in reproductive-age women, characterized by irregular periods, excess androgen levels, and ovarian cysts, often leading to infertility. While incurable, symptoms can be managed through lifestyle changes and treatments. Its exact cause is unknown, but genetic and metabolic factors are implicated. A comprehensive evaluation assessed various health markers including insulin resistance, glycemic index, lipid profile, blood pressure, BMI, and waist-to-hip ratio in PCOS women at Nnewi Anambra State Nigeria’s gynecology clinic, likely aiming to understand metabolic health, cardiovascular risks, and overall well-being. In this cross-sectional study conducted at a hospital, 45 participants diagnosed with PCOS were compared to 45 participants without PCOS, all aged between 18 and 50. Biochemical parameters were assessed using the enzyme-linked immunoassay technique. Data was expressed as Mean ± standard deviation. The differences in parameters studied between the PCOS group (test) and the control group were evaluated using an independent t-test. Statistical significance was set at a p-value of <0.05. Results showed that significantly lower differences exist in the mean serum levels of LDL-C (1.23±0.73) and Insulin resistance (15.13±8.13), in women with PCOS compared with the control (1.96±0.43) and (18.46±10.20)(p<0.05) respectively. A higher significant difference exists in the BMI (32.42±8.72) and WHR (0.71±0.14) of the test group (women with PCOS) compared with the control group (26.79±6.35) and (0.60±.178) respectively. The study found that women with PCOS attending the gynecology clinic at Nnamdi Azikiwe University Teaching Hospital in Nnewi, Anambra state exhibited obesity, without dyslipidemia as indicated by notably elevated mean values of the body mass index.

Evaluation of Some Renal Biomakers in Patients with Benign Prostatic Hyperplasia/Prostate Cancer Attending Nnamdi Azikiwe University Teaching Hospital Nnewi

Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are among the urological conditions that affect aging men. Patients with this pathology could develop renal impairment. Renal biomarkers like beta-2-microglobulin (BMG), urea, urine creatinine, microalbumin (MALB), and albumin to creatinine ratio (ACR) were assessed with total (tPSA) and free prostate specific antigen (fPSA), systolic blood pressure (SBP), diastolic blood pressure (DBP), height, weight and BMI. This cross sectional study recruited 120 men using convenient sampling technique which comprised 40 BPH, 40 PCa and 40 control attending Urology Clinic of NAUTH Nnewi, Anambra State. Five (5) milliliters of blood/ urine samples were collected from the patients and the necessary data were obtained from clinical records of the patients. The weight (kg) and height (m) were measured using standard beam balance scale and a stadiometer respectively and the BMI calculated. Blood pressure was measured using sphygmomanometer and stethoscope. PSA (ng/ml) was estimated by Enzyme immunoassay technique, BMG (mg/l) and MALB (mg/l) by immunoturbidimetric method, urea and creatinine were determined spectrophotometrically using modified Urease-Berthelot method and Jaffe slot alkaline picrate method respectively. Data analysis was conducted using SPSS version 21.0. The results were presented as median. Kruskal Wallis was used to determine significant differences between the mean values. P<0.05 was considered to be statistically significant. The results showed a significantly higher median values of tPSA, fPSA BMG and MALB in patients with BPH /PCa when compared with the control. MALB had a strong correlation with ACR in all the groups. Despite the significant increase in BMG and MALB in this study, routine indices of renal function remained normal. The increase in the sensitive markers in patients with BPH/PCa is an indication of early renal impairment.

METHAMPHETAMINE-INDUCED DISSEMINATED INTRAVASCULAR COAGULOPATHY: A CASE REPORT.

Methamphetamine abuse continues to pose a significant public health concern globally, with numerous adverse effects on various body systems. Methamphetamine is a common drug of misuse in Nigeria. It is a derivative of amphetamine, an enantiomer of ephedrine with potent addictive and majorly central nervous system (CNS) stimulating property. We present a 30-year-old female with a history of chronic methamphetamine misuse who presented to the emergency department of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, with symptoms consistent with disseminated intravascular coagulopathy (DIC). Despite intensive inpatient management, the patient's condition rapidly deteriorated within 17days duration. This case highlights the intricate interplay between methamphetamine use and the development of DIC, emphasizing the importance of prompt recognition and appropriate management in mitigating adverse outcomes.

A randomized controlled study of the effects of targeted health education on uptake of contraceptives among women of reproductive age in Nnewi City, South-East Nigeria.

There is a need for contraception uptake among people to enable them to fulfil their right to determine the timing, number and spacing of their children. In regions with poor contraceptive prevalence rates, lack of effective education has been largely implicated, and Nigeria falls among such regions. Thus, the present study is designed to examine the impact of an educational intervention on uptake of contraceptives among women aged 18-49 years seeking care at the Nnamdi Azikiwe University Teaching Hospital Nnewi. Being an interventional study to underscore the effect of targeted health education on uptake of contraceptives, a randomized controlled trials design was adopted. A total of 275 women were randomly recruited and allocated into two groups-140 in intervention group and 135 in the control group. Data was collected by trained research assistants using a pretested structured interviewer-administered questionnaire and analyzed using Statistical Package for Social Sciences version 25. The level of significance was set at p < 0.05. At baseline, the level of uptake of contraceptives was similar in both the control and the intervention group (control = 2.48 points; intervention = 2.55 points). Overall, there were no statistically discernible differences between the two groups at baseline. The level of awareness and knowledge on contraceptives as well as the uptake of contraceptives significantly increased in both groups at the end of the study period. A statistically significantly higher increase was noted in the intervention group when compared to the control in level of awareness (t = 3.235; p < 0.05) and uptake of contraceptives (t = 2.628; p < 0.05). Significant positive changes in perceptions of contraceptives were observed more among the intervention group when compared to the control. Logistic regression analysis showed uptake of contraceptives was significantly influenced by occupation, monthly income, source of information, time of first use of contraceptives, level of knowledge on contraceptives as well as the targeted educational intervention. The targeted health educational intervention had a significant and positive effect on the level of awareness and uptake of contraceptives, as displayed in the intervention group. A significant and positive change in perception of contraceptives was also noted among the intervention group in almost all the questions. Certain factors were found to significantly impact the uptake of contraceptives. There is a need for studies with longer follow-up to ascertain sustained impact of health education on uptake of contraceptives. Further studies should be carried out in the other facilities in Nnewi to ensure a better coverage and representation of the target population. Finally, related studies should be carried out among men.

Perception and Practice of Cervical Cancer Screening among Female Professionals Attending Gynaecology Clinic at A University Teaching Hospital

Background: By using the right screening tools and preventative measures, cervical cancer can be avoided. However, the underuse of preventative measures is caused by a lack of information and awareness. Professional women with sufficient knowledge can have a significant positive impact on the attitudes and behaviours of the broader public. So, we evaluated how professional women perceived and used cervical cancer screening. Objectives: To evaluate how female professionals who visit gynaecology clinics view and approach cervical cancer screening. Methods: A cohort of 160 consenting female professionals working at the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria, were used in this facility-based, single-center, descriptive, cross-sectional study. Participants filled up questionnaires about their knowledge assessment, screening for cervical cancer, and personal characteristics that influence them. Simple percentages, charts, and IBM SPSS Statistics 26 for Windows, version 26.0 (IBM Corp., Armonk, NY, USA) were used to portray and analyse the data. Results: The analysis employed a total of 160 questionnaires completed by research participants. All of the selected female professionals knew about cervical cancer screening, with nurses (49.3%) making up the majority. However, just 29.6% of them were aware that cervical cancer is connected to sexually transmitted diseases, and 33.2% were unaware that it is connected to age at first sexual activity. Only 93.2% of respondents had heard of Pap smears, despite the fact that every respondent had heard and read about cervical cancer and its screening. Despite the knowledge, only 44 (27.5%) had performed Pap tests and only 76(47.5%) had ever recommended cervical cancer screening to people. Of the women surveyed, 148 (92.5%) said they would be willing to have a cervical cancer screening, while 18 (11.25%) said they would decline. Conclusion: Despite more knowledge and awareness, the rate of cervical cancer screening among female professionals in Nnewi is still below average and insufficient. Cervical cancer can be avoided. Eliminating the morbidity and mortality frequently linked with cervical cancer would need deliberate efforts to increase screening methods' uptake and utilisation.

Nurses Job Satisfaction, Patients Satisfaction, and Quality of Care in Nnamdi Azikiwe Teaching Hospital Nnewi, Anambra State, Nigeria

Nurses are the largest workforce in healthcare facilities, providing 50% - 80% of healthcare services. They play important role in providing quality care to patients, which is important in healthcare. This study determined job satisfaction, patient satisfaction and quality of care of nurses in Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State. A descriptive cross-sectional survey was used. A self-administered questionnaire was used to obtain information from 208 nurses, 138 patients and 36 head nurses using simple randomization technique. A pilot testing was carried out with a reliability index of 0.81. Data analysis was performed using Statistical Software for Social Sciences (SPSS) database version 25. Chi square was used to test the significance hypotheses of p &lt; 0.05.The majority of nurses 82 (39.42%) were between ages 41-50 while most of them, 48 (23.08%) had between 11-15 years of experience. Most of the recruited patients (43.48%) were between the ages of 31-46 years and most respondents were female (52.17%). The results also show that the majority of nurses (55.3%) were dissatisfied with their jobs. 84.8% of the patients were satisfied with the quality of nursing care. According to head nurses reports, nurses provided quality care to patients. Communication and team building, training, leadership and management, salary, work itself, work environment, interpersonal relationship were significantly positively associated with overall job satisfaction. Job satisfaction of nurses in this research area was slightly low. On the other hand, patients are quite satisfied with the level of care. Despite nurses’ job satisfaction, they still provide quality care to patients. It recommended that hospital management and government should consider all components of job satisfaction.

Associations of Electrocardiographic Abnormalities in Stable Type 2 Diabetes Subjects: Experience from a Tertiary Health Facility in South Eastern Nigeria

Introduction: Cardiovascular abnormalities are prevalent in the setting of diabetes mellitus, even among stable subjects, necessitating the need for a regular cardiovascular disease screening for this group of patients. Electrocardiogram is a simple and reliable screening test for cardiovascular abnormalities that could be easily accessible even in resource poor and rural settings. This study was carried out to determine the association between cardiovascular risk factors and electrocardiographic abnormalities in stable type 2 diabetes subjects in South Eastern Nigeria.&#x0D; Materials and Methods: One hundred and thirty-six stable adults with type 2 diabetes mellitus were recruited consecutively from the out-patient diabetes clinic of Nnamdi Azikiwe University Teaching Hospital in South Eastern Nigeria. They were assessed for the risk factors for cardiovascular diseases that included smoking, obesity, dyslipidaemia, poor glycaemic control, hypertension, lack of exercise, presence of chronic kidney disease and metabolic syndrome. They also had a 12 lead electrocardiogram done. Results were analyzed using SPSS version 25. P value of ˂ 0.05 was considered significant.&#x0D; Result: A total of 128 subjects had complete results and were analyzed. There were 63 males and 65 females with a mean age of 58.43 ± 12.85 years and mean diabetes duration of 9.03 ± 7.36 years. A total of 45.3% of the subjects had electrocardiographic abnormalities. Hypertension was present in 54.9%, dyslipidaemia in 91.4%, central obesity in 74.3%, metabolic syndrome in 76.6% and chronic kidney disease in 57.9% of the subjects. Significant association was found between smoking and occurrence of AV block (p = 0.008), central obesity and QRS axis abnormality (p = 0.002), dyslipidaemia and ST segment abnormality (p = 0.001) and lack of exercise and ST segment abnormality (p = 0.000). No significant association was found between age, sex of the subjects, duration of DM, treatment modality for DM, level of glycaemic control, hypertension, presence of CKD and metabolic syndrome and any of the electrocardiographic abnormalities.&#x0D; Conclusion: Electrocardiographic abnormalities are common in stable type 2 diabetic subjects. There was significant association between smoking habit, central obesity, dyslipidaemia, lack of exercise and ECG abnormalities that included AV block, QRS axis and ST segment abnormalities.