Port Harcourt Medical Journal

Port Harcourt Medical Journal, a paradigm shift

2016-06-23T10:31:28+00:00

No Abstract

The effect of some social factors on adolescents nutritional status in an oil-rich Niger-Delta region of Nigeria

2016-06-23T10:31:29+00:00

Background: Adolescence is the period of transition from childhood to adulthood and the second most critical period of physical growth after the first year of life. Nutritional problems may arise from poor eating habits, snacking and consumption of nutrition deficient processed foods. Some social factors have been shown to influence their nutritional status, the result of which may have detrimental health implications as they advance into adulthood.

Aim: To determine the effect of some social factors on the nutritional status of adolescents in Port Harcourt.

Methods: A multi-staged sampling technique was used to select 960 adolescents from eightsecondary schools in Port Harcourt. Using an investigator-administered questionnaire, information on their socio-economic status, eating habits, food content and level of activity was obtained. Anthropometric measurements were taken and BMI calculated using the formula weight/height2 (kg/m2). This was then used to categorize their nutritional status. The results wereanalyzed using SPSS 14 and EPI Info 6.04.

Results: Eight hundred and nineteen adolescents (85.3%) had normal weight, 61(6.4%) were underweight while 17 (1.8%) were obese. Significantly more males (8.9%) were underweight compared to females (3.8%); while females were significantly more overweight and obese than males. Consumption of snacks (17.4%), soft drinks (10%), higher social economic class (11.5%) and watching television for >3hrs a day (18.6%) were associatedwith overweight and obesity.

Conclusion: Social economic status, snacking and hours spent watching television have a detrimental effect on the nutritional status of adolescents in Port Harcourt.

Keywords: Adolescents, Nutritional status, Social factors

Histopathological results of nasopharyngeal masses of adult patients: a study from two centres in Port Harcourt, Nigeria

2016-06-23T10:31:31+00:00

Background: Nasopharyngeal masses in adult patients in most cases are considered to be tumours unless proven otherwise.

Aim: To determine the histopathological results of nasopharyngeal masses seen in adult patients in Port Harcourt Nigeria. It will also highlight the management outcomes of these patients.

Methods: A prospective (January 2010 to December 2013) study of 45 patients with both clinical and radiological evidence of nasopharyngeal masses seen at the Ear Nose and Throat (ENT) surgery clinics of University of Port Harcourt Teaching Hospital (UPTH) and Kinx Medical Consultants clinic in Port Harcourt. All the patients had examination under anaesthesia (E/U/A) of the nose and nasopharynx and biopsy. The data collected were documented in a proforma designed for the study by the researchers. The data are bio-data, clinical features, investigations, histopathological findings, treatment, complications and management outcome. The data were entered into an SPSS version 14 computer soft ware and analyzed descriptively.

Results: Forty five adult patients had E/U/A of the nose and nasopharynx and biopsy of nasopharyngeal masses. They all had history of chronic rhinorrhoea, snoring and nasal obstruction. Age range was 18-72 years. There were 20 males and 25 females with male to female ratio of 1:1.25. The commonest histopathological diagnosis was adenoidal hyperplasia (n=36, 80%) followed by non-Hodgkin lymphoma (n=5, 11.11%).

Conclusion: Even though the predominant histopathological result of nasopharyngeal masses in adult patients we encountered was adenoidal hyperplasia, all tissues from the nasopharynx irrespective of their benign macroscopic appearances should be subjected to histopathological examination to avoid missing out more sinister diagnosis.

Keywords: Examination under anaesthesia, Nasopharyngeal masses, Non-Hodgkin lymphoma, Adenoidal hyperplasia, Squamous cell carcinoma

Pattern of strabismus in a tertiary hospital in Nigeria: a six-year review

2016-06-23T10:31:32+00:00

Background: Strabismus (ocular misalignment) is frequently seen in clinical practice. Its prevalence varies in different parts of the world with no sex predilection. Stabismus is a significant cause of ocular morbidity. Esotropia is often the commonest form of presentation among children.

Aim: To determine the frequency and clinical features of patients presenting with strabismus in the ophthalmic clinic a past 6-year period.

Methods: This was a hospital based study of all the patients diagnosed having strabismus in University of Port Harcourt Teaching hospital between January 2007 and December 2013. The medical records of a total of 74 patients who visited the ophthalmic clinic and diagnosed as having strabismus were retrospectively reviewed and subsequently analysed using Statistical Package for Social Sciences (SPSS) version 17 computer soft ware package. Ethical clearance was obtained from the Ethics committee of the University of Port Harcourt Teaching Hospital.

Results: A total of 12,334 case files were reviewed in this study. Five thousand one hundred and eighty-one (42%) were males and 7,153 (58%) females. A total of 74 cases had strabismus (0.6%). Twenty- three were males and 51 females (M:F=1:2.2). Twenty-eight (37.8%) had alternating squint, twenty- three (31.1%) had esotropia, twenty- one (28.4%) had exotropia and two (2.7%) had hypertropia.

Conclusion: This study confirmed the relatively high frequency of alternating squint and esotropia in patients with strabismus.

Keywords: Strabismus, Prevalence, Pattern

A five - year review of gestational trophoblastic diseases in Port Harcourt, Nigeria

2016-06-23T10:31:33+00:00

Background: Gestational Trophoblastic Diseases (GTD) are a spectrum of inter-related but histologically distinct tumours originating from the placenta with good prognosis when diagnosed early.

Aim: To determine the prevalence, clinical presentations, management of gestational trophoblastic disease at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.

Methods: A retrospective analysis of women treated for gestational trophoblastic disease from 1^st January 2008 to 31^stDecember 2012. The information from patients records: age, occupation, educational level, husband's occupation, parity, presenting symptoms, uterine size, mode of treatment and management options were collated and analysed. The Chi-square test was used to compare categorical variables with a p value of ≤ 0.05 as significant.

Results: A total of 38 cases of GTD were treated with a prevalence of 2.3 per 1,000 deliveries. The mean age and parity were 31 ± 6.3 years and 2 ± 1.6 respectively. Maternal age less than 35 years and low socioeconomic status were significantly associated with GTD (p=0.0000). The mean gestational age at presentation was 16.24 ± 5.4 weeks. The commonest clinical presentation was amenorrhoea in 100% of patients. Twenty-five(65.8%) cases of hydatidiform mole and 13(34.2%) cases of choriocarcinoma were observed. Twenty-two (57.9%) patients had suction evacuation only for hydatidiform mole, 3(7.9.%) had suction evacuation and cytotoxic therapy for hydatidiform mole and subsequent persistent trophoblastic disease while 8(21.1%) had chemotherapy for choriocarcinoma. Five patients with advanced choriocarcinoma did not receive definitive treatment before demise. Twenty (52.6%)defaulted in their follow up schedule.

Conclusion: There is high prevalence of GTD in Port Harcourt with high mortality among patients with malignancy. Most of the patients defaulted in their follow up; thus there is a need for education and sensitization of the populace on GTD, as well as proper counseling of patients treated on the benefits of follow up visits

Keywords: Gestational trophoblastic disease, Prevalence, Management, Outcome, Port Harcourt

Malaria chemoprophylaxis during pregnancy: a survey of current practice amongst general practitioners in Port Harcourt, Nigeria

2016-06-23T10:31:35+00:00

Background: Malaria is a common health problem especially among the pregnant women in endemic countries such as Nigeria. Sulphadoxine/pyrimethamine (SP) has been recommended by the World Health Organisation (WHO) for malaria chemoprophylaxis in pregnancy and has been incorporated into our national malaria control programme. General medical practitioners provide prenatal care for significant proportion of our women in pregnancy.

Aim: To examine the current knowledge and practice of malaria chemoprophylaxis during pregnancy among general medical practitioners in Port Harcourt, southern Nigeria.

Methods: It was a questionnaire based study of 90 general medical practitioners in Port Harcourt, southern Nigeria which sought for their socio-demographic characteristics and knowledge and practice of malaria chemoprophylaxis during pregnancy. The data were entered into a personal computer and analysed using SPSS for windows version 10.0 and presented as frequency tables and percentages.

Results: Of the 90 questionnaires, 59 duly completed forms were retrieved, giving a response rate of 65.60%. The age range of the respondents was 21-60 years with 31-40 years as the most common range. Only 33(55.93%) respondents knew the current malaria chemoprophylactic agent in pregnancy as recommended by WHO. Almost all (98.30%) respondents administered malaria chemoprophylaxis routinely to their antenatal women but only 44.06% administered correctly SP as recommended.

Conclusion: The knowledge and practice of the WHO recommended malaria chemoprophylaxis in pregnancy among general medical practitioners is below average. Training and re-training of these primary care physicians on the use of sulphadoxine-pyrimethamine will tremendously improve their knowledge and practice of this WHO recommended chemoprophylactic agent in pregnancy which will in turn reduce malaria - related perinatal and maternal complications.

Keywords: Malaria, Chemoprophylaxis, Pregnancy, WHO, General Practitioners

Laryngeal tumours: clinical features and management challenges as seen in two centres in Port Harcourt, Nigeria

2016-06-23T10:31:36+00:00

Background: Laryngeal tumours especially the malignant varieties are not uncommon with a number of factors affecting their management in most resource poor countries. Late clinical presentation and diagnosis is commonplace in the sub-Saharan region of Africa.

Aim: To determine the prevalence of laryngeal tumours as seen in two centres in Port Harcourt, Nigeria and highlights the challenges encountered in the management of these patients.

Methods: A retrospective study carried out using records of patients who presented with features of laryngeal tumours to both the University of Port Harcourt Teaching Hospital (UPTH) and Kinx Medical Consultants Hospital in Port Harcourt, Nigeria. The period of the study was from January 2003 to December 2014. Data extracted included age, gender, clinical features, radiological investigations, histopathologic diagnosis and treatment modalities. Data were analyzed using simple descriptive statistical methods.

Results: A total of thirty five cases were seen with laryngeal diseases during the 12-year period out of 2,300 patients who presented with laryngeal symptoms giving a prevalence of 1.52%. There were 30 males and 5 females giving a male to female ratio of 6: 1. The age range was 40 years to 70 years. The mean age was 58.5 ± 4.55 years. The age range 50-59 years was mostly affected. The commonest mode of presentation was hoarseness (100%). Twenty five cases (71.43%) were found to be malignant diseases while 10 (28.57%) cases were benign diseases. Twenty (57.14%) of the patients had emergency tracheostomy. The predominant histological type was well differentiated squamous cell carcinoma [15(42.86%)]. Only three (8.57 %) patients had total laryngectomy.

Conclusion: The prevalence of laryngeal tumours in our environment was found to be 1.52% and patients within the middle age group were mostly affected. Well differentiated squamous cell carcinoma was the commonest histopathological type.

Keywords: Challenges, Management, Laryngeal tumours, Squamous cell carcinoma, Papillomas, Total laryngectomy, Port Harcourt

Risk factors associated with accidental ingestion of dental prosthesis in a Nigerian tertiary hospital

2016-06-23T10:31:38+00:00

Background: Ingestion of dental prosthesis is a challenging health problem that may result in severe and at times fatal complications.

Aim: To identify risk factors that may lead to accidental ingestion of these dental prosthesis and suggest preventive strategies.

Methods: This was a prospective observational study at the University of Benin Teaching Hospital, Benin City, between 1st January, 2009 and 31st December, 2010 of patients presenting with ingestion of dental prosthesis. The bio data and data relating to circumstances surrounding the ingestion of the dental prosthesis were obtained from the patients and analyzed manually.

Results: During the study period, eight patents were see, seven male and one female. Their ages ranged from 35 to 85 years with an average of 61.13 years. All the dental prosthesis retrieved from patients in this study were unsecured. Most of the patients with impacted dental prosthesis did not have the habit of removing their denture before sleeping; eating or taking drugs orally, even-though the activity engaged in during ingestion of dental prosthesis in all the patients were during eating, drinking water or drugs. Only one of the patients ever went for check-up after the initial fitting of their denture.

Conclusion: Removal of unsecured dental prosthesis before eating, drinking water or drugs will likely reduce the incidence of their ingestion in our environment.

Keywords: Preventive, Strategies, Dental prosthesis, Impaction, Health education, Oesophagus