Port Harcourt Teaching Hospital Research Articles

Comparative evaluation of modified diurnal tension curve with water drinking test among glaucoma suspects at University of Port Harcourt Teaching Hospital, Rivers State, Nigeria

Objective: The objective of the study was to assess the correlation of intraocular pressure (IOP) peaks and fluctuation obtained using a modified diurnal tension curve (mDTC) and water drinking test (WDT) and to investigate the relevance of routine use of WDT in glaucoma suspects at University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State Nigeria. Materials and Methods: Glaucoma suspects were enrolled in this prospective comparative study. A total of 138 participants were recruited. All participants were subjected to two hourly IOP checks for 8 h (mDTC starting from 8:00 am). The WDT was done the following day, starting at 8:00 am. There was a 2-h water fast before the commencement of the WDT and IOP was measured every 15 min for 1 h after ingestion of 1 L of water. Results: Out of the 138 glaucoma suspects recruited for the study, 57 were male and 81 females, with a mean age of 37.8 ± 11.7 years. The mean peak IOP measured during mDTC (19.0 ± 3.5 mmHg) was statistically different from that measured during WDT (20.9 ± 4.4 mmHg; P < 0.001). The mean IOP fluctuation measured during the mDTC (5.6 ± 1.9 mmHg) was also statistically different from that measured by WDT (6.9 ± 2.7 mmHg) (P < 0.001). The peak IOP measured during mDTC showed a strong correlation with peak IOP during WDT (r = 0.840); however, there was moderate agreement between the two peaks (k = 0.408). The IOP peaks of mDTC and WDT showed excellent strength of association (Cronbach’s alpha = 0.901) and poor strength of association for the fluctuation in IOP (Cronbach’s alpha = 0.556). Conclusion: The WDT can provide an easier, nonexpensive, and less time-consuming method of peak IOP determination, which will aid in the timely management of glaucoma patients.

The Case for Strategic Integration of Diabetes Education in Southern Nigeria, Informed by Insights from a Pilot Study

The surge in diabetes cases affecting 3.6 million individuals in Nigeria demands a proactive response. Despite the high prevalence, the current Nigerian model is reactive leading to delayed treatment, heightened complications, elevated healthcare expenses, and diminished quality of life. This document proposes the solution of integrating culturally adapted Diabetes Self-Management Education and Support (DSMES) programs into Nigerian health policy as standard practice. Additionally, it recommends establishing diabetes educator training programs and a nationwide accreditation process. The development of such a program, in collaboration with the University of Port Harcourt Teaching Hospital, is outlined, highlighting both successes and failures during its initial implementation. These insights emphasize the importance of enhanced collaboration, sustainable funding, and a comprehensive monitoring and evaluation framework. These observations are currently driving ongoing program development.

Knowledge of occupational hazards and practice of occupational safety among diagnostic radiographers in university of port Harcourt teaching hospital, rivers state

Health workers particularly radiographers have continuously faced with various occupational hazards due to the occupational environment that is associated with unsafe working conditions and lack of protective equipment. This study aimed to explore knowledge of occupational hazards and practice of occupational safety among diagnostic radiographers in university of Port Harcourt teaching hospital, Rivers state. The study adopted descriptive cross-sectional study, a questionnaire was the instrument used to collect data from 226 radiographers. Data was analyzed using SPSS version 25.0. Results shows good knowledge occupational hazards (72.8%); and good practice of occupational safety (68.5%). Regarding safety practices, radiographers exhibited moderate radiation protection practices (71.2%), with most portraying good practices. No significant gender or age differences were found in practices. Experience did not affect practices significantly. Radiographers with specialized training displayed better practices. The study concluded that radiographers had appreciably high knowledge and moderate safety practices. The study recommended continuing education programs, monitoring of practices, adequate protective facilities, and enhanced curriculum on radiation safety are required to address knowledge and practice gaps among radiographers in Nigeria.

Glycated Hemoglobin as a Screening Tool in the Diagnosis of Diabetes Mellitus among Adult Patients in a Tertiary Health Facility in Port Harcourt, Niger Delta Region of Nigeria

Abstract Background: The prevalence of diabetes mellitus (DM) has been increasing worldwide, especially in Nigeria. However, it remains underdiagnosed in many people with the disease. There is a need for early detection and treatment of the populations that are at risk to prevent or reduce complications. There is a paucity of Nigerian studies documenting the performance of the glycated hemoglobin (HbA1c) test in diagnosing DM. This, therefore, informed our decision to embark on this study. Objective: The objective of this study was to assess the role of the HbA1c in the diagnosis of DM at the University of Port Harcourt Teaching Hospital. Materials and Methods: This was a descriptive cross-sectional study, in which 400 subjects were evaluated for the presence of glucose intolerance. Two hundred patients with hypertension and 200 nonhypertensives patients were screened for DM. A structured questionnaire was administered to the recruited subjects, and their blood samples were collected for HbA1c and fasting plasma glucose. The detection of DM using the two different screening tests was determined. The sensitivity and specificity were calculated. Results: The mean age of the hypertensive subjects was 48 ± 10 years, whereas that of the nonhypertensive subjects was 46 ± 10 years. The frequency of diabetes in the study population by the HbA1c was 7.8%, whereas it was 25.3% by the oral glucose tolerance test (OGTT) (P < 0.001). The frequency of prediabetes was 25.3% by the HbA1c as compared to 20.5% by the OGTT (P < 0.001). The sensitivity of the HbA1c test for the diagnosis of diabetes was 62.5%, whereas the specificity was 99.7%. Conclusions: This study shows that there was a significant difference in the diagnostic performance of the HbA1c test compared to the OGTT; HbA1c test was less accurate and more likely to miss some diagnoses.

Renal dysfunction in HIV-infected patients commencing antiretroviral therapy in a treatment centre in southern Nigeria

Objective: As HIV becomes a more manageable chronic condition, with increasing life expectancy and an ageing population, kidney disease due to HIV or antiretroviral therapy (ART) have become more prominent. Moreover, the nephrotoxic potential of some frontline antiretroviral drugs has become established. The study aimed to evaluate the prevalence and risk factors for renal dysfunction among HIV-infected patients commencing ART at a southern Nigerian tertiary hospital. Methods: A cross-sectional prospective study involving 263 HIV-infected treatment-naïve patients commencing ART at the University of Port Harcourt Teaching Hospital, Port Harcourt. Blood and urine samples were taken from randomly recruited patients for appropriate laboratory analysis. The MDRD formulae were used for evaluating renal function while renal dysfunction was defined as an estimated glomerular filtration rate ≤ 60mls/min/1.73m2 and /or proteinuria. Results: The average age of enrolled patients was 36.3±10.15 with 59.3% women. 33.8% had proteinuria and 6.5% had eGFR<60mls/min/1.73m2. The prevalence of renal dysfunction was 37.6%. Age > 50 years, anaemia and use of Traditional medicine were independent predictors of renal dysfunction. Conclusion: In this cohort of treatment naïve HIV patients, a high prevalence of renal dysfunction exists. Older age, anaemia and traditional medicine use were predictors of renal dysfunction. There is a need for clinicians to monitor these variables, especially the use of Traditional medicine which is easily overlooked in practice.

Factors Influencing Attitude and Adherence toward Principles of Medical Ethics among Midwives and Midwifery Students in University of Port Harcourt Teaching Hospital

Introduction: The professional ethics of midwives at the University of Port Harcourt Teaching Hospital (UPTH) in Rivers State, Nigeria, represent a crucial aspect of healthcare delivery, influencing both patient care and educational frameworks within midwifery. This study investigated factors influencing attitudes and adherence to principles of medical ethics among practising midwives and midwifery students. Methodology: A cross-sectional quantitative design was adopted to survey 124 participants drawn using purposive sampling. The participants were predominantly aged between 18 and 45 years, with a minor segment over 46. The majority, 89.5%, were female, reflecting a significant gender imbalance, while males constituted only 10.5%. Data collection was carried out using a questionnaire, which included items on demographic data and various ethical considerations in midwifery practice. Mean and standard deviation were employed for data analysis. Results: Findings from the study revealed a positive attitude (3.41±0.773) and a strong adherence to medical ethics principle (3.39±0.642). The most challenging factors to adherence were balancing conflicting ethical principles in complex cases(3.12 ± 0.694) and workplace culture and policies (3.01 ± 0.716) while regular training and updates on medical ethics (3.64 ± 0.483) and recognition and appreciation for ethical behaviour (3.45 ± 0.603) as the most effective ways to overcome the challenges. Conclusion: Despite the positive attitude and high level of adherence to medical, challenges remain. As such, continuous education and reinforcement of ethical principles are imperative to ensure that these standards are not only understood theoretically but are also consistently applied in clinical practice.

Test characteristics of glycated albumin in the diagnosis of gestational diabetes mellitus

This study determined the test characteristics of glycated albumin in the diagnosis of gestational diabetes mellitus. The gold standard for diagnosing gestational diabetes mellitus is the oral glucose tolerance test which requires patient preparation, drinking of glucose solution, and multiple sample collections. A possible alternative biomarker for the diagnosis of gestational diabetes is glycated albumin does not require patient preparation and only one sample is collected. Glycated albumin levels are higher among Black Americans than in Caucasians.The study involved 200 pregnant women attending the antenatal clinic at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was made using the World Health Organization 2013 diagnostic criteria. The test characteristics of glycated albumin were determined using the area under the curve of the receiver operator characteristic curve, sensitivity, specificity, positive predictive value, and negative predictive value. The prevalence of gestational diabetes mellitus was 9.0%. The area under the receiver operator characteristic curve for glycated albumin was 0.8 (95% CI 0.7-0.9; p=0.0001). The sensitivity and specificity of glycated albumin were 83.3% and 86.8% respectively. The positive predictive value was 38.5% and the negative predictive value was 98.1%. Glycated albumin has high sensitivity, specificity, and negative predictive values and therefore, can be used as a preliminary test for gestational diabetes mellitus.

Post Partum Resumption of Sexual Activity and Its Determinants in Nursing Mothers: A Port Harcourt Study

Introduction: Influenced by cultural, spiritual and religious beliefs. A lot of couples suspend sexual activities and resume at various different times due to influences by different factors. Materials and Method: This was a descriptive cross-sectional study among 376 postpartum women and nursing mothers visiting the immunization/infant welfare clinic, postnatal and family planning clinic at the University of Port Harcourt Teaching Hospital. Data were obtained using pretested semi-structured interviewer-administered questionnaire, which was designed based on variables from existing literature pretested and revised to ensure the quality of information collected. The data retrieved was analysed and variables presented in tables. Results: Approximately 2/3rd (66.0%) of the women had a tertiary level of education. The result show 200(53.19%) of the women started sexual activity less than 6 weeks after delivery, with about 43.6% of the participants reporting various sexual dysfunctions like loss of desire, dyspareunia, vaginal dryness and others. The majority of the women (89.9%) were knowledgeable about contraception and the majority of those who knew about contraception 222(59%), made use of it. A higher proportion of women who had puerperal complications used contraception. Logistic regression analysis showed that women on contraception were about 12 times more likely to resume sexual activity after 6 weeks. Conclusion: Early resumption of sexual intercourse is common to women irrespective of sociodemographics and obstetric characteristics.

Male urethral stricture disease in a tertiary hospital in Port Harcourt, Nigeria: a five-year review of features, management and outcome.

Introduction: The aim is to assess the early impact of the current increased use of transurethral endoscopic procedures and emerging technologies on the management of urethral stricture disease (USD) in adult males at the University of Port Harcourt Teaching Hospital (UPTH), Nigeria. Material and Methods: The design of the study was cross-sectional and descriptive. Secondary data of patients treated between 01/6/2017 to 30/6/2022, with confirmed diagnosis of USD were used. Their registration numbers were used to access their records at the Health Records Department of the Hospital. Information obtained included sociodemographic data, aetiology, clinical features, types, sites and diagnostic tests of male USD, , uroflowmetry, urethral, and abdominopelvic ultrasonography, cystourethrography results, treatment methods, outcomes, complications and co-morbidities of USD. Data obtained were analyzed with simple statistics and presented. Results: Of 10,450 Urology patients 245 had USD. Data on 224 were found and analyzed. Their age profiles in years were mean, 45.7±18.6; age range 10-95. Married were 174 (77.68%). Urethral strictures were post inflammatory 126(56.25%); post traumatic 43.75%; bulbar,73(32.59%); bulbomembranous23.22%; posterior urethral 52(23.21%); penile 34(15.18%); and pan urethral 13, (5.18%). At presentation, 105 (46.88%) were hypertensive; 40.2% had UTI with Gram-negative bacilli. Recurrence of strictures occurred 6 months to one year after DVIU; 2 months to 6 years after urethroplasty. Non-compliance with schedules and follow-p occurred in 111 (49.55%) patients. Conclusion: USD prevalence was 24/1000 urology patients. UTIs were probably healthcare and prolonged catherization associated. Screening/review of service processes warranted. Lack of validated tools for measurement of outcome or dependent treatment variables made comparative studies unrealistic.

Inflammatory Patterns in the Prostate Gland and Serum Cytokine Activities in Primary Adenocarcinoma of the Prostate in Port Harcourt, Nigeria

Introduction: Chronic inflammation and pro-inflammatory cytokines such as (1L-6 and TNF-α) have been implicated in prostate carcinogenesis and metastasis. This study aims to evaluate serum concentrations of IL-6 and TNF-α, and to determine their association with clinicopathological patterns of prostate cancer in affected patients. Materials and Methods: Ninety (90) patients with histologically diagnosed prostate cancer (PCa), treated at the Urology Division of the University of Port Harcourt Teaching Hospital (UPTH), Nigeria were involved in this study. The enzyme-linked immunosorbent assay (ELISA) technique was used to assay cytokines (IL-6 and TNF-α), and serum PSA. Gleason Scores were categorized as well differentiated (GS of ≤ 6), moderately differentiated (GS = 7), and poorly differentiated (GS 8-10). Results were analyzed with IBM SPSS version 20.0. Pearson’s correlation test was used to determine the correlation between the cytokines (IL-6 and TNF-α) and Gleason Scores. Results: The modal age group with PCa was 60-69 years. The mean age of patients was 68.788.26 years, and the mean serum PSA 93.2478pg/ml. Serum levels of IL-6 and TNF-α were 8.0pg/ml, 11.2pg/ml and (27.0±26.4pg/ml) respectively. Forty-six subjects had poorly differentiated PCa (GS 8-10); 17 moderately differentiated (GS 7); and 27 well differentiated (GS ≤ 6). Mean serum levels of IL-6, TNF-α and PSA (113.1ng/ml) were raised and found highest in those with poorly differentiated PCa. Conclusion: The observed correlation was positive but weak. The patients might have commenced undeclared anti-inflammatory drugs that depressed inflammation. However, a larger sample size would probably confirm the prognostic value of IL-6 and TNF-α in PCa subjects.

Public-Private Partnership: Optimising the Outcomes for Plastic Surgery in a Resource-Limited Setting at the University of Port Harcourt, (UPTH) Rivers State, Nigeria

Background: Public Private Partnership (PPP) refers to a form of cooperation between public authorities and the world of business which aims to ensure the funding, construction, renovation, management and maintenance of an infrastructure or the provision of better services, better quality, better and better health in a relatively cost- effective manner or approach to the society.  Aim and Objectives: This paper highlights the role of PPP in optimizing outcomes for patients who require plastic surgical services.  Materials and Methods: This study was carried out to bring to light the perennial problems of the health care mixes within a period of 6 months in the Plastics and Reconstructive Surgery unit of The University of Port Harcourt Teaching Hospital. This work looked at the Public Private sector mixes in health care system using Nigeria as a case study.  Results: Cases managed at the public facility alone, cases managed at the private facility alone and the cases managed through the combined effort of both the Private and Public sector (PPP) were analyzed.  Conclusion: Public Private Partnership is key to the success and effectiveness of healthcare delivery in a resource poor setting as the PPP drives the marriage of effectiveness in administration and business prototype in the marriage of government infrastructure and large medical market with turn over into a partnership where the private component brings in the specific funding and equipment and expertise needed to make the medical business model.

Trauma-Related Deaths in the Accident and Emergency Department of a Nigerian Teaching Hospital

Background: Trauma is a significant contributor to morbidity, disabilities, loss of man hours and mortality in both the developed and developing world with 90% of global trauma deaths occurring in low and middle income countries. The extent of motor vehicular use, degree of adherence to use of safety gadgets, strength of enforcement of industrial safety regulations, level of civil unrest as well as other socio-demographic indices predict the contribution of various etiologic factors. Deaths from the trauma may perhaps have far more psychologic and physical impact on families that from acute/chronic medical cases Method: A retrospective study of the admission records and in-patient records of all trauma related deaths in the accident and emergency unit of the University of Port Harcourt Teaching Hospital from 1st January 2018 to 31st December 2022 was done. Relevant information was extracted and analyzed. Data obtained was analyzed descriptively. Results were presented in tables and charts where necessary. Means and standard deviations were used to represent certain variables. Results: Total emergencies (medical and surgical) seen within the study period were 42,443, total injuries seen were 10,787 giving a crude injury prevalence rate of 25.4%. There were a total of 766 deaths among injured patients giving a crude mortality rate of 7.1%. Road traffic accidents (RTAs) (46.3%) and Firearm injuries (23.5%) were the most common injury mechanisms seen. Traumatic brain injuries are by far the leading cause of trauma-related deaths in the ER (82.5%) with most deaths (96.1%) occurring within the first 72hours of Admission. Conclusion: Trauma-related deaths occur in 7.1% of all injuries presenting at the study sight. The most common mechanism is RTA while the most affected victim is the young adult male. Traumatic brain injury accounts for more deaths than all others combined with most of the deaths occurring within the first 72hours of presentation. All efforts at reducing these injuries should be encouraged.

Prevalence and Pattern of Stroke Cases Seen at the Neurology Clinic of Physiotherapy Department, University of Port Harcourt Teaching Hospital, Port Harcourt: A Ten-Year Retrospective Study .

Background: Stroke is a condition of public health concern. It affects people of different age brackets, leading to long-term debilitation with a significant percentage of survivors left with permanent disabilities Methods: The study adopted a descriptive retrospective study design in which the data of a total of 338 adult male and female stroke patients who attended the neurology clinic of Physiotherapy Department, University of Port Harcourt Teaching Hospital (UPTH), between December 2012 and December 2022 were retrieved and studied following ethical clearance. Data were analysed using the Statistical Package for Social Science (SPSS) version 25. Descriptive statistics was used to present the data in frequency tables. Results: Majority of the stroke patients were male 208 (61.5%), married 300 (88.8%), and between the ages of 51 and 60 (28.7%). The most common type of stroke was ischaemic stroke 295 (87.2%) with majority between the age bracket of 61-70 (26.6%). First episode of stroke was the most prevalent 301 (89.0%) with majority of the survivors between the age bracket of 51-60 (25.7%). Hypertension was the most prevalent risk factor 195 (57.7%) and was also most prevalent among the age bracket of 51-60 (16.0%). Lastly, majority of the stroke patients had right sided hemiparesis 192 (56.9%). Conclusion: The risk factors and clinical presentation of stroke vary from individuals to individuals. Adequate education, counseling, medical, and financial support should be given to stroke survivors in order to prevent and manage the condition.

Physiotherapy Management of Guillain-Barré Syndrome in a Tertiary Hospital in South-South Nigeria: A Case Report.

Background: Guillain-Barré Syndrome (GBS) is a potentially life-threatening post infectious disease characterized by rapidly progressive, symmetrical weakness of the extremities. It can cause life-threatening complications, particularly if the breathing muscles are affected or if there is dysfunction of the autonomic nervous system. Case Presentation: This is a case report of Physiotherapy management of a 51-year old female patient with Guillain-Barré Syndrome (GBS). Patient was referred from the neurology unit, department of Internal Medicine, University of Port Harcourt Teaching Hospital (UPTH) to the neurology clinic of the physiotherapy department, UPTH as a case GBS after series of investigations. Appropriate physiotherapy intervention was given for a period of 36 weeks after a thorough assessment of the patient. The Guillain-Barre Syndrome Disability Score was used to assess the overall functional status of the patient while the Oxford Muscle Grading Scale was used to assess for muscle strength. The Numerical Pain Rating Scale (NPRS) was used to assess the level of pain in the limbs while the Berge Balance Scale (BBS) was used to assess the patient’s balance. The case report was presented in line with the CARE: Case Report Guideline for case reports. All ethical procedures were followed. Treatment outcome: Treatment outcome revealed that the Guillain-Barré Syndrome Disability Score reduced from 4 to 2 while that of Berg Balance Scale increased from 3 to 42 after 36 weeks of intervention. Pain level on range of motion of the limbs based on the Numerical Pain Rating Scale reduced from 6/10 to 1/10 on the upper limb and from 8/10 to 2/10 on the lower limbs. Conclusion: Physiotherapy is effective in the management of patients with Guillain-Barré Syndrome. Early referral to Physiotherapy is key to pain management, balance control and overall functional status of the patients.

Seroprevalence of cytomegalovirus (CMV) among pregnant women at a tertiary facility in southern Nigeria

Background: Cytomegalovirus (CMV) also called human cytomegalovirus (HCMV) or human herpesvirus-5 (HHV-5) is an encapsulated double-stranded deoxyribonucleic acid (DNA) virus. It is an opportunistic virus which often remains latent and only become symptomatic in immune-suppressed individuals such as pregnant women, HIV/AIDS patients and other immune weakening disease conditions. It is also estimated to have an 86% global sero-prevalence among reproductive women. Objectives: To determine the sero-prevalence of CMV infection, investigate the relationship between risk factors and CMV infection and to determine the relationship between obstetric characteristics and CMV infections among pregnant women. Method: A cross-sectional study among a cross-section of pregnant women receiving ante-natal care in the University of Port Harcourt Teaching Hospital from August 2022 to December 2022. A structured pro forma data sheet was used as interviewer-administered questionnaire by medical personnel to collect data from the study participants. 5ml of blood was collected from each participant and assessed for the presence of anti-CMV IgG using commercial Enzyme-linked Immunosorbent Assay (ELISA). The data were analyzed using Statistical Package for Social Sciences (SPSS) version 25. Descriptive statistics (mean, median, frequency percentage and standard deviation), Chi-square test and Fischer’s exact test were used appropriately. Results: Out of 101 respondents, only 24 (24%) were positive for CMV IgG, while 77 (76%) were negative. About 50% of the women were in their 3rd decade of life, while (3) were in the 4th decade of life. All the respondents were married and were Christians. Three quarters of the women [75(74.3%)] had tertiary education, 20 (19.8%) had secondary education, while 6 (5.9%) were Postgraduate students. Based on income, women with income < #50,000 (53.5%) were the most common. The relationship between demographic factors such as age, religion, income, educational level, employment status, marital status and CMV results were statistically insignificant. The relationship between obstetric characteristics and CMV results were not statistically significant, while risk factors for CMV and presence of CMV infection were not statistically significant as well. Conclusion: The 24% sero-prevalence for CMV at University of Port Harcourt Teaching Hospital was quite low; however it can be reduced to the barest minimum, by encouraging intensive awareness campaigns about the virus and providing free serum testing to all categories of the population, since CMV affects all ages.

Complications of femoral access for hemodialysis: A surgical perspective

Background: Vascular access, especially arteriovenous fistula (AVF), is critical for patients requiring haemodialysis. Due to delayed diagnosis, late referral, poverty and limited availability of competent access surgeons, many patients commence haemodialysis without an AVF, hence the frequent use of venous catheters. Objectives: To assess the pattern of complications associated with repeated femoral punctures for haemodialysis. Materials and Methods: This is a multicentre prospective study conducted at the Cardiovascular units of the University of Port Harcourt Teaching Hospital, Port Harcourt and Federal Medical Centre, Umuahia between January 2017 and December 2022. 66 patients were recruited for the study. Data obtained were patients’ demography, complications of femoral access, surgical approach and outcome. Results: 15 patients presented with severe lower limb pains and inability to walk, 10 with fibrosis/ hardening of the skin of both groins, 8 with skin infection at the repeated puncture sites, 12 had Pseudoaneurysm of the superficial femoral artery (SFA), 6 had iatrogenic femoro-femoral Arteriovenous Fistula (AVF) of the SFA and superficial femoral vein (SFV), 5 had groin abscess. All the patients had internal jugular venous catheters inserted. Some patients had Fogarty catheter thrombectomies and interposition Great Saphenous Vein (GSV) graft repairs, while some others had successful takedown of the AVF, Fogarty thrombectomy and direct prolene 6/0 repair of the vein & arterial wall defects. All those that underwent surgical treatment had successful recovery. Conclusion: Femoral vein cannulation, apparently easy to perform, should not be used as the vascular access of choice for chronic haemodialysis.

Profile of women with Gynaecological cancers at a Tertiary Hospital in Southern Nigeria

Background: Gynaecological cancers remain a major public health concern in Low-and Middle-Income Countries. In sub-Saharan Africa, gynaecological cancers account for approximately one-third of all female cancers. Objectives: To determine the socio-demographic, reproductive, and clinical characteristics of gynaecological cancer patients at the University of Port Harcourt Teaching Hospital. Materials and Methods: This was a prospective cross-sectional study of 75 women with histologically confirmed gynaecological cancer managed at the University of Port Harcourt Teaching Hospital, from January 1, 2022, to December 31, 2022. A structured interviewer-administered questionnaire was used to obtain socio-demographic characteristics and clinical profile from the patients and their clinical records after informed consent was obtained. Data was entered into a MS Excel spreadsheet and analyzed with SPSS version 25. Results: Most 27 (36%) of the women were between 40-49 years of age, with a mean age of 50.4 ± 12.3 years. Majority 46 (61.3%) were married, 27 (36%) had tertiary education, and two-thirds earned N30,000 or less (≤ $20) per month. Many 23 (30.7%) were Para ≥ 5, almost all 63 (84%) of the women were referred to UPTH, with one-third 21 (33.3%) of the referrals coming from other tertiary health facilities. Most 63 (84%) of the women had never had a Pap smear screening, and 48 (64%) were menopausal. The most common presenting symptom was vaginal bleeding 37 (49.3%). Cervical cancer accounted for about half 40 (53.3%) of the cases, followed by ovarian cancer 27 (36%), with the majority 28 (43%) presenting with stage III disease. Chemotherapy was administered to all the patients. However, treatment was delayed in 57 (76%) of the women due to financial constraints, with most of the funding and support coming from family members in 43 (57.3%) of the women. Conclusion: There is an urgent need to increase advocacy for gynaecological cancers to increase awareness, prevent late presentation and progression of early disease. Furthermore, the government needs to subsidize the cost of cancer care to encourage early presentation and treatment.

Reliability Model of Medical Equipment in University of Port Teaching Hospital

In this research, on medical equipment maintainability and reliability we conducted basic statistics analysis using University of Port Harcourt Teaching Hospital as the case study; the data collected covered 18 departments, namely; Anatomical Pathology, Micro Biology, Chemical Pathology Laboratory, Radiography Department, Pediatrics, Hemodialialysis, Hematology and Blood Transfusion, Physiotherapy, Dental Department, MDR-TB unit, Pharmacy, ICU, Assisted Conception Unit, Orthopedic Ward, Care for Elderly Laboratory, Family Planning Unit, Community Medicine and Labour Ward. The results of the parametric Weibull distribution percentile suggested that the reliability of the devices tends to fail every 21 days. The reliability plot of the model indicated that the devices tend to decrease its life span with age, the Weibull model was adequately fitted following the results of Anderson adjust test of goodness of fit and the probability plot. In comparison, the Probability value of goodness of fit P(0.0000) of Weibull distribution model was compared with that of exponential distribution model P(0.034), the outcome showed that Weibull distribution is better to model the data of medical equipment in University of Port Harcourt Teaching Hospital.

Development of a Diabetes Mellitus Diagnostic System Using Self-Organizing Map Algorithm: A Machine Learning Approach

Delivery of Health care services in developing nations has posed a huge problem to the world at large. The United Nations and the World Health Organization have been on the front burner sorting for ways of improving these problems to abate the yearly mortality rates which are caused largely by inadequate health facilities, poor technical know-how, and poor health care administration. One disease that has a high number of patients is diabetes. In Nigeria, out of a population of 200 million, diabetes kills over 2% yearly. To reduce this menace, early diagnosis and awareness are important. And automation of the medical diagnostic system is one of the sure ways of achieving these feet. This paper explores the potential of a self-organizing map algorithm; a machine learning technique in the development of a diabetes mellitus diagnostic system (DMDS). Data collected from 120 patients from the University of Port Harcourt Teaching Hospital (UPTH) was used in the training and validation of the model. The confusion matrix formula was used in testing the sensitivity and accuracy of the model which yielded 75.63% and 87.2% respectively which are within the accepted range, predefined by expert physicians. Keywords Artificial Intelligence, self-organizing map, diagnosis, neural networks, diabetes mellitus

Evaluation of the Outcome of Interventions for Thoracic Endometriosis Syndrome at a Tertiary Level Health Institution in Southern Nigeria

Background: Thoracic Endometriosis Syndrome (TES) is a clinical condition characterized by the presence of endometrial tissue within the thoracic cavity, catamenial pneumothorax, catamenial haemothorax, catamenial haemopneumothorax, catamenial haemoptysis and or endometrial nodular lung mass. The management can be challenging as treatment is fraught with recurrence.
 Aim: To evaluate the outcome of interventions for Thoracic Endometriosis Syndrome.
 Methods: This was a prospective cross-sectional study of 14 patients with thoracic endometriosis syndrome who were managed at the university of Port Harcourt Teaching Hospital between August 1, 2017, and July 31, 2023. A proforma was used to collect data on socio-demographic characteristics, clinical presentation, type of intervention and evidence of recurrence of chest symptoms and entered into a spread sheet. Data analysis was done with SPSS version 28. Results are presented as frequency tables and percentages.
 Results: The age of the patients ranged between 20 and 44 years. Of the 14 patients, 11 (78.6%) were married, and 3 (21.4%) of the patients had established abdominal endometriosis with symptoms of thoracic endometriosis, while 4 (28.6%) had a histologic diagnosis of thoracic endometriosis. Pneumothorax was observed in 9 (64.23%) patients, 3 (21.43%) had haemopneumothorax, 2 (14.29%) with cyclical haemoptysis and haemothorax, and 4 (28.57%) of the patients had thoracic endometriotic nodules, while all the married patients had primary infertility. Twelve (85.7%) of the patients had closed tube thoracostomy drainage (CTTD) with chemical pleurodesis, while 4 (28.6%) had thoracotomy, decortication, bleb, and nodules resection with chemical pleurodesis. All the patients had hormonal therapy using luteinizing hormone-releasing hormone (LHRH) analogues. There was recurrence in 2 (14.3%) of the patients after a one-to-six-year period of follow-up.
 Conclusion: The treatment of TES using CTTD with pleurodesis, thoracostomy, decortication, bleb resection and or hormonal therapy with appropriate patient selection is effective as only two cases of recurrences were recorded.