University Of Port Harcourt Teaching Hospital Research Articles

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.

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.

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.

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

Obstetric Outcome in Patients with Previous Abdominal Myomectomy at a Tertiary Hospital in South-South Nigeria

Background: Abdominal myomectomy refers to the surgical removal of fibroids from the uterus through an abdominal incision. It is one of the treatment options for uterine fibroids. Women who had this form of treatment may be faced with increased risks and complications during future pregnancies and deliveries. Aim: To assess the obstetric risk and delivery outcome of pregnancies achieved after abdominal myomectomy. Methodology: This was a retrospective study of pregnancy outcome in women who had abdominal myomectomy at University of Port Harcourt Teaching Hospital (UPTH) from 2018 to 2022. The case records of the patients were retrieved, and data on socio-demographic characteristics, mode of delivery, obstetric complications, and foetal outcome was extracted and analysed using SPSS version 25. Results: There were 7,602 antenatal clinic attendees during the study period, out of which 83 of the women had previous myomectomy and were delivered in UPTH. This accounted for 1.1% of booked patients who attended antenatal care and delivered at the hospital. Seventy-two case notes were retrieved, giving a case retrieval rate of 86.7%. The mean age was 34.89 ± 4.27 years (range from 18 to 47 years). The total Live birth post myomectomy was 56 (77.8%). There were 14 (19.4%) miscarriages and 2 (2.8) stillbirths. Patients that conceived spontaneously were 61 (84.7%), while 11 (15.3%) had in-vitro fertilization (IVF). Caesarean section was used in 67 (93.1%) of deliveries with elective caesarean section accounting for 45 (62.5%) of the deliveries. The commonest indication for caesarean section was previous myomectomy with breached endometrium in 53 (79.1%) cases. Forty-one (56.9%) of the deliveries occurred at 38-40 weeks of gestation. Conclusion: Obstetric outcome after abdominal myomectomies was good with high live birth rate and no maternal mortality recorded. Women who had abdominal myomectomy should be counselled to attend antenatal care and deliver in adequately equipped centres with skilled personnel to avert adverse pregnancy outcomes.

ECG pattern among adult patients on antipsychotic medications at the university of port Harcourt teaching hospital, River State, Nigeria

Background: Antipsychotic medications treat neuropsychiatric disorders like Schizophrenia and Bipolar disorder. Despite their symptom management benefits, they carry cardiovascular risks. Electrocardiogram (ECG) monitoring is crucial for detecting abnormalities. This research aims to identify and understand these risks, aiding healthcare professionals in implementing effective monitoring for better patient outcomes. Methods: A retrospective study on subjects who are patients on Antipsychotic medications from the University of Port Harcourt Teaching Hospital (UPTH). Results: In a study with 100 patients on antipsychotic medications, 68% displayed abnormal ECG changes during treatment, while 32% had normal patterns. Left Ventricular Hypertrophy (LVH) and Atrial Enlargements were common, affecting 30% and 26% respectively, while QT interval prolongation was rare (2%). Risperidone, Sodium Valproate, and Trihexyphenidyl showed the most abnormal ECG changes, whereas Olanzapine, Fluoxetine, and Escitalopram were relatively safer. Conclusion: ECG monitoring is an essential component of the management of patients on antipsychotic drugs. It enables the early detection of QT interval prolongation and other cardiac abnormalities, allowing for timely interventions and personalized treatment plans. Our study showed just 2% of the patient had QT interval prolongation, however Left Ventricular Hypertrophy was a common finding in the ECG of the patients, 30%.

Molecular detection and association of HIV and HSV-2 IgM co-infection among asymptomatic pregnant women in Port Harcourt, Nigeria

HSV-2 is a common human pathogen that can cause primary and recurrent infection of the mucous membrane. Genital infection with HSV-2 facilitates the acquisition of HIV, both mutually reinforcing infection. Infection with herpes simplex virus type 2 is a significant public health problem being the leading cause of genital ulcerative disease. This study aimed at Molecular investigation and association of HIV and HSV-2 IgM co-infection among asymptomatic pregnant women in Port Harcourt, Nigeria. This is a cross-sectional study conducted at the antenatal unit of the University of Port Harcourt Teaching Hospital (UPTH), River State. A total of 168 consenting pregnant women were selected. The study involved collecting socio-demographic data and laboratory determination of HSV-2 immunoglobulin M (IgM) and HIV seroprevalence using enzyme linked immunosorbent assay (DIAPRO Diagnostic Bioprobes, Milan, Italy) and ALERE determine/STAT PAK respectively. Data analysis was done using graph pad statistical package. Chi square analysis was used to determine the correlation of the infection with socio-demographic factors. The seroprevalence for HSV-2 IgM was 29.8% (50/168) of the respondents while there was no co-infection between IgM and HIV. All HIV respondents were married. Majority are trader having tertiary educational qualification and are in a monogamous relationship. With regard to IgM seropositivity age, marital status, religion and gestation period were significantly associated with IgM while educational level, occupation, type of family and parity were not significantly associated with HSV-2 IgM. There is a significant correlation between HIV seropositivity with parity and history of sexually transmitted disease while there is no significant difference between HIV prevalence with age, marital status education level occupation type of family, religion history of abortion and the prevalence of HSV-2 was high among women of childbearing age in Port Harcourt, Nigeria. Effort should be made to increase the awareness of HSV-2 and HIV infection among the childbearing populace and serological testing of pregnant women should be included as a routine test.

Pattern and Prevalence of Drug Use among a Population of Mentally Ill Patients attending the University of Port Harcourt Teaching Hospital

Background: People with mental illness are at increased risk for substance use and individuals who experience a substance use disorder (SUD) during their lives may experience a co-occurring mental disorder and vice versa. The dual diagnosis often affects the illness course, worsens prognosis and presents a management difficulty. Aim: This study aimed to look at the prevalence of psychoactive use among mentally ill patients at the University of Port Harcourt Teaching Hospital. Materials and Methods: This was a descriptive cross-sectional study conducted among attendees of Neuropsychiatric Outpatient Clinic of the University of Port Harcourt Teaching Hospital (UPTH). A structured questionnaire covering socio-demographic characteristics and other factors were self-administered to 75 patients diagnosed with various psychiatric disorders by consultants Psychiatrists and attending the out-patient clinic via a systematic random sampling. Ethical approval was obtained from the ethical committee of the University of Port Harcourt Teaching Hospital and all other ethical provisions were followed. Descriptive statistics was used to analyze the data. Results: Majority of the respondents were male (81%), single (76.0%), unemployed (36.0%), low income earners (73.4%) and between the ages of 21 and 30 (44%).. Majority had tertiary education (58.7%) followed by respondents with secondary education (33.3%). The prevalence of psychoactive substance use was 48% with Cannabis being the most reported consumed drug (24%), cocaine 16%, nicotine 14.7%, heroine 10.7%, alcohol 6.7%, then volatile substance and hypno-sedation 2.7% and 1.3% respectively. Majority of the Respondents had use drugs between 1- 10 years. Conclusion: Drug use is common among the persons suffering from mental disorders in UPTH. Better evaluation for and proper management of this dual diagnosis will help to improve their mental well-being and quality of life.

Impacts of Pandemics on Healthcare Workers in Teaching Hospitals in Rivers State, Nigeria: Perspective from Healthcare Workers’ Experience during Pandemics

Background: Pandemics are wide-ranging incidences of infectious diseases that significantly increase morbidity and mortality in extensive geographic area. The study assessed impacts of pandemics experienced by healthcare workers in teaching hospitals in Rivers State, Nigeria.
 Materials and Methods: This study was conducted among healthcare workers in teaching hospitals (University of Port Harcourt Teaching Hospital (UPTH) and Rivers State University Teaching Hospital (RSUTH) in Rivers State Nigeria. Multi-stage sampling method was adopted to recruit 754 healthcare workers into the study, and a descriptive cross-sectional study design was used. A structured questionnaire was developed and pre-tested. The reliability of the questionnaire for this study was performed with the index of internal consistency and was calculated with Cronbach’s alpha coefficient which gave a considerable value of 0.72. The responses gotten from the participants were entered into, and analysed with IBM Statistical Package for Social Sciences (SPSS) software version 25. Ethical clearance to conduct the study was gotten from the Research and Ethics Committee of the University of Port Harcourt. Informed consents were obtained from each of the participants.
 Results: Most (62.2%) of the participants experienced psychological impact of pandemics, (59.4%) of the participants experienced emotional impact of pandemics, (54.5%) of the participants experienced financial impact of pandemics and the overall (58.2%) of experienced impact of pandemics on the HCWs was obtained. Also, the result revealed a statistically significant association between marital (p=0.0001), sex (p=0.003), religion (p=0.0001), level of education completed (p=0.039), income (p=0.0001), professional category (p=0.0001), duration of work (p=0.0001) and overall experienced impact of pandemics on the participants. We predicted that among the participants, marital status, sex, religion, education, income professional category, and work duration at (p≤ 0.05), significantly contributed to the level of experienced impact of pandemics among the participants.
 Conclusion: Majority of the healthcare workers reported impact of pandemics. However, psychological impact of the pandemics was most prevalent impact experienced by the healthcare workers who took part in this study. The level of impact of pandemics experienced by the health workers were substantially influenced by their socio-demographic characteristics. We recommend hospital management should improve the work setting and provide necessary support to the workers. Also, the healthcare workers should participant trainings on coping strategies during pandemics.

A Case Report of Limb Dystonia Management in a Nigerian Hospital: Physiotherapy Perspective

Background: Dystonia is a common movement disorder characterized by abnormal postures of the affected body part. The disabilities associated with dystonia are socially disabling and disfiguring, ranging from pain, loss of muscle strength and activities of daily living, poor quality of sleep and even depression. This article presents a case report of physiotherapy approach in the management of a patient with limb dystonia with major focus on pain management, balance control and functional independence. Case Presentation and Treatment Outcome: A case report of the management of a 48-year old female patient with limb dystonia. Patient was referred from the neurology unit, department of Internal Medicine, University of Port Harcourt Teaching Hospital (UPTH) to the neurology unit of the physiotherapy department, UPTH as a case of lower limb dystonia with an unknown cause. Appropriate physiotherapy intervention was given for a period of 12 weeks after a thorough assessment of the patient. The Numerical Pain Rating Scale (NPRS) was used to assess the level of pain in the affect limbs. The Berge Balance Scale (BBS) was used to assess the patient’s balance while Barthel Index (BI) was used to assess the functional independence of the patient. The case report was presented in line with CAse REport (CARE) guideline for case reports. All ethical procedures were followed. Treatment Outcome revealed that the score on Berg Balance Scale increased from 25 to 45 while that of Barthel Index scale increased from 13 to 18 after 12 weeks of intervention. Pain level on Range of Motion (ROM) based on the Numerical Pain Rating Scale (NPRS) reduced from 4/10 to 0/10 on the upper limb and from 9/10 to 1/10 on the lower limbs. Conclusion: Physiotherapy is effective in the management limb dystonia. Early referral to Physiotherapy is key to pain management, balance control and overall functional independence of the patients.

The first serological evidence of recent dengue virus infection among HIV-infected patients attending the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria

Dengue fever has grown to be a significant public health issue. By testing HIV-infected patients for IgM antibodies to the dengue virus, the study sought to determine its serological evidence in Port Harcourt Nigeria. Infected patients with HIV who were seen at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria, were the subject of this cross-sectional study. A total of 94 HIV-positive patients were enlisted, and after gaining consent, approximately 5 ml of whole blood was taken. Enzyme Linked Immunosorbent Assay was used to detect the presence of IgM antibodies to the dengue fever virus (ELISA). IgM antibodies prevalence to the dengue fever virus was found to be 35.1%. Females (43.6%) had a higher prevalence. Age- wise, the group of those under 25 showed a higher prevalence (46.7%). Single people (37.9%), people with tertiary degrees (52.9%), those without jobs (42.9%), and people who live in cities (37.8%) all had higher incidence rates. Several sociodemographic characteristics and dengue fever did not differ significantly (p > 0.05), although sex (p = 0.04), employment (p = 0.02), and place of residence (p = 0.001) were statistically linked to the prevalence of dengue IgM. This study found significant serological evidence of IgM antibodies to the dengue virus, indicating that HIV-infected patients in Port Harcourt, Nigeria, were carriers of this virus. Further research on this virus is required to build on the relationship between age, marital status, education, and most importantly, the seasonal variation of the virus in terms of infection rates.

The etiology of major, acquired female urogenital and rectovaginal lesions in Port Harcourt, Nigeria

Introduction: New and emerging trends in the causation of urogenital and rectovaginal lesions, and changing patterns of behavior of female patients with the diseases were observed. The aim of this study is to determine the risk factors and etiology of these diseases. Methods: This was a cross-sectional observational study of records of consecutive female patients operated on at the University of Port Harcourt Teaching Hospital (UPTH), Nigeria, with major urogenital and rectovaginal lesions from 01/01/2018 to 31/12/2022. Each patient’s records, sociodemographic data, clinical assessment, laboratory investigations, diagnosis, and intraoperative findings were studied and recorded. Data obtained were analyzed with simple statistics, and presented in charts prose, and tables. Results: Twelve major cases were found and studied. Their age statistics (in years) were as follows: mean age, 38.6±11.5; median, 34; and age range of 25 to 68. Ten of them were within the childbearing age (15-45 years). One patient had a uterocutaneous fistula with subcutaneous endometriosis. Another had anorectal carcinoma with rectovesical and rectouterine fistulas. One had uterovesical fistulas with menouria (Youssef’s syndrome), and the fourth had uterovesical fistula with a perineal tear. Four patients had uterovaginal prolapse, and 4 had vesicovaginal fistulas. Obstetric and gynecological trauma and sexual battery accounted for nine of 12 cases. The patients had high-risk pregnancies but had antenatal care and labor managed by either traditional birth attendants or primary healthcare staff at peripheral institutions. Conclusion: Most of the risk and etiological factors of the lesions were found modifiable. Appropriate measures have been suggested for the management and prevention of the lesions.

Socio-demographic and HIV-Related Factors Associated with Depression among Retroviral Positive Adolescents in Port Harcourt

Introduction: Depression with HIV constitute a co-morbid condition associated with severe sequalae, which include deliberate self-harm and suicide, even among adolescents. Identifying demographic and HIV-related determinants of depression among adolescents living with HIV is vital for instituting relevant evidence-based interventions for curbing this problem. Thus this aimed to determine the relationship between these factors (socio-demographic and HIV-related factors) and depression among adolescents living with HIV.
 Methods: A cross-sectional hospital-based study was employed. It involved 140 HIV-infected adolescents, who were selected from the HIV Paediatric clinic of the University of Port Harcourt Teaching Hospital (UPTH) via systematic sampling method. Depression was determined based on the depression component of the depression anxiety stress scale (DASS-21), while social support was assessed using the social support rating scale. Socio-demographic and HIV-related factors comprised independent variables, while dependent variable was depression. Bivariate and multivariate analyses were performed at p<0.05.
 Results: The mean (±) age of HIV-infected adolescents in the study was 14.05±2.68years. Close to half of the adolescents in the study had been living with HIV from birth (46.4%;n=65). The prevalence of depression was 14.2% (n=20). HIV-infected adolescents aged ≥16 years were four times more likely to experience depression than their younger aged counterparts (AOR: 4.40;95%CI:1.42-13.70). Also, those with higher social support had significantly lower odds of experiencing depression (AOR:0.94;95%CI:0.90-0.99).
 Conclusion: About 1 in 7 adolescents living with HIV are burdened with depression in the study area. Social support and age of adolescents showed significant relationship with depression in the study. The integration of mental health in Paediatric HIV care could optimize health outcomes.

Assessment of Plasmodium falciparum Resistance to Artemisinin Among Attendees of Selected Health Facilities in Rivers State, Nigeria

Across-sectional research, aimed at evaluating artemisinin drug resistance in falciparum malaria patients attending selected health facilities in Rivers State, Nigeria, was done between July 2019 and March 2020. The selected hospitals were Rivers State University Teaching Hospital (RSUTH), University of Port Harcourt Teaching Hospital (UPTH) and Model Primary Health Centre (MPHC), Iriebe, all in Rivers State, Nigeria. The study population was 1000 subjects with an overall malaria prevalence of 25.5%, the number of enrolled participants from RSUTH was 494 with the highest infection rate of 32.5%, 300 from UPTH which had the least (11%) prevalence, while 206 were from MPHC, Iriebe with 29.6% prevalence accordingly. Blood samples were collected from these subjects by phlebotomy method. Plasmodium falciparum parasite was determined by microscopy using thick and thin blood films stained with Giemsa staining technique. Artemisinin resistance markers were assessed using the nested polymerase chain reaction method. The study population consisted of children, pregnant women, and other adults of both sexes. Out of the forty-seven isolates assayed for K13 and ATPase 6 genes, who carried the artemisinin-sensitive wild-type allele, none of these isolates exhibited both ATPase 6 and Kelch -13 resistance genes/mutations hence no single nucleotide polymorphism was observed. This suggests that this part of the country is not under the threat of artemisinin resistance. However, this should not undermine the need for continuous monitoring and surveillance of the response of P. falciparum to Artemisinin and Artemisinin combination therapy (ACTs) in River State.

Comparative Study of Interleukin- 6 (Il-6) and Tumour Necrosis Factor Alpha (Tnf-Α) Levels in Prostate Cancer and Benign Prostatic Hyperplasia Subjects

Prostate cancer (PC) is an age-related malignancy that is very common in adult males with a very high morbidity and mortality rate worldwide. Chronic inflammation is thought to play a role in carcinogenesis. Pro-inflammatory cytokines, such as interleukin-6 (IL-6) and tissue necrosis factor-α(TNF-α), have been implicated in the pathogenesis of prostate cancer (PC). Its diagnosis remains a challenge even with a combination of methods. Serum prostate specific antigen (Serum-PSA) is the universally accepted biomarker for PC detection. However, it is neither specific nor confirmatory. The aim of this study was to compare IL-6 and TNF-α levels in PC and benign prostatic hyperplasia (BPH) subjects. This cross-sectional, descriptive, non-random study involved 60 histologically diagnosed PC and 20 BPH subjects attending the Urology Clinic of the University of Port Harcourt Teaching Hospital (UPTH). The Enzyme Linked Immunosorbent Assay (ELISA) technique was used to assay the cytokines (IL-6 and TNF-α). From this study the peak incidence of PC and BPH subjects was observed at 60-69 years with a mean age of 68.31± 7.72 years and 66.5 ± 10.6 years respectively. The observed difference in IL-6 level in the PC and BPH subjects was not statistically significant (P = .6696). However, the mean serum TNF-α level (29.6 ± 3.2pg/ml) was significantly higher in PC subjects when compared to BPH subject levels (25.3 ± 4.7pg/ml) for TNF α. This study has shown that PC subjects have higher level TNF-α and as such it can serve as a differential marker for PC.

Pattern of psychiatric presentation among a population of mentally ill patients at the University of Port Harcourt Teaching Hospital

Background: Mental illness is a serious condition of public health concern. It affects people of all ages with different clinical presentations, and usually affects the overall functioning of the individuals Aim: This study determined the pattern of psychiatric presentation among a population of mentally ill patients at the University of Port Harcourt Teaching Hospital, Port Harcourt. Materials and Methods: This was a descriptive cross-sectional study conducted among attendees of Neuropsychiatric Outpatient Clinic of the University of Port Harcourt Teaching Hospital (UPTH). A structured questionnaire covering socio-demographic characteristics and other factors were self-administered to 75 patients diagnosed with various psychiatric disorders via a systematic random sampling technique. Ethical approval was obtained from the ethical committee of the University of Port Harcourt Teaching Hospital. Descriptive statistics was used to analyze the data and expressed in frequency tables. Results: Majority of the mentally ill patients were male (81%), single (76.0%), and between the ages of 21 and 30 (44%). The most common psychiatric presentation include depression 19(25.3%), followed by anxiety disorder 16(21.3%), BAD 12(16.0%), substance misuse 9(12.0%), schizophrenia 11(14.7%), sleep 1(1.3%), and personality disorder 1(1.3%). The duration of treatment of mental illness was majorly within the last 5 years with the highest percentage representation (34.7%). Conclusion: Psychiatric presentations among the mentally ill exits in different forms. Depression is the most prevalent mental disorder among those studied. More medical, social and financial support should be given to the mentally ill as most of them have very high chances of developing depression.

Prevalence and Pattern of Sexual Assaults among the Mentally Ill attending the University of Port Harcourt Teaching Hospital

Background: Sexual assault among the mentally ill has become a common trend of public health concern occurring in various forms and perpetrated by different classes of individuals. It has become a more accurate predictor of suicidal ideation and attempt than any other form of abuse. Aim: This study determined the prevalence and pattern of sexual assaults among the mentally ill attending the University of Port Harcourt Teaching Hospital. Materials and Methods: This was a descriptive cross-sectional study conducted among attendees of Neuropsychiatric Outpatient Clinic of the University of Port Harcourt Teaching Hospital (UPTH). A structured questionnaire covering socio-demographic characteristics and other factors were self-administered to 75 patients diagnosed with various psychiatric disorders by consultant Psychiatrists at the out-patient clinic via a systematic random sampling method. Ethical approval was obtained from the ethical committee of the University of Port Harcourt Teaching Hospital. Descriptive statistics was used to analyze the data. Results: Majority of the mentally ill patients were male (81%), had tertiary education (58.7%), and between the ages of 21 and 30 (44%). The most common mental illness experienced by victims of sexual assault include depression 21(28.0%), the least being sleep and personality disorders 1(1.3%). 16% reported that they had experienced sexual assault, and majority (38.7%) reported that the assault occurred when they were between the ages of 10 and 18. Majority of perpetrators of sexual assault were siblings 5(6.7%), followed by mother 3(4.0%). Some percentage was strangers (1.3%), with the rest being either a visitor to the house (1.3%), or neighbor (1.3%). Only (2.7%) of those who experienced sexual assault reported the assault, (9.3%) did not report it, while 66 (88%) had no response. Conclusion: Sexual assault among the mentally ill is on the rise and manifests in several forms. Measures should be taken by all stakeholders including the government to curb this ugly trend.

Pattern and prevalence of psychiatric comorbidity among people living with HIV (PLWHIV) at the University of Port Harcourt teaching hospital (UPTH)

Background: HIV, a communicable disease, is assuming an alarming epidemic dimension with increasing level of psychiatric co-morbidity and mortality. These psychiatric comorbidities appear to be generally under-recognized and under-treated by clinicians. Aim: The aim of this study, therefore, was to determine the pattern and prevalence of psychiatric co-morbidity among PLWHIV attending the virology clinic of UPTH. Methodology: Following ethical approval from the ethical committee of the hospital and informed consent from the participants, 230 subjects were recruited based on the study’s inclusion and exclusion criteria, via a systematic random sampling. PLWHIV were further administered with the study’s instruments including the socio-demographic questionnaire and GHQ-12. The data were analyzed using the SPSS version 20 statistical package. Confidence interval was set at 95% while P- value of less than 0.05 was considered statistically significant. Results: One hundred and sixty (69.6%) out of the total number of 230 PLWHIV studied had no psychiatric diagnosis while 70 (30.4%) had different associated psychiatric morbidity. Of the total number with psychiatric diagnosis, 38 (16.0%) had depressive illness. Generalized anxiety disorder was diagnosed in 8 (3.5%) respondents, while 4 (1.7%) respondents had mixed anxiety and depression. Nine (9) (3.8%) patients had adjustment disorder while 3 (1.3%) females were diagnosed with hyposexual dysfunction. Six (2.6%) patients had alcohol abuse, 11 (5.8%) were diagnosed with PTSD and only 1 patient (0.4%) had panic disorder. Conclusion: The findings of this study support the impression that HIV infection is a chronic debilitating illness, associated with psychiatric co-morbidity. The results support the call that the management of patients with HIV should include attention to their mental health status in order to enhance the quality of care.

Cardiovascular Disease Spectrum and Mortality in the Medical Wards of University of Port-Harcourt Teaching Hospital: A 5-Year Review

Background: Cardiovascular disease is a leading cause of mortality globally. Approximately 80% of deaths occur in low- and middle-income countries like Nigeria, where preventive health practices are poor or non-existent. The aim of this study was to assess the pattern of cardiovascular disease admissions and mortality over a 5-year period in a tertiary hospital in Rivers State, Nigeria.
 Methods: Admissions records of patients admitted into the medical wards within the study period (January 2017 to December 2021) were reviewed and relevant information pertaining to the study objectives was retrieved for analysis. Data obtained from the records were the age, sex, final diagnosis, co-morbidities, duration of admission and outcome.
 Results: There were a total of 1901 cardiovascular admissions with a male to female ratio of 1.3 to 1. Cardiovascular mortality was also higher in males with a ratio of 1.0 to 0.9. Cerebrovascular accident accounted for 44.9% of total admissions which was closely followed by heart failure (39.4%), hypertensive crises (10.2%) and pulmonary embolism also accounted for 3.5% of cases. Acute coronary syndrome, arrhythmias, pericarditis, and peripheral vascular disease accounted collectively for less than 2% of cases. Cardiovascular related mortality accounted for 20.6% over the 5-year study period. Males had significantly higher cases of heart failure during the study period.
 Conclusion: A high burden of cardiovascular disease related admissions and mortality was found with an exponential increase over the 5-year study period. Cerebrovascular accident and heart failure accounted for the commonest cause of CV mortality. Preventive measures to reduce the burden of CV disease is essential to curtail this growing menace.