Introduction: Reducing and maintaining viral load is crucial to reducing morbidity and mortality associated with HIV infection in children. The aim of this study was to determine the factors influencing the maintenanc...Introduction: Reducing and maintaining viral load is crucial to reducing morbidity and mortality associated with HIV infection in children. The aim of this study was to determine the factors influencing the maintenance of children and adolescents on antiretroviral therapy in the continuum of care. Methodology: This was a descriptive and analytical cross-sectional study conducted from August 1 to August 31, 2023. It included all children living with HIV, under 15 years of age, with at least two viral load results and whose parents consented to participate in the study. Participants were recruited during their child’s treatment renewal consultations. Results: The study included 143 children, mostly boys (55.2%), with a mean age of 11.54 years (±2.8). More than half (55.2) were unaware of their HIV-positive status, and most treatments were administered by parents (60.8%). Of the 99 children with an undetectable viral load at the first test, 23 (23.2%) showed a viral rebound at the last test, mainly due to poor treatment compliance (p Conclusion: Virological rebound after suppression in children is worrying. It is crucial that the national AIDS program improves Therapeutic Education, trains health workers to communicate results and encourages ongoing dialogue with young people to reinforce adherence and maintain viral suppression.展开更多
BACKGROUND Pediatric cataract is a public health concern,and it causes long-term functional impairment and impacts the quality of life of the child with cataract.Visual impairment in children due to cataract has devas...BACKGROUND Pediatric cataract is a public health concern,and it causes long-term functional impairment and impacts the quality of life of the child with cataract.Visual impairment in children due to cataract has devastating consequences on their health,social life,and academic performance and places a socio-economic burden on the child’s family and society as a whole.Globally,pediatric cataract is a significant contributor to ocular morbidity and blindness.Findings from this study will help quantify the visual benefits of pediatric cataract surgical interventions and identify opportunities for improving pediatric cataract services.AIM To evaluate the visual acuity outcomes of children after cataract surgery.METHODS The study employed a retrospective electronic review of pediatric cataract surgeries from January 2019 to July 2021 at the pediatric unit of the eye department at Komfo Anokye Teaching Hospital(KATH),Ghana.Patient clinical data including demographics,cataract presentation,pre-operative and post-operative visual acuity,surgical procedure,postoperative complications,interventions and refraction were collected and analyzed using the Statistical Package and Service Solution.Pearson'sχ2 test and regression statistics were used to summarize data at a significance of P<0.05.RESULTS 163 children(257 eyes)underwent cataract surgery at KATH.The overall mean age was 3.81±3.56 years.Congenital cataract was commonly observed(56.4 All children underwent keratometry and phacoemulsification procedures.A few children(9.8%)experienced postoperative complications while 90.8%did not require further intervention after the surgery.After the surgery 27.0%of the children had refraction and the majority were corrected for myopia and near addition(12.9%).An analysis of the association of postoperative visual acuity and the type of cataract was statistically significant(P value<0.05).There was a significant improvement in the visual outcomes following cataract surgery.CONCLUSION Timely pediatric cataract surgery improves postoperative visual outcomes.Creating awareness and implementing screening programs is important to ensure that the prevalence of childhood blindness is reduced to the barest minimum.展开更多
Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this s...Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this study was to examine the effect of nurse-physiotherapist collaborative rehabilitation on functional recovery,motor function,quality of life,and disability among stroke patients.Materials and Methods:A parallel-group randomized controlled trial was conducted at the University of Uyo Teaching Hospital,Nigeria.Ninety adult stroke patients were randomized into intervention(n=45)and control(n=45)groups.The intervention group received a 6-week rehabilitation program combining joint goal setting,coordinated nursing and physiotherapy sessions,shared documentation,and weekly team reviews,whereas the control group received standard care.Outcomes were measured at baseline,6 weeks,and 3 months using the Barthel Index(primary),Fugl-Meyer assessment,stroke-specific quality of life(SS-QOL),and modified Rankin scale(mRS).Data were analyzed with repeated measures analysis of variance,with P<0.05 considered significant.Results:Patients in the intervention group showed greater functional improvement than controls.Barthel Index scores increased from 35.4±10.2 at baseline to 85.1±10.7 at 3 months,compared with 36.1±9.8-68.9±12.0 in controls(P<0.001).Similar patterns were observed for Fugl-Meyer assessment,SS-QOL,and mRS.High adherence,few adverse events,and consistent program fidelity supported feasibility.Improvements were attributed to the combination of nursing reinforcement,structured physiotherapy,patient education,and psychosocial support.Conclusion:Nurse-physiotherapist collaboration significantly enhances functional recovery,motor function,quality of life,and reduces disability in stroke patients.Implementing structured interprofessional rehabilitation in clinical practice is feasible and beneficial.展开更多
Background: Diabetes is a set of metabolic abnormalities typified by hyperglycemia believed to be associated with aberrant insulin secretion, insulin action, or both. Erectile dysfunction and infertility are globally ...Background: Diabetes is a set of metabolic abnormalities typified by hyperglycemia believed to be associated with aberrant insulin secretion, insulin action, or both. Erectile dysfunction and infertility are globally prevalent complications among male diabetic patients. There is a need to understand the role of a male reproductive hormone in the etiology of infertility in diabetic patients. Objective: This study aims to determine the effect of diabetes mellitus on the Male reproductive hormone (testosterone) on diabetic patients attending the Urology unit of Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria and the effect of industrial sugar consumption in rats model. Materials and Methods: 30 samples (including repeats, n = 3) were collected from known diabetic patients and 30 (including repeats, n = 3) control-non diabetic healthy individuals. Five millilitres (5 ml) of blood was collected from the antecubital vein of each participant and placed into a plain container for serum testosterone measurement using the enzyme-linked immunoassay technique. Blood was also collected from the same subjects in a fluoride oxalate container for plasma enzymatic glucose estimation using a Randox Glucose oxidase kit. For in vivo rat model, the albino rats were grouped into 2 of five (5) rats. The control group (1) was only given normal rat food and water while the test group (2) was treated with 0.4 g of industrial sugar/mL/body weight in addition to rat food and water via oral intubation for 21 days. Blood samples were collected via ocular puncture into plain tubes for testosterone measurement as described above. Results: There is a significant (p Conclusion: In conclusion, data available from this study suggests that increased plasma glucose levels and excessive industrial sugar consumption are associated with decreased testosterone levels in both human and animal models respectively. The mechanism is yet unclear but it could be that DM alters conventional sperm parameters, spermatogenesis, and biosynthesis of testosterone and induces degenerative changes in the testis and epididymis and ejaculatory dysfunction. These mechanisms need to be investigated.展开更多
Introduction: Lyell’s syndrome (SL), called Toxic Epidermal Necrolysis is one of the most serious forms of medication accidents. It is an acute, rare pathology, its incidence is estimated at 1 to 2 cases out of one m...Introduction: Lyell’s syndrome (SL), called Toxic Epidermal Necrolysis is one of the most serious forms of medication accidents. It is an acute, rare pathology, its incidence is estimated at 1 to 2 cases out of one million inhabitants per year and its evolution can be fatal. Materials and Methods: We report the observation of a 60-year-old patient, with no significant pathological history, admitted to our intensive care unit at the Renaissance University Teaching Hospital in N’Djamena for the treatment of Toxic Epidermal Necrolysis. In whom the onset of symptoms dates back to few hours after vaccination against COVID-19 with Ag Johnson and Johnson. Results: An ophthalmology opinion was requested and the patient was put on Fucithalmic. In our case, in addition to the advanced age of the patient (60 years old), her SCORTEN was ≥5. Conclusion: The late management as well as the absence of a specific department for severe burns, which condition the presence of a technical plate was fatal to her despite multidisciplinary care: Resuscitators, Traumato-Orthopedist and ophthalmologist.展开更多
<strong>Introduction: </strong>Temporomandibular joint ankylosis (TMJA) is a fusion of joint surfaces by fibrous or bone tissue and the resulting limitation of mouth opening. The objectives of this study w...<strong>Introduction: </strong>Temporomandibular joint ankylosis (TMJA) is a fusion of joint surfaces by fibrous or bone tissue and the resulting limitation of mouth opening. The objectives of this study were to determine the frequency of TMJA, describe the clinical aspects and assess management. <strong>Materials and Method:</strong> It was a retrospective study that was carried out in the Department of Odontostomatology and Maxillofacial Surgery of Donka National Hospital for a period of 5 years (January 2016 to December 2020). Included were all records of inpatients and managed cases of TMJA during the study period. Socio-demographic, clinical and therapeutic variables were analyzed. <strong>Results:</strong> During the study 13 TMJA cases were collected with the frequency of 0.47%. The age group 1 - 9 was the most affected (61.54%) with extremes of 4 and 28 years. Men were the most concerned (53.87%). Restriction of mouth opening was the main reason for consultation (69.23%). The etiologies of ankylosis were dominated by infection including cellulitis of dental origin (53.85%) followed by facial trauma (30.77%). Arthroplasty was the most commonly used technique (73%), two cases of recurrence were noted (15.38%). <strong>Conclusion: </strong>TMJA affects mainly children and the etiology is dominated by cellulite of dental origin hence the interest of sensitization of the population for early management of oral diseases.展开更多
A cerebrole is a patient with a neurological deficit of central origin;these patients very often present disorders of the ion concentration, hence the need for hospitalization in intensive care. The aim of our study w...A cerebrole is a patient with a neurological deficit of central origin;these patients very often present disorders of the ion concentration, hence the need for hospitalization in intensive care. The aim of our study was to study hydro-electrolyte disorders in brain-damaged patients, to describe the clinical aspects, to identify the contributing factors and to determine the prognosis of these patients in the intensive care unit of gabriel touré teaching hospital. <strong>Material and Methods:</strong> It was a prospective cross-sectional study, descriptive of a period of 11 months going from June 2015 to April 2016 in the intensive care unit of CHU Gabriel TOURE we included all the cerebral patients admitted in intensive care in which hydro-ionic disorders have detected on arrival or during hospitalization. Data were collected through transfer sheets, a survey sheet and medical records. Data entry and analysis were done respectively on SPSS software (version 19) and Microsoft Word Starter 2010 software. <strong>Results:</strong> During our study, out of 450 hospitalization patients, we identified 110 brain-damaged patients and 75 patients were retained in our study, i.e. a prevalence of 16.6%. Male was predominant with 72% with a sex ratio of 2.5 the age group 20 - 50 years was majority with 45.3%, the average age was 38.49 years. The majority of patients (58.7%) were admitted from the emergency department. The most common reason for admission was impairment of consciousness in 94.7% (Table 1) of cases and the Glasgow admission score was less than or equal to 8 in 58.7% (Table 1) of patients. Hydro-electrolyte disturbances were present in 93.3% of patients on admission. Hyponatremia was the most common disorder with 56% (42 cases). Followed by hyperkalaemia 10.7% (8 cases), hypernatremia 9.3% (7 cases), at hypocalcemia 9.3% (7 cases), associated disorders 8% (6 cases). Brain CT was performed in 52% of the patients. In our study, malaria was the most common etiology of ionic disorders with 36%. Of the patients who died, 80% had developed hyponatremia after 5 days in hospital, and the overall lethality was 73.3%. <strong>Conclusion:</strong> Hydro-electrolyte disorders are frequent in the intensive care setting and their management must be rapid in order to reduce morbidity and mortality.展开更多
<strong>Background: </strong>Thrombocytopenia plays an important role in the diagnosis of malaria in most countries because of the rapid decrease of platelets during malaria onset and also in severe forms ...<strong>Background: </strong>Thrombocytopenia plays an important role in the diagnosis of malaria in most countries because of the rapid decrease of platelets during malaria onset and also in severe forms of the disease. The study sought to assess platelet numbers and determine the prevalence of malarial thrombocytopenia among children with febrile malaria at the Korle-Bu Teaching Hospital (KBTH). <strong>Methodology:</strong> It was a cross-sectional study carried out in the Department of Child Health and the Polyclinic of KBTH from April to July 2018. A total of 100 children aged from 1 to 12 years who tested malaria positive for both thick and thin blood film and Rapid Diagnostic Tests (RDTs) were recruited into the study. Venous blood sample was obtained from the children and analyzed for platelet count using a haematology auto analyzer. Parasite speciation and quantification was used to classify the disease into mild, moderate and severe, and platelet numbers were also categorized into low, normal and high. Data obtained was then analyzed for prevalence of malarial thrombocytopenia in severe malaria. <strong>Results:</strong> The total studied participants were 100, 61 (61%) were males whiles 39 (39%) were females. Both severe malaria and thrombocytopenia were mostly seen in children less than 5 years of age and the males recorded more thrombocytopenia (66%) and normal platelet numbers 34 (64.2%) than the females. There was a significant higher percentage of malaria children with thrombocytosis being females (64%) as compared to those being males (36%). 53 (53%) children had normal platelet numbers, 33 (33%) had thrombocytopenia, and 14 (14%) had thrombocytosis. The prevalence of uncomplicated malaria and complicated malaria were 80% and 20% respectively. The overall prevalence of thrombocytopenia was 33%, and the prevalence of thrombocytopenia in uncomplicated and severe malaria was 18.8% and 90% respectively. The prevalence of malaria types among children with thrombocytopenia was assessed. Out of the 33 (33%) patients who had thrombocytopenia, 15 (45.5%) of them had uncomplicated malaria and 18 (54.5%) of them had complicated or severe malaria. No child was found to have thrombocytosis during complicated malaria. <strong>Conclusion: </strong>The study indicates a significant higher prevalence of thrombocytopenia in severe malaria among children at the Korle-Bu Teaching Hospital, and this could be used as a useful indicator to investigate malaria or as a diagnostic clue for malaria in children.展开更多
Background :Non-Hodgkin lymphomas are the first childhood cancer in sub-Saharan Africa. Objective: The purpose of this study was to assess non-Hodgkin lymphomas cases in our setting. Methodology: A retrospective and d...Background :Non-Hodgkin lymphomas are the first childhood cancer in sub-Saharan Africa. Objective: The purpose of this study was to assess non-Hodgkin lymphomas cases in our setting. Methodology: A retrospective and descriptive study carried out in the pediatric oncology unit of the Gabriel Touré Teaching Hospital Bamako over 10 years from 1st January 2005 to 31th December 2015. Results: We exploited 274 (21.6%) cases of Non-Hodgkin Lymphoma out of 1295 cancer cases registered, the age group 6 - 10 years was the most represented (46.4%);the male sex was predominant with a sex-ratio of 1.8;digestive signs were the most common signs of discovery (44.2%) followed by maxillary swelling (42.7%);the majority of patients (52.9%) consulted between 1 and 3 months after the onset of signs;the malnutrition rate was 39.8%, of which 24.1% were severe cases and 15.7% were moderate rate. Abdominal localization was the most common (43.1%) followed by maxillofacial localization (33.9%). Almost all were Burkitt type cytology (92.7%), the majority (73.4%) were in Murphy stage III. Almost all (96%) had received chemotherapy and the modified LMB 01 protocol was widely used (62.4%). The majority of patients (85%) were chemosensitive at day 7 or after the third cyclophosphamide injection but at the end of induction only 31% were in complete remission. Gastrointestinal toxicity was the most common (37.13%) followed by hematologic toxicity 35.09 %;9.12 % of patients were lost of follow-up and 22.26% died. Tumor progression was the most common cause of death (60.66%) followed by infection (21.31%). Conclusion: In light of these findings, the late diagnosis and the poor management of NHL, as well as the limited ability to primarily treat metabolic complications, explain the high case-fatality rate, hence the important role of early diagnosis and treatment multidisciplinary.展开更多
Objective:To investigate the quality of indoor air of different wards and units of Olabisi Onabanjo University Teaching Hospital, Sagamu, to ascertain their contribution to infection rate in the hospital.Methods:The m...Objective:To investigate the quality of indoor air of different wards and units of Olabisi Onabanjo University Teaching Hospital, Sagamu, to ascertain their contribution to infection rate in the hospital.Methods:The microbial quality of indoor air of nine wards/units of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria was conducted. Sedimentation technique using open Petri-dishes containing different culture media was employed and samplings were done twice daily, one in the morning shortly after cleaning and before influx of people/patients into the wards/units and the other in the evening when a lot of activities would have taken place in these wards. Isolates were identified according to standard methods.Results:Results showed that there was a statistically significant difference(氈2= 6.0167) in the bacteria population of the different sampling time whereas it was not so for fungi population(氈2= 0.2857). Male medical ward(MMW) and male surgical general(MSG) recorded the highest bacterial and fungal growth while the operating theatre(OT) was almost free of microbial burden. The bacteria isolates were Staphylococcus aureus, Klebsiellasp., Bacillus cereus, Bacillus subtilis, Streptococcus pyogenes andSerratia marscenceswhile the fungi isolates includedAspergillus flavus, Penicilliumsp.,Fusariumsp.,Candida albicansandAlternariasp.Staphylococcus aureuswas the predominantly isolated bacterium whilePenicilliumsp. was the most isolated fungus.Conclusions:Though most of the microbial isolates were potential and or opportunistic pathogens, there was no correlation between the isolates in this study and the surveillance report of nosocomial infection during the period of study, hence the contribution of the indoor air cannot be established. From the reduction noticed in the morning samples, stringent measures such as proper disinfection and regular cleaning, restriction of patient relatives' movement in and out of the wards/units need to be enforced so as to improve the quality of indoor air of our hospital wards/units.展开更多
Background: Ectopic pregnancy is a common cause of maternal morbidity and mortality in the 1st trimester of pregnancy;without timely diagnosis and intervention, ruptured ectopic pregnancy can become a life threatening...Background: Ectopic pregnancy is a common cause of maternal morbidity and mortality in the 1st trimester of pregnancy;without timely diagnosis and intervention, ruptured ectopic pregnancy can become a life threatening condition. Objective: This study aims to give baseline indices on the incidence, clinical presentation, risk factors and the management of cases of ectopic pregnancy that presented in Alex Ekwueme Federal University Teaching Hospital, Abakaliki over a 5-year period. Materials and Method: This is a 5-year retrospective study of patients who were diagnosed with ectopic pregnancy between January 1st 2012 and December 31st 2016. The statistical analysis was done using SPSS version 22. Result: During the study period, there were 11,932 deliveries while 7725 Gynaecology patients were admitted. Over the same period there were 156 patients diagnosed and managed for ectopic pregnancy, accounting for 1.31% of all deliveries and 2.0% of all Gynaecological admissions. The modal age group was 26 - 30 years 68 (43.6%), 122 (78.2%) were married, while 34 (21.7%) were single. Nulliparous were 41 (26.3%) and primiparous were 33 (21.2%). The commonest presenting complaints were lower abdominal pain and amenorrhea, and the commonest identified risk factor was previous pelvic inflammatory disease. Most of the cases were ruptured prior to presentation and partial salpingectomy was the management in all tubal pregnancy while two cases were unruptured and had salpingostomy and another case was abdominal pregnancy and had exploratory laparotomy only. Out of 156 women that presented with ectopic pregnancy, 8 (5.1%) died before surgery could be done due to late presentation. Fifty-seven women presented in a state of shock and 9 (5.8%) of the cases were complicated with acute renal failure. Conclusion: Ruptured ectopic pregnancy is a major cause of maternal morbidity and early pregnancy loss. Late presentation is a common feature in our environment;hence widespread advocacy on case identification and early presentation is urgently needed.展开更多
Background: There is paucity of literature on the determination of the root canal length of Bantu subjects in dental professional practicing in Africa and Democratic Republic of Congo in particular. Aims: The aim of t...Background: There is paucity of literature on the determination of the root canal length of Bantu subjects in dental professional practicing in Africa and Democratic Republic of Congo in particular. Aims: The aim of the present study was to determine the root canal length of teeth of Bantu patients extracts attending the Teaching Hospital of Kinshasa University. Methods and Material: Prospective cross-sectional study was carried out in the service of Conservative Dentistry. The patients suffering with pulpitis of permanent teeth which were selected for root canal treatment during the period of January 2014 to December 2016 were included. All patients whose main root canals were inaccessible, teeth carrying prosthesis, teeth with large coronal decay, teeth having periapical periodontitis, supernumerary teeth, wisdom and primary teeth were excluded. Results: The upper canines presented some significant longer canals compared to the lower canine (23.4 ± 2.3 mm and 21.6 ± 1.8 mm). Palatal canals of the first and second molar were respectively longer as compared to the superior teeth canals (21.5 ± 1 mm, 21.3 ± 2 mm). The distal canals of the first and second molar were the longest in the mandibular arch respectively measuring 20.7 ± 2.0 mm and 21.5 ± 1.7 mm. Conclusion: Data obtained from Bantu patients show slightly shorter roots compared to some European populations, but longer than some Asian populations.展开更多
Objective: To determine the trends in burn admissions, and aetiology, severity and mortality of patients admitted to the Burns Intensive Care Unit of the Komfo Anokye Teaching Hospital from May 2009 to April 2016 (7 y...Objective: To determine the trends in burn admissions, and aetiology, severity and mortality of patients admitted to the Burns Intensive Care Unit of the Komfo Anokye Teaching Hospital from May 2009 to April 2016 (7 years). Methods: Patients' data used in this longitudinal and retrospective study were accessed from the records of the Reconstructive Plastic Surgery and Burns Unit. Processed data were depicted in tables and figures as appropriate. Univariate and multivariate analysis and Pearson's rank correlation were used in comparing relevant groups. Data analysis was conducted using Excel version 2013 and SPSS version 17.0. Results: A total of 681 patients, with a male to female ratio of 1.1:1.0, were analysed. The average annual incidence was 97.28 with a progressive decline in incidence. Mortality rate was 24.2%. Majority of the patients were children less than 10 years (43.5%) with scalds as the main aetiology in this group. Open flame was the major aetiology of burns (49.9%). Majority of the patients spent less than 10 days on admission (67.1%). Mean total body surface area was 30.54%. There was correlation between TBSA and disposition, total body surface area and aetiology and number of days in the Burns Intensive Care Unit, total body surface area and aetiology, and aetiology and number of days in the Burns Intensive Care Unit. Conclusions: Children below 10 years were the main victims. There was a shift from scald to open flame burns in this current study. Mean total body surface area and mortality rate have increased. There is urgent need for prevention campaign of flame burn and first aid education on intensive burns.展开更多
<strong>Objective</strong><span><span><span style="font-family:;" "=""><strong>:</strong> To evaluate and compare the prognostic contribution of diffe...<strong>Objective</strong><span><span><span style="font-family:;" "=""><strong>:</strong> To evaluate and compare the prognostic contribution of different UGIB prognostic scores. <b>Patients and Method</b>: Descriptive cross-sectional study with retrospective collection conducted from January 2014 to December 2019. Patients hospitalized in the Gastroenterology Department of Campus Teaching Hospital of Lome for upper gastrointestinal hemorrhage were included. The analytical component of this study had consisted of an evaluation of the sensitivity and specificity of different prognostic scores (GBS, mGBS, FRS, CRS, AIMS65) in predicting the occurrence of death and/or re-bleeding within 42 days. These different scores were compared using ROC (Receiver Operating Characteristic) curves. <b>Results</b>: We included 314 patients in our study. The male to female sex ratio was 2.48. Fibroscopy found non-related portal hypertension UGIB in 70.94% of the cases. The “FRS” was the most accurate score in predicting death or re-bleeding in all patients. The “FRS” was the most precise score in predicting the occurrence of spotting in all patients. The “FRS” was the most accurate score in predicting death among all patients. The mortality of patients at low risk of death (below the threshold value) was 2.2% for the “FRS”, 9.3% for the “CRS”, 0% for the “GBS” (p = 0.565), 50% for the “mGBS” and 11.4% for the “AIMS65”. Scores were more accurate for non-related portal hypertension UGIB. <b>Conclusion</b>: The “FRS” and the “CRS” are two precise scores in predicting the occurrence of an incident in the event of upper gastrointestinal hemorrhage. However, these scores were less effective in related portal hypertension UGIB</span></span></span><span><span><span style="font-family:;" "="">.</span></span></span>展开更多
Introduction: Tuberculosis (TB) still causes significant morbidity and mortality amongst adults and children despite all the efforts which have been put into the control of the disease. However, the prevalence of the ...Introduction: Tuberculosis (TB) still causes significant morbidity and mortality amongst adults and children despite all the efforts which have been put into the control of the disease. However, the prevalence of the disease in school age children is unknown because of scarcity of TB screening surveys in Nigerian schools. The aim of this study was to evaluate the proportion of school age children treated for TB in the Directly Observed Treatment Short Course (DOTS) clinic of University of Port Harcourt Teaching Hospital (UPTH). Methods: The records of all children 6 to 18 years who were treated in the DOTS clinic from 2011 to 2014 were reviewed. Information sought included age, sex, sputum Acid Fast Bacillus (AFB) status, Human Immunodeficiency Virus (HIV) status and treatment outcome. Results: One hundred and forty children aged 6 to 18 years were treated in the University Port Harcourt Teaching Hospital DOTS clinic, representing 41.79% of childhood TB cases seen over the study period. Seventy one (50.71%) patients were males and 69 (49.29%) were females. Their mean age was 12 ± 3.86. Thirty-one (22.14%) had smear positive TB. Sputum smear positivity was commonest (54.84%) among those who were 16 years and above compared to the other age groups and this is statistically significant (x2 = 17.72, p = 0.001). Forty-one (35%) patients were HIV positive and 6 (4.29%) were positive for both HIV and AFB. Ninety (64.29%) patients recovered fully following treatment, 48 (34.29%) were referred to other DOTS centres and 2 (1.43%) died. Gender, age group, AFB and HIV status showed no relationship with treatment outcome. Conclusion: School age children 6 to 18 years made up a large proportion of childhood TB cases seen within the study period in the DOTS clinic. More than one third of them were HIV/TB co-infected. An effective School Health Services should be established in schools in Port Harcourt to curb the spread of TB and other communicable diseases within the schools.展开更多
Background: While the combined oral contraceptive pill (COCP) is one of the most commonly used methods of birth control especially in the developed countries, robust and current information on the pill use in developi...Background: While the combined oral contraceptive pill (COCP) is one of the most commonly used methods of birth control especially in the developed countries, robust and current information on the pill use in developing countries including Nigeria is at best lacking. Objectives: The study was conducted to determine the prevalence rate, efficacy and side effects of COCP at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Southern Nigeria. Methods: It was a retrospective analysis of all clients who used the COCP between 1st January 1997 and 31st December, 2016, at the family planning clinic of UPTH Port Harcourt. Data on sociodemographic profile, side effects and source of information were extracted from the clients’ case notes coded and fed into Excel spread sheet and analysed. Results: Of the 8310 new acceptors of modern contraceptive methods in UPTH, 399 clients used the COCP, giving a prevalence rate of 4.8%. The mean age of the acceptors was 26.42 ± 4.27 years while the mean parity was 1.90 ± 0.36. Menstrual disruption was the most common complications with 78 episodes constituting 47.0% of all the complications. One unintended pregnancy occurred during the period of observation, giving a Pearl index of 0.01. Conclusion: The study showed that although COCP is very effective, readily available, safe and reliable method of fertility control, the acceptance rate is very low and the patronage rapidly declining and may therefore go into extinction as a family planning method in Port Harcourt, Southern, Nigeria.展开更多
Introduction: Severe preeclampsia is a frequent cause of maternal death, and also a frequent indication for caesarean deliveries when faced with the need to expedite delivery. We sought complications specific to caesa...Introduction: Severe preeclampsia is a frequent cause of maternal death, and also a frequent indication for caesarean deliveries when faced with the need to expedite delivery. We sought complications specific to caesarean deliveries in patients with severe preeclampsia. Methods: It was a case-control study carried out over 6 months, from December 1st, 2015 to May 31st, 2016 at the Yaoundé Central and the Yaoundé Gynaeco-Obstetric and Paediatric Hospitals. We evaluated 159 women undergoing a caesarean delivery to assess the risk of maternal and foetal postoperative complications in patients with severe preeclampsia. Significance level was set at 0.05. Results: The incidence of postoperative complications stood at 26.4%. Maternal and foetal complications were more frequent in preeclamptic women at 54.5% versus 11.5% (p < 0.05) and 47.3% versus 27.9% (p < 0.05) respectively. The incidence of adverse events was greater in women with preeclampsia: pruritus and limb pain (RR = 2.96;p < 0.001), the persistence of high blood pressure (RR = 4.51, p < 0.001), maternal death (RR = 2.93, p < 0.001), postpartum convulsions (RR = 3, p < 0.001) headaches resistant to first-line analgesics (RR = 3, p < 0.001), Disseminated Intravascular Coagulation (DIC) (RR = 2.92, p < 0.001), a cute pulmonary oedema (RR = 2.92, p < 0.001), prematurity (RR = 4.43, p < 0.001), neonatal asphyxia (RR = 2.93, p < 0.001), and hyaline membrane disease (RR = 2.93, p Conclusion: Severe preeclampsia is associated with an increased risk of postoperative complications.展开更多
Objective: Despite the presence of hand washing material and the training given to medical staff regarding hygiene measures and health care procedures in October 2015, the prevalence of nosocomial infections in the ne...Objective: Despite the presence of hand washing material and the training given to medical staff regarding hygiene measures and health care procedures in October 2015, the prevalence of nosocomial infections in the neonatal unit of the National University Teaching Hospital of Cotonou (CNHU-Cotonou) was estimated at 8% in January 2016. To determine the factors that contribute to these infections, this study assessed medical staff compliance with hand hygiene measures and procedures. Method: This research was a cross-sectional and observational study conducted from February 15 to March 31, 2016 through direct and cautious observation of 47 members of the medical and paramedical staff. The study variables were hand washing before entering the neonatal unit and before entering each treatment room, hand washing before and after seeing each patient, compliance with hand washing steps, the use of hydroalcoholic solutions and adhering to the ban on mobile phone use inside the treatment room. Results: Only 15% of the medical staff followed all of the rules and measures governing hand hygiene. The result showed that 76.6% of them did not wash their hands before entering the unit;32% washed their hands before each care session;95.7% washed their hands after each care session;and 85% did not comply with the hand washing steps. Only 21.3% of the personnel used hydroalcoholic solution, and only 85% of the personnel adhered to the ban on mobile phone use within the treatment room. Conclusion: Compliance with hand hygiene measures is insufficient. These low compliance rates facilitate the occurrence of nosocomial infections. Nosocomial infections could be prevented by identifying the reasons that medical personnel do not wash their hands and by implementing a program for education/awareness on hygiene measures based on an analysis of errors and care procedures and sustained by regular evaluations.展开更多
Objective: To determine the incidence of primary postpartum haemorrhage, identify risk/aetiological factors contributing to primary postpartum haemorrhage and review the different therapeutic approaches in the managem...Objective: To determine the incidence of primary postpartum haemorrhage, identify risk/aetiological factors contributing to primary postpartum haemorrhage and review the different therapeutic approaches in the management of primary postpartum haemorrhage. Method: A retrospective case-control study of all patients with primary postpartum haemorrhage from January 1, 2001 to December 31, 2010 at Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Result: In the period under review, 272 cases of primary postpartum haemorrhage were documented while there were a total of 5929 deliveries, giving an incidence of 1 in 26 (25.6%). The average blood loss in the cases reviewed was 1550 mls whilst in the controls, the average blood loss was 200 mls. There was statistical significant difference between the grandmultiparous cases and grandmultiparous controls (58.4% versus 16.5%, OR = 6.74, p < 0.05), suggesting that grandmultiparity may be an implicated factor in primary postpartum haemorrhage. In the unbooked cases, retained placenta was the major cause of primary postpartum haemorrhage constituting 109 (51.7%), whereas in booked cases, uterine atony contributed 70.5% to primary postpartum haemorrhage. Four maternal deaths were recorded giving a case fatality rate of 1.5%;all were unbooked. Conclusion: Postpartum haemorrhage ranks high in the list of causes of maternal death and the case fatality rate can be very high. Prevention is the key to reducing the incidence of PPH and its sequale, with preventive measures based upon the identification of risk factors, surveillance of women at risk and seemingly not at risk and avoidance of procedure during delivery which could potentially result in complications.展开更多
Objective: To study the epidemiology and current trend in the management of urologic complications following obstetric and gynaecologic surgeries at CUUA University hospital of Cotonou. Patients and Methods: It was a ...Objective: To study the epidemiology and current trend in the management of urologic complications following obstetric and gynaecologic surgeries at CUUA University hospital of Cotonou. Patients and Methods: It was a retrospective study of patients referred with urologic complications following obstetric and gynaecological surgeries. The study took place at the Teaching Clinic of Urology Andrology at CNHU of Cotonou between April 1, 2008 and March 31, 2013. Results: Forty-one patients were studied. They represented 3.5% of people hospitalized at CUUA throughout the study period. The average age was 41 years swith range of 20 and 57 years. Twenty-one (51.2%) of them were married. Thirty patients (73.2%) were referred from a non-academichospital, while 7 patients (17.1%) were referred from academic hospital. Caesarean section was the primary gynecological surgery in 22 cases (53.7%) and hysterectomy in 19 cases (46.3%). Clinically, the pre- dominant symptoms were leakage of urine throughout the vagina and obstructive anuria with or without back pain. We found 31 cases of VVF, 5 cases of bilateral ligation of the ureters, 3 cases of unilateral ligation of the ureter, 1 ureteralinjury and 1 uretero-vaginal fistula. These complications were diagnosed postoperatively in 95.1% of cases. Surgeries done included VVF repair in 31 cases (75.6%), unilateral ureteral reimplantation in 4 cases (9.8%), removal of ligation of the ureters in 3 cases (7.3%), bilateral ureteral reimplantation for 2 cases (4.9%) and end-to-end anastomosisin 1 case (2.4%). The postoperative period was uneventful in 29 cases and we observed 7 cases of surgical site infection. The overall success rate was 87.8%. Conclusion: Urological complications following gynecologic surgeries managed at the urologic department of teaching hospital of Coto-nou had an even higher incidence. Early diagnosis especially during the operative procedure would save the patients’ serious complications and open surgery due to the lack of endo-urological facilities. The most important factor in prevention is good knowledge of pelvicanatomy and good knowledge of the surgical techniques of caesarean operation section and trans-abdominal hysterectomy.展开更多
文摘Introduction: Reducing and maintaining viral load is crucial to reducing morbidity and mortality associated with HIV infection in children. The aim of this study was to determine the factors influencing the maintenance of children and adolescents on antiretroviral therapy in the continuum of care. Methodology: This was a descriptive and analytical cross-sectional study conducted from August 1 to August 31, 2023. It included all children living with HIV, under 15 years of age, with at least two viral load results and whose parents consented to participate in the study. Participants were recruited during their child’s treatment renewal consultations. Results: The study included 143 children, mostly boys (55.2%), with a mean age of 11.54 years (±2.8). More than half (55.2) were unaware of their HIV-positive status, and most treatments were administered by parents (60.8%). Of the 99 children with an undetectable viral load at the first test, 23 (23.2%) showed a viral rebound at the last test, mainly due to poor treatment compliance (p Conclusion: Virological rebound after suppression in children is worrying. It is crucial that the national AIDS program improves Therapeutic Education, trains health workers to communicate results and encourages ongoing dialogue with young people to reinforce adherence and maintain viral suppression.
文摘BACKGROUND Pediatric cataract is a public health concern,and it causes long-term functional impairment and impacts the quality of life of the child with cataract.Visual impairment in children due to cataract has devastating consequences on their health,social life,and academic performance and places a socio-economic burden on the child’s family and society as a whole.Globally,pediatric cataract is a significant contributor to ocular morbidity and blindness.Findings from this study will help quantify the visual benefits of pediatric cataract surgical interventions and identify opportunities for improving pediatric cataract services.AIM To evaluate the visual acuity outcomes of children after cataract surgery.METHODS The study employed a retrospective electronic review of pediatric cataract surgeries from January 2019 to July 2021 at the pediatric unit of the eye department at Komfo Anokye Teaching Hospital(KATH),Ghana.Patient clinical data including demographics,cataract presentation,pre-operative and post-operative visual acuity,surgical procedure,postoperative complications,interventions and refraction were collected and analyzed using the Statistical Package and Service Solution.Pearson'sχ2 test and regression statistics were used to summarize data at a significance of P<0.05.RESULTS 163 children(257 eyes)underwent cataract surgery at KATH.The overall mean age was 3.81±3.56 years.Congenital cataract was commonly observed(56.4 All children underwent keratometry and phacoemulsification procedures.A few children(9.8%)experienced postoperative complications while 90.8%did not require further intervention after the surgery.After the surgery 27.0%of the children had refraction and the majority were corrected for myopia and near addition(12.9%).An analysis of the association of postoperative visual acuity and the type of cataract was statistically significant(P value<0.05).There was a significant improvement in the visual outcomes following cataract surgery.CONCLUSION Timely pediatric cataract surgery improves postoperative visual outcomes.Creating awareness and implementing screening programs is important to ensure that the prevalence of childhood blindness is reduced to the barest minimum.
基金the staff of UUTH for their support during data collection.
文摘Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this study was to examine the effect of nurse-physiotherapist collaborative rehabilitation on functional recovery,motor function,quality of life,and disability among stroke patients.Materials and Methods:A parallel-group randomized controlled trial was conducted at the University of Uyo Teaching Hospital,Nigeria.Ninety adult stroke patients were randomized into intervention(n=45)and control(n=45)groups.The intervention group received a 6-week rehabilitation program combining joint goal setting,coordinated nursing and physiotherapy sessions,shared documentation,and weekly team reviews,whereas the control group received standard care.Outcomes were measured at baseline,6 weeks,and 3 months using the Barthel Index(primary),Fugl-Meyer assessment,stroke-specific quality of life(SS-QOL),and modified Rankin scale(mRS).Data were analyzed with repeated measures analysis of variance,with P<0.05 considered significant.Results:Patients in the intervention group showed greater functional improvement than controls.Barthel Index scores increased from 35.4±10.2 at baseline to 85.1±10.7 at 3 months,compared with 36.1±9.8-68.9±12.0 in controls(P<0.001).Similar patterns were observed for Fugl-Meyer assessment,SS-QOL,and mRS.High adherence,few adverse events,and consistent program fidelity supported feasibility.Improvements were attributed to the combination of nursing reinforcement,structured physiotherapy,patient education,and psychosocial support.Conclusion:Nurse-physiotherapist collaboration significantly enhances functional recovery,motor function,quality of life,and reduces disability in stroke patients.Implementing structured interprofessional rehabilitation in clinical practice is feasible and beneficial.
文摘Background: Diabetes is a set of metabolic abnormalities typified by hyperglycemia believed to be associated with aberrant insulin secretion, insulin action, or both. Erectile dysfunction and infertility are globally prevalent complications among male diabetic patients. There is a need to understand the role of a male reproductive hormone in the etiology of infertility in diabetic patients. Objective: This study aims to determine the effect of diabetes mellitus on the Male reproductive hormone (testosterone) on diabetic patients attending the Urology unit of Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria and the effect of industrial sugar consumption in rats model. Materials and Methods: 30 samples (including repeats, n = 3) were collected from known diabetic patients and 30 (including repeats, n = 3) control-non diabetic healthy individuals. Five millilitres (5 ml) of blood was collected from the antecubital vein of each participant and placed into a plain container for serum testosterone measurement using the enzyme-linked immunoassay technique. Blood was also collected from the same subjects in a fluoride oxalate container for plasma enzymatic glucose estimation using a Randox Glucose oxidase kit. For in vivo rat model, the albino rats were grouped into 2 of five (5) rats. The control group (1) was only given normal rat food and water while the test group (2) was treated with 0.4 g of industrial sugar/mL/body weight in addition to rat food and water via oral intubation for 21 days. Blood samples were collected via ocular puncture into plain tubes for testosterone measurement as described above. Results: There is a significant (p Conclusion: In conclusion, data available from this study suggests that increased plasma glucose levels and excessive industrial sugar consumption are associated with decreased testosterone levels in both human and animal models respectively. The mechanism is yet unclear but it could be that DM alters conventional sperm parameters, spermatogenesis, and biosynthesis of testosterone and induces degenerative changes in the testis and epididymis and ejaculatory dysfunction. These mechanisms need to be investigated.
文摘Introduction: Lyell’s syndrome (SL), called Toxic Epidermal Necrolysis is one of the most serious forms of medication accidents. It is an acute, rare pathology, its incidence is estimated at 1 to 2 cases out of one million inhabitants per year and its evolution can be fatal. Materials and Methods: We report the observation of a 60-year-old patient, with no significant pathological history, admitted to our intensive care unit at the Renaissance University Teaching Hospital in N’Djamena for the treatment of Toxic Epidermal Necrolysis. In whom the onset of symptoms dates back to few hours after vaccination against COVID-19 with Ag Johnson and Johnson. Results: An ophthalmology opinion was requested and the patient was put on Fucithalmic. In our case, in addition to the advanced age of the patient (60 years old), her SCORTEN was ≥5. Conclusion: The late management as well as the absence of a specific department for severe burns, which condition the presence of a technical plate was fatal to her despite multidisciplinary care: Resuscitators, Traumato-Orthopedist and ophthalmologist.
文摘<strong>Introduction: </strong>Temporomandibular joint ankylosis (TMJA) is a fusion of joint surfaces by fibrous or bone tissue and the resulting limitation of mouth opening. The objectives of this study were to determine the frequency of TMJA, describe the clinical aspects and assess management. <strong>Materials and Method:</strong> It was a retrospective study that was carried out in the Department of Odontostomatology and Maxillofacial Surgery of Donka National Hospital for a period of 5 years (January 2016 to December 2020). Included were all records of inpatients and managed cases of TMJA during the study period. Socio-demographic, clinical and therapeutic variables were analyzed. <strong>Results:</strong> During the study 13 TMJA cases were collected with the frequency of 0.47%. The age group 1 - 9 was the most affected (61.54%) with extremes of 4 and 28 years. Men were the most concerned (53.87%). Restriction of mouth opening was the main reason for consultation (69.23%). The etiologies of ankylosis were dominated by infection including cellulitis of dental origin (53.85%) followed by facial trauma (30.77%). Arthroplasty was the most commonly used technique (73%), two cases of recurrence were noted (15.38%). <strong>Conclusion: </strong>TMJA affects mainly children and the etiology is dominated by cellulite of dental origin hence the interest of sensitization of the population for early management of oral diseases.
文摘A cerebrole is a patient with a neurological deficit of central origin;these patients very often present disorders of the ion concentration, hence the need for hospitalization in intensive care. The aim of our study was to study hydro-electrolyte disorders in brain-damaged patients, to describe the clinical aspects, to identify the contributing factors and to determine the prognosis of these patients in the intensive care unit of gabriel touré teaching hospital. <strong>Material and Methods:</strong> It was a prospective cross-sectional study, descriptive of a period of 11 months going from June 2015 to April 2016 in the intensive care unit of CHU Gabriel TOURE we included all the cerebral patients admitted in intensive care in which hydro-ionic disorders have detected on arrival or during hospitalization. Data were collected through transfer sheets, a survey sheet and medical records. Data entry and analysis were done respectively on SPSS software (version 19) and Microsoft Word Starter 2010 software. <strong>Results:</strong> During our study, out of 450 hospitalization patients, we identified 110 brain-damaged patients and 75 patients were retained in our study, i.e. a prevalence of 16.6%. Male was predominant with 72% with a sex ratio of 2.5 the age group 20 - 50 years was majority with 45.3%, the average age was 38.49 years. The majority of patients (58.7%) were admitted from the emergency department. The most common reason for admission was impairment of consciousness in 94.7% (Table 1) of cases and the Glasgow admission score was less than or equal to 8 in 58.7% (Table 1) of patients. Hydro-electrolyte disturbances were present in 93.3% of patients on admission. Hyponatremia was the most common disorder with 56% (42 cases). Followed by hyperkalaemia 10.7% (8 cases), hypernatremia 9.3% (7 cases), at hypocalcemia 9.3% (7 cases), associated disorders 8% (6 cases). Brain CT was performed in 52% of the patients. In our study, malaria was the most common etiology of ionic disorders with 36%. Of the patients who died, 80% had developed hyponatremia after 5 days in hospital, and the overall lethality was 73.3%. <strong>Conclusion:</strong> Hydro-electrolyte disorders are frequent in the intensive care setting and their management must be rapid in order to reduce morbidity and mortality.
文摘<strong>Background: </strong>Thrombocytopenia plays an important role in the diagnosis of malaria in most countries because of the rapid decrease of platelets during malaria onset and also in severe forms of the disease. The study sought to assess platelet numbers and determine the prevalence of malarial thrombocytopenia among children with febrile malaria at the Korle-Bu Teaching Hospital (KBTH). <strong>Methodology:</strong> It was a cross-sectional study carried out in the Department of Child Health and the Polyclinic of KBTH from April to July 2018. A total of 100 children aged from 1 to 12 years who tested malaria positive for both thick and thin blood film and Rapid Diagnostic Tests (RDTs) were recruited into the study. Venous blood sample was obtained from the children and analyzed for platelet count using a haematology auto analyzer. Parasite speciation and quantification was used to classify the disease into mild, moderate and severe, and platelet numbers were also categorized into low, normal and high. Data obtained was then analyzed for prevalence of malarial thrombocytopenia in severe malaria. <strong>Results:</strong> The total studied participants were 100, 61 (61%) were males whiles 39 (39%) were females. Both severe malaria and thrombocytopenia were mostly seen in children less than 5 years of age and the males recorded more thrombocytopenia (66%) and normal platelet numbers 34 (64.2%) than the females. There was a significant higher percentage of malaria children with thrombocytosis being females (64%) as compared to those being males (36%). 53 (53%) children had normal platelet numbers, 33 (33%) had thrombocytopenia, and 14 (14%) had thrombocytosis. The prevalence of uncomplicated malaria and complicated malaria were 80% and 20% respectively. The overall prevalence of thrombocytopenia was 33%, and the prevalence of thrombocytopenia in uncomplicated and severe malaria was 18.8% and 90% respectively. The prevalence of malaria types among children with thrombocytopenia was assessed. Out of the 33 (33%) patients who had thrombocytopenia, 15 (45.5%) of them had uncomplicated malaria and 18 (54.5%) of them had complicated or severe malaria. No child was found to have thrombocytosis during complicated malaria. <strong>Conclusion: </strong>The study indicates a significant higher prevalence of thrombocytopenia in severe malaria among children at the Korle-Bu Teaching Hospital, and this could be used as a useful indicator to investigate malaria or as a diagnostic clue for malaria in children.
文摘Background :Non-Hodgkin lymphomas are the first childhood cancer in sub-Saharan Africa. Objective: The purpose of this study was to assess non-Hodgkin lymphomas cases in our setting. Methodology: A retrospective and descriptive study carried out in the pediatric oncology unit of the Gabriel Touré Teaching Hospital Bamako over 10 years from 1st January 2005 to 31th December 2015. Results: We exploited 274 (21.6%) cases of Non-Hodgkin Lymphoma out of 1295 cancer cases registered, the age group 6 - 10 years was the most represented (46.4%);the male sex was predominant with a sex-ratio of 1.8;digestive signs were the most common signs of discovery (44.2%) followed by maxillary swelling (42.7%);the majority of patients (52.9%) consulted between 1 and 3 months after the onset of signs;the malnutrition rate was 39.8%, of which 24.1% were severe cases and 15.7% were moderate rate. Abdominal localization was the most common (43.1%) followed by maxillofacial localization (33.9%). Almost all were Burkitt type cytology (92.7%), the majority (73.4%) were in Murphy stage III. Almost all (96%) had received chemotherapy and the modified LMB 01 protocol was widely used (62.4%). The majority of patients (85%) were chemosensitive at day 7 or after the third cyclophosphamide injection but at the end of induction only 31% were in complete remission. Gastrointestinal toxicity was the most common (37.13%) followed by hematologic toxicity 35.09 %;9.12 % of patients were lost of follow-up and 22.26% died. Tumor progression was the most common cause of death (60.66%) followed by infection (21.31%). Conclusion: In light of these findings, the late diagnosis and the poor management of NHL, as well as the limited ability to primarily treat metabolic complications, explain the high case-fatality rate, hence the important role of early diagnosis and treatment multidisciplinary.
文摘Objective:To investigate the quality of indoor air of different wards and units of Olabisi Onabanjo University Teaching Hospital, Sagamu, to ascertain their contribution to infection rate in the hospital.Methods:The microbial quality of indoor air of nine wards/units of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria was conducted. Sedimentation technique using open Petri-dishes containing different culture media was employed and samplings were done twice daily, one in the morning shortly after cleaning and before influx of people/patients into the wards/units and the other in the evening when a lot of activities would have taken place in these wards. Isolates were identified according to standard methods.Results:Results showed that there was a statistically significant difference(氈2= 6.0167) in the bacteria population of the different sampling time whereas it was not so for fungi population(氈2= 0.2857). Male medical ward(MMW) and male surgical general(MSG) recorded the highest bacterial and fungal growth while the operating theatre(OT) was almost free of microbial burden. The bacteria isolates were Staphylococcus aureus, Klebsiellasp., Bacillus cereus, Bacillus subtilis, Streptococcus pyogenes andSerratia marscenceswhile the fungi isolates includedAspergillus flavus, Penicilliumsp.,Fusariumsp.,Candida albicansandAlternariasp.Staphylococcus aureuswas the predominantly isolated bacterium whilePenicilliumsp. was the most isolated fungus.Conclusions:Though most of the microbial isolates were potential and or opportunistic pathogens, there was no correlation between the isolates in this study and the surveillance report of nosocomial infection during the period of study, hence the contribution of the indoor air cannot be established. From the reduction noticed in the morning samples, stringent measures such as proper disinfection and regular cleaning, restriction of patient relatives' movement in and out of the wards/units need to be enforced so as to improve the quality of indoor air of our hospital wards/units.
文摘Background: Ectopic pregnancy is a common cause of maternal morbidity and mortality in the 1st trimester of pregnancy;without timely diagnosis and intervention, ruptured ectopic pregnancy can become a life threatening condition. Objective: This study aims to give baseline indices on the incidence, clinical presentation, risk factors and the management of cases of ectopic pregnancy that presented in Alex Ekwueme Federal University Teaching Hospital, Abakaliki over a 5-year period. Materials and Method: This is a 5-year retrospective study of patients who were diagnosed with ectopic pregnancy between January 1st 2012 and December 31st 2016. The statistical analysis was done using SPSS version 22. Result: During the study period, there were 11,932 deliveries while 7725 Gynaecology patients were admitted. Over the same period there were 156 patients diagnosed and managed for ectopic pregnancy, accounting for 1.31% of all deliveries and 2.0% of all Gynaecological admissions. The modal age group was 26 - 30 years 68 (43.6%), 122 (78.2%) were married, while 34 (21.7%) were single. Nulliparous were 41 (26.3%) and primiparous were 33 (21.2%). The commonest presenting complaints were lower abdominal pain and amenorrhea, and the commonest identified risk factor was previous pelvic inflammatory disease. Most of the cases were ruptured prior to presentation and partial salpingectomy was the management in all tubal pregnancy while two cases were unruptured and had salpingostomy and another case was abdominal pregnancy and had exploratory laparotomy only. Out of 156 women that presented with ectopic pregnancy, 8 (5.1%) died before surgery could be done due to late presentation. Fifty-seven women presented in a state of shock and 9 (5.8%) of the cases were complicated with acute renal failure. Conclusion: Ruptured ectopic pregnancy is a major cause of maternal morbidity and early pregnancy loss. Late presentation is a common feature in our environment;hence widespread advocacy on case identification and early presentation is urgently needed.
文摘Background: There is paucity of literature on the determination of the root canal length of Bantu subjects in dental professional practicing in Africa and Democratic Republic of Congo in particular. Aims: The aim of the present study was to determine the root canal length of teeth of Bantu patients extracts attending the Teaching Hospital of Kinshasa University. Methods and Material: Prospective cross-sectional study was carried out in the service of Conservative Dentistry. The patients suffering with pulpitis of permanent teeth which were selected for root canal treatment during the period of January 2014 to December 2016 were included. All patients whose main root canals were inaccessible, teeth carrying prosthesis, teeth with large coronal decay, teeth having periapical periodontitis, supernumerary teeth, wisdom and primary teeth were excluded. Results: The upper canines presented some significant longer canals compared to the lower canine (23.4 ± 2.3 mm and 21.6 ± 1.8 mm). Palatal canals of the first and second molar were respectively longer as compared to the superior teeth canals (21.5 ± 1 mm, 21.3 ± 2 mm). The distal canals of the first and second molar were the longest in the mandibular arch respectively measuring 20.7 ± 2.0 mm and 21.5 ± 1.7 mm. Conclusion: Data obtained from Bantu patients show slightly shorter roots compared to some European populations, but longer than some Asian populations.
文摘Objective: To determine the trends in burn admissions, and aetiology, severity and mortality of patients admitted to the Burns Intensive Care Unit of the Komfo Anokye Teaching Hospital from May 2009 to April 2016 (7 years). Methods: Patients' data used in this longitudinal and retrospective study were accessed from the records of the Reconstructive Plastic Surgery and Burns Unit. Processed data were depicted in tables and figures as appropriate. Univariate and multivariate analysis and Pearson's rank correlation were used in comparing relevant groups. Data analysis was conducted using Excel version 2013 and SPSS version 17.0. Results: A total of 681 patients, with a male to female ratio of 1.1:1.0, were analysed. The average annual incidence was 97.28 with a progressive decline in incidence. Mortality rate was 24.2%. Majority of the patients were children less than 10 years (43.5%) with scalds as the main aetiology in this group. Open flame was the major aetiology of burns (49.9%). Majority of the patients spent less than 10 days on admission (67.1%). Mean total body surface area was 30.54%. There was correlation between TBSA and disposition, total body surface area and aetiology and number of days in the Burns Intensive Care Unit, total body surface area and aetiology, and aetiology and number of days in the Burns Intensive Care Unit. Conclusions: Children below 10 years were the main victims. There was a shift from scald to open flame burns in this current study. Mean total body surface area and mortality rate have increased. There is urgent need for prevention campaign of flame burn and first aid education on intensive burns.
文摘<strong>Objective</strong><span><span><span style="font-family:;" "=""><strong>:</strong> To evaluate and compare the prognostic contribution of different UGIB prognostic scores. <b>Patients and Method</b>: Descriptive cross-sectional study with retrospective collection conducted from January 2014 to December 2019. Patients hospitalized in the Gastroenterology Department of Campus Teaching Hospital of Lome for upper gastrointestinal hemorrhage were included. The analytical component of this study had consisted of an evaluation of the sensitivity and specificity of different prognostic scores (GBS, mGBS, FRS, CRS, AIMS65) in predicting the occurrence of death and/or re-bleeding within 42 days. These different scores were compared using ROC (Receiver Operating Characteristic) curves. <b>Results</b>: We included 314 patients in our study. The male to female sex ratio was 2.48. Fibroscopy found non-related portal hypertension UGIB in 70.94% of the cases. The “FRS” was the most accurate score in predicting death or re-bleeding in all patients. The “FRS” was the most precise score in predicting the occurrence of spotting in all patients. The “FRS” was the most accurate score in predicting death among all patients. The mortality of patients at low risk of death (below the threshold value) was 2.2% for the “FRS”, 9.3% for the “CRS”, 0% for the “GBS” (p = 0.565), 50% for the “mGBS” and 11.4% for the “AIMS65”. Scores were more accurate for non-related portal hypertension UGIB. <b>Conclusion</b>: The “FRS” and the “CRS” are two precise scores in predicting the occurrence of an incident in the event of upper gastrointestinal hemorrhage. However, these scores were less effective in related portal hypertension UGIB</span></span></span><span><span><span style="font-family:;" "="">.</span></span></span>
文摘Introduction: Tuberculosis (TB) still causes significant morbidity and mortality amongst adults and children despite all the efforts which have been put into the control of the disease. However, the prevalence of the disease in school age children is unknown because of scarcity of TB screening surveys in Nigerian schools. The aim of this study was to evaluate the proportion of school age children treated for TB in the Directly Observed Treatment Short Course (DOTS) clinic of University of Port Harcourt Teaching Hospital (UPTH). Methods: The records of all children 6 to 18 years who were treated in the DOTS clinic from 2011 to 2014 were reviewed. Information sought included age, sex, sputum Acid Fast Bacillus (AFB) status, Human Immunodeficiency Virus (HIV) status and treatment outcome. Results: One hundred and forty children aged 6 to 18 years were treated in the University Port Harcourt Teaching Hospital DOTS clinic, representing 41.79% of childhood TB cases seen over the study period. Seventy one (50.71%) patients were males and 69 (49.29%) were females. Their mean age was 12 ± 3.86. Thirty-one (22.14%) had smear positive TB. Sputum smear positivity was commonest (54.84%) among those who were 16 years and above compared to the other age groups and this is statistically significant (x2 = 17.72, p = 0.001). Forty-one (35%) patients were HIV positive and 6 (4.29%) were positive for both HIV and AFB. Ninety (64.29%) patients recovered fully following treatment, 48 (34.29%) were referred to other DOTS centres and 2 (1.43%) died. Gender, age group, AFB and HIV status showed no relationship with treatment outcome. Conclusion: School age children 6 to 18 years made up a large proportion of childhood TB cases seen within the study period in the DOTS clinic. More than one third of them were HIV/TB co-infected. An effective School Health Services should be established in schools in Port Harcourt to curb the spread of TB and other communicable diseases within the schools.
文摘Background: While the combined oral contraceptive pill (COCP) is one of the most commonly used methods of birth control especially in the developed countries, robust and current information on the pill use in developing countries including Nigeria is at best lacking. Objectives: The study was conducted to determine the prevalence rate, efficacy and side effects of COCP at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Southern Nigeria. Methods: It was a retrospective analysis of all clients who used the COCP between 1st January 1997 and 31st December, 2016, at the family planning clinic of UPTH Port Harcourt. Data on sociodemographic profile, side effects and source of information were extracted from the clients’ case notes coded and fed into Excel spread sheet and analysed. Results: Of the 8310 new acceptors of modern contraceptive methods in UPTH, 399 clients used the COCP, giving a prevalence rate of 4.8%. The mean age of the acceptors was 26.42 ± 4.27 years while the mean parity was 1.90 ± 0.36. Menstrual disruption was the most common complications with 78 episodes constituting 47.0% of all the complications. One unintended pregnancy occurred during the period of observation, giving a Pearl index of 0.01. Conclusion: The study showed that although COCP is very effective, readily available, safe and reliable method of fertility control, the acceptance rate is very low and the patronage rapidly declining and may therefore go into extinction as a family planning method in Port Harcourt, Southern, Nigeria.
文摘Introduction: Severe preeclampsia is a frequent cause of maternal death, and also a frequent indication for caesarean deliveries when faced with the need to expedite delivery. We sought complications specific to caesarean deliveries in patients with severe preeclampsia. Methods: It was a case-control study carried out over 6 months, from December 1st, 2015 to May 31st, 2016 at the Yaoundé Central and the Yaoundé Gynaeco-Obstetric and Paediatric Hospitals. We evaluated 159 women undergoing a caesarean delivery to assess the risk of maternal and foetal postoperative complications in patients with severe preeclampsia. Significance level was set at 0.05. Results: The incidence of postoperative complications stood at 26.4%. Maternal and foetal complications were more frequent in preeclamptic women at 54.5% versus 11.5% (p < 0.05) and 47.3% versus 27.9% (p < 0.05) respectively. The incidence of adverse events was greater in women with preeclampsia: pruritus and limb pain (RR = 2.96;p < 0.001), the persistence of high blood pressure (RR = 4.51, p < 0.001), maternal death (RR = 2.93, p < 0.001), postpartum convulsions (RR = 3, p < 0.001) headaches resistant to first-line analgesics (RR = 3, p < 0.001), Disseminated Intravascular Coagulation (DIC) (RR = 2.92, p < 0.001), a cute pulmonary oedema (RR = 2.92, p < 0.001), prematurity (RR = 4.43, p < 0.001), neonatal asphyxia (RR = 2.93, p < 0.001), and hyaline membrane disease (RR = 2.93, p Conclusion: Severe preeclampsia is associated with an increased risk of postoperative complications.
文摘Objective: Despite the presence of hand washing material and the training given to medical staff regarding hygiene measures and health care procedures in October 2015, the prevalence of nosocomial infections in the neonatal unit of the National University Teaching Hospital of Cotonou (CNHU-Cotonou) was estimated at 8% in January 2016. To determine the factors that contribute to these infections, this study assessed medical staff compliance with hand hygiene measures and procedures. Method: This research was a cross-sectional and observational study conducted from February 15 to March 31, 2016 through direct and cautious observation of 47 members of the medical and paramedical staff. The study variables were hand washing before entering the neonatal unit and before entering each treatment room, hand washing before and after seeing each patient, compliance with hand washing steps, the use of hydroalcoholic solutions and adhering to the ban on mobile phone use inside the treatment room. Results: Only 15% of the medical staff followed all of the rules and measures governing hand hygiene. The result showed that 76.6% of them did not wash their hands before entering the unit;32% washed their hands before each care session;95.7% washed their hands after each care session;and 85% did not comply with the hand washing steps. Only 21.3% of the personnel used hydroalcoholic solution, and only 85% of the personnel adhered to the ban on mobile phone use within the treatment room. Conclusion: Compliance with hand hygiene measures is insufficient. These low compliance rates facilitate the occurrence of nosocomial infections. Nosocomial infections could be prevented by identifying the reasons that medical personnel do not wash their hands and by implementing a program for education/awareness on hygiene measures based on an analysis of errors and care procedures and sustained by regular evaluations.
文摘Objective: To determine the incidence of primary postpartum haemorrhage, identify risk/aetiological factors contributing to primary postpartum haemorrhage and review the different therapeutic approaches in the management of primary postpartum haemorrhage. Method: A retrospective case-control study of all patients with primary postpartum haemorrhage from January 1, 2001 to December 31, 2010 at Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Result: In the period under review, 272 cases of primary postpartum haemorrhage were documented while there were a total of 5929 deliveries, giving an incidence of 1 in 26 (25.6%). The average blood loss in the cases reviewed was 1550 mls whilst in the controls, the average blood loss was 200 mls. There was statistical significant difference between the grandmultiparous cases and grandmultiparous controls (58.4% versus 16.5%, OR = 6.74, p < 0.05), suggesting that grandmultiparity may be an implicated factor in primary postpartum haemorrhage. In the unbooked cases, retained placenta was the major cause of primary postpartum haemorrhage constituting 109 (51.7%), whereas in booked cases, uterine atony contributed 70.5% to primary postpartum haemorrhage. Four maternal deaths were recorded giving a case fatality rate of 1.5%;all were unbooked. Conclusion: Postpartum haemorrhage ranks high in the list of causes of maternal death and the case fatality rate can be very high. Prevention is the key to reducing the incidence of PPH and its sequale, with preventive measures based upon the identification of risk factors, surveillance of women at risk and seemingly not at risk and avoidance of procedure during delivery which could potentially result in complications.
文摘Objective: To study the epidemiology and current trend in the management of urologic complications following obstetric and gynaecologic surgeries at CUUA University hospital of Cotonou. Patients and Methods: It was a retrospective study of patients referred with urologic complications following obstetric and gynaecological surgeries. The study took place at the Teaching Clinic of Urology Andrology at CNHU of Cotonou between April 1, 2008 and March 31, 2013. Results: Forty-one patients were studied. They represented 3.5% of people hospitalized at CUUA throughout the study period. The average age was 41 years swith range of 20 and 57 years. Twenty-one (51.2%) of them were married. Thirty patients (73.2%) were referred from a non-academichospital, while 7 patients (17.1%) were referred from academic hospital. Caesarean section was the primary gynecological surgery in 22 cases (53.7%) and hysterectomy in 19 cases (46.3%). Clinically, the pre- dominant symptoms were leakage of urine throughout the vagina and obstructive anuria with or without back pain. We found 31 cases of VVF, 5 cases of bilateral ligation of the ureters, 3 cases of unilateral ligation of the ureter, 1 ureteralinjury and 1 uretero-vaginal fistula. These complications were diagnosed postoperatively in 95.1% of cases. Surgeries done included VVF repair in 31 cases (75.6%), unilateral ureteral reimplantation in 4 cases (9.8%), removal of ligation of the ureters in 3 cases (7.3%), bilateral ureteral reimplantation for 2 cases (4.9%) and end-to-end anastomosisin 1 case (2.4%). The postoperative period was uneventful in 29 cases and we observed 7 cases of surgical site infection. The overall success rate was 87.8%. Conclusion: Urological complications following gynecologic surgeries managed at the urologic department of teaching hospital of Coto-nou had an even higher incidence. Early diagnosis especially during the operative procedure would save the patients’ serious complications and open surgery due to the lack of endo-urological facilities. The most important factor in prevention is good knowledge of pelvicanatomy and good knowledge of the surgical techniques of caesarean operation section and trans-abdominal hysterectomy.
