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Record No. 13486 Record ID 013486 Publication type Journal Article Title The pattern of Obstructed Labour among Parturients in a Tertiary Hospital in Southern Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Jeremiah, I.; Nwagwu, V. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 6(1) Pages 89-95, fig., tab. Language English Descriptor Obstetric Labor Complications; Dystocia; Perinatal Mortality; Hospitals, Teaching Descriptor-Geographic Nigeria Abstract Background: Obstructed labour is an obstetric entity which is almost never seen in the developed world but remains very prevalent in the developing world. This study aims to determine the pattern of obstructed labour in our environment as well as examine its contribution to perinatal and maternal morbidity and mortality. Methods: This retrospective study was based on analysis of medical records of 116 cases of obstructed labour who presented for delivery at the Obstetrics Unit of the University of Port Harcourt Teaching Hospital, Nigeria, from 1st January, 2004 to December 31, 2008. Data collected from the records included patients' admission diagnosis, socio-demographic data, obstetric history and outcome. Data management was done using SPSS 15.0 for Windows® statistical software. Results: The incidence of obstructed labour was 0.78. All the patients were unbooked. Most of the parturients [65(66.4)] were aged between 20-30 years while 57(58.8) were nulliparous. Fifty three (55.2) had no formal education or primary education. Unemployed housewives, petty traders, hair dressers, seamstresses or farmers comprised 87.6of the patients. Forty seven (47.4) babies were stillborn. Twenty nine babies (29.9) were admitted into the Special Care Baby Unit. Thirty nine babies (40.2) were discharged home. The perinatal mortality rate was 597 per 1000 live births. Puerperal sepsis was the commonest maternal complication [30(30.8)]. There were seven maternal deaths giving a case fatality ratio of 7216.5/100,000. Conclusion: Obstructed labour, is still prevalent in our environment and contributes significantly to maternal and perinatal morbidity and mortality. Most of its victims are unbooked nulliparous ladies with poor socio-economic and educational backgrounds

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Record No. 13485 Record ID 013485 Publication type Journal Article Title Contraception with Combined Oral Contraceptive Pills in Port Harcourt, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Enyindah, C. E.; Nonye-Enyidah, E. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 6(1) Pages 81-88, fig., tab. Language English Descriptor Contraception Contraceptives, Oral, Combined-adverse effects; Patient Acceptance of Health Care Health Education Descriptor-Geographic Nigeria-Port Harcourt; Abstract Background: Millions of women worldwide use the combined oral contraceptive pill (COCP) as an effective form of contraception. This has contributed immensely to population control and improvement of maternal wellbeing. Aim: To determine the acceptability, efficacy and side effect of COCP in Port Harcourt and compare with the experience elsewhere. Methods: This was a retrospective study of all clients who accepted COCP between 1st January 1997, and 31st December 2006 at the Family Planning Clinic of University of Port Harcourt Teaching Hospital (UPTH). Information obtained included sociodemographic characteristics, side effects, reasons for discontinuing the method and source of information. Results: A total of 4,160 clients accepted contraception during the study period, out of which 360 used COCP, giving a prevalence rate of 8.7. The mean age and parity of acceptors were 27.14 ± 4.68 years and 1.82±0.45 respectively. Among the clients, 99.4had formal education while 66.1were single and 49.7were students. Prevalent side effects were menstrual disruptions (47.9), weight gain (33.7), hypertension and headaches (5.4each) amongst others. The common reasons for discontinuing COCP were weight gain (28.6), menstrual disruptions (28.5) and non-compliance (14.2). Mass media was the commonest source of information, and one accidental pregnancy occurred (Pearl index 0.03 per 100 woman years). Conclusion: This study shows that combined oral contraceptives pills appear to be acceptable, safe and effective in Port Harcourt. This compares to world wide experience. Concerted effort should be made in improving information dissemination on COCP especially amongst students and single clients.

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Record No. 13484 Record ID 013484 Publication type Journal Article Title Knowledge, Attitude and Practice of Cervical Cancer Screening - Papanicolaou test (Pap smear) among Female Health Care Providers in Port Harcourt Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Addah, A. O.; Ojule, J. D.; Fiebai, P. O. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 6(1) Pages 47-80, fig., tab. Language English Descriptor Uterine Cervical Neoplasms; Vaginal Smears; Mass Screening; Health Knowledge, Attitudes, Practice; Personal Health Services; Physicians, Women Descriptor-Geographic Nigeria-Port Harcourt; Abstract Background: Cervical cancer is the second most common malignancy affecting women globally and the commonest female genital cancer in Nigeria. It can be prevented through regular cytologic screening by Pap smear. The general public sees health care providers as models, therefore, their attitudes and actions would predictably influence societal health behaviour. Aim: To assess the knowledge, attitude and practices of female health workers in Port Harcourt, towards cervical cancer screening. Methods: A questionnaire-based survey of 133 female health care providers at the Braithwaite Memorial Specialist Hospital and the University of Port Harcourt Teaching Hospital, Port Harcourt, which evaluated the socio-demographic characteristics of respondents, knowledge of cervical cancer, attitude and utilization of cervical cancer screening service was carried out. The data were entered into SPSS version 11.0 which was used for analysis and results are presented as Frequency tables, percentages and means. The level of significance was set at p-value 0.05. Results: Up to 123 (92.2) respondents had knowledge of Pap smear as a screening tool for cervical cancer, and 96 (72.2) respondents recognized early sexual debut as a risk factor. Nine-three (70) respondents would be willing to have Pap smear. Only 17(12.8) had done a Pap smear previously. Conclusion: The high knowledge of cervical cancer screening and their positive attitudes towards it did not translate to service utilization by female health professionals in Port Harcourt.There is therefore need to improve uptake of Pap smear by health professionals in order to improve their effectiveness in encouraging the public to utilize this service.

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Record No. 13483 Record ID 013483 Publication type Journal Article Title The perception of Patients of Doctor-Patient Relationship in Otorhinolaryngology Clinics of the University of Port Harcourt Teaching Hospital (UPTH) Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Onotai, L. O.; Ibekwe, U. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 6(1) Pages 65-73, fig., tab. Language English Descriptor Otolaryngology; Physician-Patient Relations; Perception; Hospitals, Teaching Descriptor-Geographic Nigeria-Port Harcourt; Abstract Background: The doctor-patient relationship is central to the practice of medicine and is essential for the delivery of high quality healthcare in the diagnosis and treatment of diseases. Recently, patient participation has gained increasing prominence in healthcare delivery. Aim: To explore the perceptions of Nigerian adult patients who attend the University of Port-Harcourt Teaching Hospital (UPTH) Otorhinolaryngology clinics with regard to relation with their doctors during consultations. Methods: This is a descriptive cross-sectional study; the duration of the field work was two weeks. The study population consisted of adult patients who attended the otorhinolaryngology clinics. Data collection was carried out using interviewer-administered semi-structured questionnaires that explored the perception of patients of doctor-patient relationship. Forty patients were selected for the study and the sampling was purposeful. An average of twenty interviews was conducted per clinic day. Each interview took approximately 15 minutes. Results: The majority (95) of patients' treatment was decided by the doctors. The majority of the patients (87.5) welcomed the opportunity to have more involvement in making treatment decisions. Most of the patients (67.5) were not satisfied with the services received from their doctors. Conclusion: This study established paternalistic model as the dominant pattern of doctor-patient relationship in UPTH otorhinolaryngology clinics. The patients preferred a more cordial relationship.

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Record No. 13482 Record ID 013482 Publication type Journal Article Title Three-Year Clinico-Pathological Observations of Breast Carcinoma in Okolobiri, Bayelsa State, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Fente, B. G.; Alagoa, P. J. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 6(1) Pages 59-64 Language English Descriptor Breast Neoplasms-physiopathology; Breast Neoplasms-diagnosis; Breast Neoplasms-therapy; Mastectomy Descriptor-Geographic Nigeria-Bayelsa State; Abstract Aim: To ascertain the clinico-pathological pattern of breast cancer at the Niger Delta University Teaching Hospital. Methods: This was a retrospective study of all BC patients treated from January 2007 to December 2009 in the Surgical Department of the Niger Delta University Teaching Hospital. Okolobiri, Bayelsa State, Nigeria. Relevant data including name, age, sex, history and examination findings and results of histopathology and other investigations were collected from case files of all the patients treated for BC during the period under review. The data was then analysed manually and by using stat-graphics version 2.3. Results: A total of 42 patients were included in the study and they were all females. Twelve patients (28.6) were of the 31-40 years age group, followed by 21-30 years age group with 10 patients (23.8). Thirty-one patients (73.8) between the ages of 21-50 years were premenopausal. The commonest histological type was infiltrating ductal carcinoma which was found in 23 (54.7) patients. Late presentation was seen in 38 (90.5) patients. The right breast was affected in 22 (52.4) cases, the left in 19 (45.2) and only one (2.4) was bilateral. Mortality was 4.8. Conclusion: Cancer of the breast is still a common problem presenting in the young to middle age groups. Infiltrating ductal carcinoma is the commonest variant. Late stage presentation is often the norm in this locality. There is the need to increase the awareness of the disease

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Record No. 13481 Record ID 013481 Publication type Journal Article Title Prevalence of Dental Caries among Adult Patients Attending a Tertiary Dental Institution in South-South Region of Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Omitola, O. G.; Arigbede, A. O. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 6(1) Pages 52-58 Language English Descriptor Dental Caries; Prevalence; Socioeconomic Factors; Adult; Cross-Sectional Studies Descriptor-Geographic Nigeria Abstract Background: Oral health is an important component of the general health and dental caries status of a community is a good indicator of oral health status of that community. Epidemiological studies on dental caries are rare in the Niger Delta region of Nigeria. Aim: To determine the prevalence of dental caries among adult patients attending University of Port Harcourt Teaching Hospital Dental centre and to compare it with previously reported results. Methods: A cross-sectional study of all patients aged 18years and above presenting with dental caries at the centre over a one-year period was conducted. A self-administered anonymous questionnaire was used to get the socio-demographic data of the patients. The patients were all examined and caries was diagnosed using the WHO criteria (1997). Decay, missing and filled teeth (DMFT) were recorded and restorative index was calculated (F/F+D percent). SPSS version 15 was used to generate summary statistics and student t-test was used to compare means between two groups. Results: Out of 1,927 patients that presented during the study period, only 435 had dental caries or one of its sequelae giving a prevalence of 22.6. The mean DMFT score for the group was 3.57; that of females was 3.88 while that for males was 3.08. The difference in the mean DMFT scores between the two sexes was statistically significant (p=0.026). The restorative index was 25.3. Conclusion: The prevalence of dental caries in our centre (22.6) falls within the previously reported 4-30rates for Nigeria. The mean DMFT score was 3.51 and the restorative index is 25.3

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Record No. 13480 Record ID 013480 Publication type Journal Article Title Prevalence of Risk Factors for Chronic Kidney Disease in a Rural Adult Population in Rivers State Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Wokoma, F. S.; Emem-Chioma, P. C. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 6(1) Pages 36-45 Language English Descriptor Kidney Failure, Chronic; Risk Factors; Adult; Rural Population Descriptor-Geographic Nigeria Abstract Background: The prevalence of chronic kidney disease (CKD) is on the increase globally with attendant heavy disease burden and high morbidity and mortality especially in the resource poor countries. Preventive measures are increasingly being explored. We undertook a survey to determine the prevalence of some risk factors of CKD and identify the at-risk individuals. Methods: Body mass index (BMI), dip-stick urine protein and urine glucose, random blood glucose and blood pressures were measured in adult subjects of Barako, a rural community in the Gokana Local Government area of Rivers state during a one-day Rotary eye camp exercise. Results: Out of the 154 subjects that responded, 152 satisfied the inclusion criteria and were studied. They had a mean age of 48.9 + 14.8(18-85) years and M:F ratio of 1:1.4. The mean body mass index (BMI) was 25.8 + 4.8 (11.1-40 .9) kg/m2. Forty-nine subjects (34.8) were pre-obese while 13.5were Obese. Proteinuria was seen in 29.7while none of the subjects had glycosuria. The mean random blood glucose was 6.6 +1.4(4.2-9.8) mmol/l. Four subjects (5) were previously diagnosed diabetics.The mean systolic blood pressure was 129.9 + 21.6(100-220) mmHg, mean diastolic blood pressure was 70.9 + 13.1(50-110) mmHg and the prevalence of hypertension was 27.9. BMI showed positive correlation with proteinuria (r = +0.2), while both systolic and diastolic blood pressures showed weak positive correlations with proteinuria (r = +0.02 and r = +0.06 respectively). Conclusions: The study shows, that the evaluated risk factors of CKD, obesity, hypertension, diabetes and proteinuria are common in this rural community of Rivers State.

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Record No. 13479 Record ID 013479 Publication type Journal Article Title Preliminary Outcome of the Management of Eclampsia at the Imo State University Teaching Hospital Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Okeudo, C.; Ojiyi, E. C.; Ezem, B. U.; Dike, E. I. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 6(1) Pages 23-29, tab. Language English Descriptor Eclampsia-epidemiology; Eclampsia-mortality; Morbidity Prenatal Diagnosis Hospitals, Teaching Descriptor-Geographic Nigera-Imo State; Abstract Background: Eclampsia continues to be a major cause of maternal and perinatal mortality in developing countries. Early identification and management of pre-eclampsia will help reduce the mortality due to eclampsia. Aim: This study aims at determining the prevalence and management outcome of eclampsia in our centre with a view to proffering solutions for an optimal or near optimal care.Methods: A retrospective review of the case records of patients managed for eclampsia at the Imo State University Teaching Hospital (IMSUTH), Orlu from 1st October 2004 to 30th September 2009 was carried out. Data on socio-demographic characteristics as well as clinical management and outcome were extracted and analyzed.Results: The prevalence of eclampsia was 2.7of all the deliveries. The prevalence was significantly higher in the unbooked than the booked patients (p0.05). The prevalence was also significantly higher in primigravidae than in multiparae (p0.05). Twenty-eight (93.3) of the eclampsia occurred antepartum. Twenty-eight (93.3) had severe hypertension on presentation. Twenty nine (95.8) of the patients had 2-5 episodes of convulsions prior to presentation to the hospital. Twenty-six (86.7) of the patients had emergency Caesarean section was carried out, mostly for unfavourable cervix. The perinatal mortality was 6.7while maternal mortality was 3.3. Complications included acute renal failure, aspiration pneumonitis and abruptio placentae. Conclusion: The prevalence of eclampsia is unacceptably high in our centre. Early antenatal booking, antenatal care follow-up to identify the imminent signs and prompt treatment of cases of pre-eclampsia will reduce the burden of eclampsia in this environment.

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Record No. 13478 Record ID 013478 Publication type Journal Article Title Parents' Perception on Use of Insecticide-Treated Bed Net in Port Harcourt Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Alex-Hart, B. A.; Frank-Briggs, A. I. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 6(1) Pages 17-22, tab. Language English Descriptor Insecticide-Treated Bednets-utilization; Malaria Control Perception Parents Infant Child, Preschool Descriptor-Geographic Nigeria-Port Harcourt; Abstract Background: Insecticide treated bed nets (ITN) are protective against malaria, but they are poorly utilized. The utilization of the nets, especially by the under fives, will depend on their caregivers' awareness of the net and their perception of its usefulness. The study therefore aims to evaluate awareness and utilization of ITN . Methods: This was a descriptive hospital-based study. It involved the distribution of 15-itemed questionnaires to 212 parents (with at least one under five aged child), who brought their children to the Paediatrics outpatient clinic of University of Port Harcourt Teaching Hospital. Questions asked covered: the awareness of ITN, the number of ITN owned by each participant and the number of under fives who slept under ITN the night preceding the interview. Results: A total of 212 parents participated in this study. Male to female ratio was 1:4. One hundred and eighty nine (89.2) participants had heard of ITN. The two most common advantages opined by the participants were that it prevents malaria (42.0) and mosquito bite (38.2). The commonest identified side effects was that it causes heat (45.8) and 113(53.3) participants owned at least one ITN. Only 45 (21.2) participants said their under fives slept under ITN on the night preceding the interview. Conclusion: There is a fair awareness of the use of ITNs for malaria control, however there is poor utilization of the nets by the under five aged children in Port Harcourt.

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Record No. 13477 Record ID 013477 Publication type Journal Article Title Posterior Urethral Valve in Childhood in Port Harcourt, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Jaja, T.; Anochie, I. C.; Eke, F. U. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 6(1) Pages 10-16, tab. Language English Descriptor Urethral Stricture Early Diagnosis Urethral Stricture-mortality; Morbidity Pediatrics Child Hospitals, Teaching Descriptor-Geographic Nigeria-Port Harcourt; Abstract Background: Posterior urethral valve (PUV) accounts for 20-40of end stage renal diseases in children. In developed countries, prenatal diagnosis and early surgery has improved the outcome. Aim: To determine the prevalence, morbidity and mortality in children with PUV seen over a 2-year period in University of Port-Harcourt Teaching Hospital. Methods: All children seen in the paediatric units of the Hospital with diagnosis of posterior urethral valves were recruited to determine the clinical presentation, treatment and outcome. Results: Out of 36,700 paediatric patients seen, 15 (0.04) had diagnosis of PUV, giving an incidence of 1: 2447. The age range was 3days to 15years (mean of 22.8±19.4months). Three (20) patients had valve ablation before the study. Symptoms started in the first week of life in 11(73.3) patients of which 4(36.4) presented in the neonatal period and 12 (80) presented in infancy. The commonest symptom was dribbling of urine in all patients. The commonest complications were urinary tract infection [10(66.7)], acute renal failure [7(46.7)] and end stage renal disease [2(13.3)]. Prenatal diagnosis was made in only one patient. Abdominal ultrasound at diagnosis revealed lower obstructive uropathy in 13 (86.7). Micturating cystourethrogram showed dilated posterior urethra and bladder wall thickness in 8(53.3). None had vesicoureteric reflux. Hospital mortality rate was 20.0and 5 (33.3Conclusion: PUV is a significant cause of end stage renal disease and mortality with delayed presentation in our environment. Early diagnosis and surgery with prolonged follow up of all patients by nephrologists is advocated.

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Record No. 13476 Record ID 013476 Publication type Journal Article Title Changes in Total and Differential white Cell Counts, Total Lymphocyte and CD4 Cell Counts during the Menstrual Cycle in Healthy Female Undergraduate Students in Port Harcourt, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Dapper, D. V.; Kote, N.; Akevwighome, S. O.; Nworah, D. C. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 6(1) Pages 2-9, tab. Language English Descriptor CD4 Lymphocyte Count; Menstrual Cycle; Leukocytes; Students; Women's Health; Students Descriptor-Geographic Nigeria-Port Harcourt; Abstract Background: Published reports on the possible changes in the various immune cell populations, especially the total lymphocyte and CD4 cell counts, during the menstrual cycle in Nigerian female subjects are relatively scarce. Aim: To determine possible changes in the total and differential white blood cell [WBC] counts, total lymphocyte count [TLC] and CD4 cell count during the menstrual cycle in apparently healthy reproductive aged female undergraduate students in Port Harcourt, Nigeria. Methods: A total of 61 apparently healthy HIV sero-negative female undergraduate students of the University of Port Harcourt, Nigeria aged between 17 and 30 years, were recruited into the study. Subjects were allowed their normal daily routines but restricted from excessive physical activities for the duration of the study. After a menstrual history, blood was collected from each subject at the different phases of the menstrual cycle: menstrual, follicular, ovulatory and luteal. Total WBC and differential counts were determined manually; TLC was obtained by multiplying the percentage lymphocytes by the total WBC count; CD4 cell counts were determined by flow cytometry. Results: Single factor analysis of variance showed significant differences only in the values of total WBC, and differential neutrophils, lymphocytes, and eosinophil counts [p0.05]; no significant differences were observed in the values of monocytes, basophils, TLC and CD4 cell count during the phases of the menstrual cycle.Conclusion: The present study confirms previous reports of significant physiological variations in the leukocyte counts during the phases of the normal menstrual cycle. However, our results suggest that apparently TLC and CD4 cell count do not undergo a similar physiological variation.

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Record No. 13119 Record ID 013119 Publication type Journal Article Title Factors Associated with Ergonomic Injuries in a Tertiary Health Facility in Port Harcourt, South South Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ugboma, H. A.; Omojunikanbi, A.; Agi, C. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 5(3) Pages 361-366, tab., fig. Language English Descriptor Wounds and Injuries; Muscle, Skeletal; Risk Factors; Workplace; Health Facilities Descriptor-Geographic Nigeria-Port Harcourt; Abstract Background:Injuries to the musculoskeletal system at work place are called ergonomic injuries. Its rising incidence is a concern. Aim: The increasing complaint of musculoskeletal injuries amongst surgeons in our hospital necessitated this study. Methods: A structured questionnaire randomly distributed amongst 50 surgeons in the various subspecialties in the month of November was analyzed for ergonomic injuries. Results: The mean age of the surgeons was 37.9 +7.6 years. Their mean height was 1.6 +0.08m. Their mean weight was 78.9 +11.6kg. The mean hours of surgery done per week were 8.52 +4.07hours. The frequency distribution for age and hours of surgery per week were not normally distributed. Conclusion: Information on Ergonomics including causes and prevention are essential tools to surgeons. Provision of safer working environment by employers and immediate medical attention to the injured will go a long way to improving workers health.

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Record No. 13118 Record ID 013118 Publication type Journal Article Title Ocular Disorders in Asthmatics Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ukponmwan, C. U.; Egbagbe, E. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 5(3) Pages 353-360, tab. Language English Descriptor Eye Diseases; Steroids; Prevalence; Status Asthmaticus Descriptor-Geographic Nigeria Abstract Background: Steroids may be used in asthmatics. These drugs are of aetiological importance in some ocular disorders. Aim: To find out the prevalence of ocular diseases in asthmatics and determine the need for regular ophthalmic examination .Design: A prospective non-randomized study.Methods: All consecutive new patients with a diagnosis of asthma at the chest clinic between July 2006 and June 2007 were included in this study. A questionnaire was administered to all the patients and their eyes were examined.Results: There were 104 patients (29 males and 75 females).The age range was 4 to 76 years with a mean age of 42.6±17.2years. Sixty four (61.5) patients had ocular disorders. Allergic conjunctivitis was the most common disorder in 29.8, followed by cataract (7.7) and glaucoma (3.8).Twenty one (20.2) patients had a combination of allergic conjunctivitis, cataract and glaucoma. Other disorders were refractive errors, pterygium, pingueculum and age related macula degeneration. Eleven patients (10) were blind, eight had uniocular blindness while three had bilateral blindness. Cataract was the most common cause of blindness followed by glaucoma. All the patients except one were treated with steroids for asthma. Conclusion: Cataract and glaucoma can occur from systemic steroid use. The cornea can also be involved in some cases of allergic keratoconjunctivitis. Both groups can cause blindness, thus there is a need for regular ocular examination of asthmatic patients especially those on steroid medications to enable early detection and treatment of these diseases.This will avoid unnecessary visual disability and blindness in these patients.

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Record No. 13117 Record ID 013117 Publication type Journal Article Title Autosomal Dominant Polycystic Kidney Disease: an Analysis of Six Cases Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Emem-Chioma, P. C.; Oko-Jaja, R. I.; Wokoma, F. S. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 5(3) Pages 345-352, tab. Language English Descriptor Polycystic Kidney, Autosomal Dominant-diagnosis; Hypertension Mass Screening Hospitals, Teaching Descriptor-Geographic Nigeria-Port Harcourt; Abstract Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disorder in adults.The prevalence of this disease in Africa, especially Nigeria has not been established. Aim: To analyse six cases of ADPKD which were seen at the renal unit, University of Port Harcourt Teaching Hospital (UPTH), Choba, Port Harcourt over a period of nine months (January to September, 2008). Methods: The case notes of the patients with the diagnosis of ADPKD seen over the period were retrieved from the records department of UPTH and relevant socio-demographic, clinical and laboratory data were extracted for analysis with SPSS version 12.0. Results: Six cases of ADPKD were seen and consisted of 4 (66.7) males and 2 (33.3) females. Their age ranged from 30 to 56 years with a mean age of 46.17±12.34 years. Only 2 (33.3) had positive family history of hypertension and 1 (16.7) had positive family history of ADPKD. The common clinical features were hypertension (83.33), ballotable kidneys (66.7), peripheral oedema (50.0) and pallor (50.0). The mean systolic BP was 161. 67±22.29 mmHg and mean diastolic BP was 97.50±14.05 mmHg.The mean estimated glomerular filtration rate (eGFR) for the six patients was 40.83±57.24 ml/min/1.73 m2 and four patients (66.7) were in ESRD with a mean eGFR of 7.6±1.44 ml/min/1.73 m2 .Conclusion: Late presentation (with impaired kidney function) and hypertension are common amongst our patients with ADPKD, hence the need for early diagnosis of ADPKD through public education and targeted screening of at-risk individuals

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Record No. 13116 Record ID 013116 Publication type Journal Article Title Cystourethrography in Posterior Urethral Valves: Review of 20 Cases Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Nwankwo, N. C. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 5(3) Pages 339-344, tab., fig. Language English Descriptor Urinary Bladder Neck Obstruction-diagnosis; Urinary Bladder Neck Obstruction-complications; Radiography Child Male Descriptor-Geographic Nigeria-Port Harcourt; Abstract Background: Posterior urethral valves (PUV) is a common cause of bladder outlet obstruction in the male infant, child or adolescent. Early diagnosis is important in order to prevent renal damage. Aim: To highlight delays in early diagnosis as a result of changing dressing habits-use of diapers in children.Methods: A retrospective review of 20 patients with posterior urethral valves seen by the author over a period of five years (1999-2003) at a private radiological diagnostic centre in Port Harcourt. Results: In the period under review, 208 patients had cystourethrography in the centre. Of these, 35(16) were paediatric patients. Twenty(57) of the paediatric patients had posterior urethral valves and all the patients were males. Majority of the patients (85) were seen in the first two years of life. All the patients presented with abdominal distension. Five of the patients whose mothers were primips were not able to describe the pattern of urine flow from the children as they always had diapers on. Diverticulum was seen in five patients (25) and these were aged one year and above.Conclusion: Posterior urethral valves is a common cause of bladder outlet obstruction in male children. Diverticulum, a complication of bladder outlet obstruction was common. Use of diapers and poor education may contribute to delays in diagnosis. Early diagnosis is important to prevent end-stage renal failure.

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Record No. 13115 Record ID 013115 Publication type Journal Article Title Refractive Error in Yenagoa Bayelsa State, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Azonobi, R. I. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 5(3) Pages 331-338, tab. Language English Descriptor Refractive Errors; Prevalence; Astigmatism Descriptor-Geographic Nigeria-Bayelsa; Abstract Background:The prevalence and pattern of presentation of refractive error is presently unknown in Yenagoa. Aim:To determine the prevalence and pattern of presentation of refractive error in Yenagoa, Bayelsa state, Nigeria. Method: A prospective study was conducted on all new patients who presented to the Eye Clinic of the Niger Delta University Teaching Hospital over a period of one year. All patients with refractive errors were studied. They underwent a full ocular examination including an objective refraction using a Carl Zeiss 599R autorefractometer and a subjective refraction. Cycloplegic refraction using 1.0atropine was done for children under the age of 12 years. Information obtained from the patients included their age, gender occupation and visual acuity with or without pin hole. Statistical analysis was done using the statistical package for social scientists(SPSS,11.0). Results: One thousand, one hundred and sixty eight(1168) new patients were seen and 132 had refractive error (prevalence ,11.3).There were 61 males and 71 females(M:F=1:1.2),with ages ranging from 6- 83 years( mean, 35.2 ±4.1 years). Hypermetropia was the most common refractive error seen(37.1) followed by astigmatism(33.3) and myopia (29.5). Simple myopic astigmatism was the commonest form of astigmatism seen(61.4) followed by compound myopic astigmatism (20.5) and mixed astigmatism(18.2) respectively. Majority of the spherical and cylindrical errors were in their low degrees(85.2and 95.5) respectively. There was an increase in the number of hypermetropia with age increase with myopia exhibiting the opposite relationship. Although there was more myopia in females compared to males, the difference was not statistically significant(p0.05). Conclusion: Refractive error is a common ocular problem in the study population especially among civil servants and students. Hypermetropia was the commoner variety seen.

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Record No. 13114 Record ID 013114 Publication type Journal Article Title Blood Bacterial Isolates in Sickle Cell Anaemia Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Osime, E. O.; Asemota, O. J. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 5(3) Pages 325-330, tab. Language English Descriptor Anemia, Sickle Cell; Blood; Bacterial Infections Descriptor-Geographic Nigeria-Benin; Abstract Background:Sickle cell anaemia is a haemoglobinopathy characterized by the presence of sickle haemoglobin. Sickling can occur in these patients with sluggish flow of blood which accentuates the sickling phenomenon and susceptibility to infection. Notable among such infections are those caused by bacteria such as Streptococcus pneumoniae, Salmonella, Staphylococcus and Haemophilus influenzae. Aims: To ascertain the incidence of bacteria isolates among sickle cell individuals and to determine the antibiotics sensitivity pattern of such organism isolated.Methods: Thirty five (35) blood samples were randomly collected from sickle cell anaemia patients attending the University of Benin Teaching Hospital and Central Hospital, Benin City. Fifteen (15) blood samples comprising seven (7) with Hb-genotype AA and eight (8) Hb-genotype AS served as controls. Verbal informed consent was gotten from them. Cultural method was used in isolating microorganisms present in the blood samples.Results: There was strong association between genotype and bacterial isolates with genotype SS being more infected. A significant weak association exists between gender and bacterial isolate among sicklers. Age, tribe and occupation did not have any association with bacterial isolate among the studied population. Staphylococcus aureus was the predominant isolate (66.7), while ciprofloxacin and perfloxacin were the most active drugs against the isolates.Conclusion: From our study, 25.7of sickle cell anaemia patients had bacterial infection with a higher rate in females and Staphylococcus aureus being the most incriminated organism.

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Record No. 13113 Record ID 013113 Publication type Journal Article Title Psycho-Social Determinants of Road Traffic Accidents among Commercial Motorcycle (Okada) Riders in a Semi-Urban Area of Bayelsa State Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Osinowo, O. A.; Kunle-Olowu, A. O.; Osinowo, H. O. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 5(3) Pages 312-324, tab., fig. Language English Descriptor Accidents, Traffic; Psychology, Social; Motorcycles Descriptor-Geographic Nigeria-Bayelsa; Abstract Background:The trauma and mortality associated with commercial motorcycle taxis (Okada) in Nigeria have become a public health issue. This research focuses on the psychosocial determinants of road traffic accidents (RTA) among Okada riders.Methods: The study was carried out in Yenagoa and Wilberforce Island in Bayelsa State. The research design was questionnaire-based. Accident proneness was predicted using binary logistic regression.Results: A total of 403 Okada riders were interviewed. All were males. The mean age was 29.3 ± 7.1 years. The peak was in the 21-30 years age group (61.3). Age and marital status were not significant factors in the causation of RTA (p=0.463; p=0.297 respectively). The number of years riding Okada did not affect the occurrence of RTA (p=0.31). The level of education had no significant effect on RTA (p=0.838). Number of previous accidents and months elapsed since the last accident correlated with the rider's propensity for having accidents (p=0.000; p=0.000 respectively). Time of day and type of road correlated significantly with the occurrence of RTA (p=0.000; p=0.000 respectively). The frequency of alcohol intake significantly affected the occurrence of RTA (p=0.005). The use of hard drugs (mainly cannabis) and the duration of drug misuse did not significantly affect the proneness to RTA (p=0.582; p=0.940 respectively). Neither cigarette smoking nor number of cigarettes smoked per day had a significant effect on RTA (p=0.171; p=0.264 respectively). Conclusions: Okada riders exhibit a high level of risk-taking behaviours. Social and behavioural restructuring, improvement in road infrastructure and traffic regulations enforcement may reduce Okada accidents.

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Record No. 13112 Record ID 013112 Publication type Journal Article Title Surgical Glove Perforations During Surgical Operations: an Ever Existing Risk in the Theatre Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Jamabo, R. S.; Elenwo, S. N. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 5(3) Pages 307-311, tab. Language English Descriptor Gloves, Surgical-utilization; Risk Intraoperative Period Incidence Descriptor-Geographic Nigeria Abstract Background:The use of surgical gloves as a protective barrier between the surgeon and the patient has been the accepted standard. The prevalence of intraoperative glove perforations is high and often not recognized. Perforations may increase the potential for wound sepsis and for accidental exposure of the surgeon and the patient to human immunodeficiency virus (HIV) and hepatitis B virus.Aim: To investigate the incidence of glove perforations during surgery and to evaluate the extent to which glove perforations remain undetected during surgery. Methods: A prospective study in which a total of 2541 gloves used to perform surgical operations on 210 patients within a period of 12 months (January - December, 2009) were analyzed for perforations. These gloves were worn by the surgeons and scrub nurse and were double gloves. Twenty five unused gloves were used as control. The operations were all for general surgical cases. All gloves were tested for perforations by a simple water inflation technique at the end of each procedure. Results: By this water inflation technique, 225 gloves (8.9) were observed to have had perforations. Twenty one gloves (9.3) were noticed to have perforated in course of the surgery while 204 (90.7) were unnoticed. None of the unused gloves showed any perforation. There was an obvious difference in the perforate rate between the inner and outer gloves. It was 13.7for inner gloves as against 88.3for outer gloves.Conclusion: The incidence of surgical glove perforations is unacceptably high. The risk of transmission of diseases between surgeon/patient remains present. Protective measures like double gloving, the use of blunt needles, needle puncture resistance surgical gloves, glove liners and finger guards should be introduced in hospitals.

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Record No. 13111 Record ID 013111 Publication type Journal Article Title The Effect of Blood Glucose Concentration on the Error Monitoring and Processing System in Alcohol Users During Intensive Mental Activities Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Welcome, M. O.; Razvodovsky, Y. E.; Pereverzeva, E. V.; Pereverzev, V. A. Journal Title Port Harcourt Medical Journal ISSN 0795-3038 Place of Publication Port Harcourt Publisher College of Health Sciences, University of Port Harcourt Date of publication 2011 Volume and n° 5(3) Pages 293-306, tab., fig. Language English Descriptor Blood Glucose; Alcohols; Mental Processes Descriptor-Geographic Nigeria Abstract Background:The error monitoring and processing system (EMPS) located in the substantia nigra of the midbrain, basal ganglia and cortex of the forebrain, plays a leading role in error detection and correction. Although recent data show that alcohol disrupts the EMPS, the mechanism of alcohol's effect on this system remains unknown.Aims: To suggest a hypothesis that explains the processes and mechanism of alcohol-related disruption of EMPS. Methods:We critically examined our recent research data, as well as peer-reviewed literature on the effect of alcohol on blood glucose levels, and cognitive functions. The role of blood glucose concentration in the EMPS, including associated theories and hypothesis were also reviewed. Databases utilised were African Journals On Line, Elsevier, Science Direct, Medline from January 1940 to February 2010 . Results: Blood glucose concentration plays a vital role in the EMPS. The effect of blood glucose concentration on the EMPS is realised through the modulation of the activity of the dopaminergic system by proportional changes in the brain glucose level. Based on current literatures and the results of our recent study, here we suggest a hypothesis of alcohol-related glucose-dependent system of error monitoring and processing.The main postulate of this hypothesis holds that the disruption of EMPS by ethanol is related to disorders in glucose metabolism, which in turn may determine the dopamine level the major component of EMPS.Conclusion: Alcohol may disrupt the EMPS indirectly by affecting dopamine level through disorders in glucose homeostasis regulation.

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