Post-Neonatal Hypoglycaemia and Paediatric Emergency Room Admissions: A Study In The University Of Port Harcourt Teaching Hospital.

Background: Hypoglycaemia, a common complication of many childhood diseases, significantly increases disease-related morbidity and mortality. The objective of this study is to determine the prevalence, morbidity pattern and outcomes of hypoglycaemia at admission of postneonatal children in the Children's Emergency Ward (CHEW) of the University of Port Harcourt Teaching (UPTH).Methods: All post-neonatal children admitted into the UPTH CHEW from September 2007-January 2008 who met the inclusion criteria were prospectively studied using a pre-tested proforma which obtained their sociodemographic and clinical data. In all subjects, plasma glucose was determined on admission (using glucometer and glucose oxidase tests) before management. Data analysis was with EPI Info version 6.04 and statistical significance was set at 0.05.Results: Three hundred and seventy children aged 1month-15 years (mean 36.7±40 months) with 272(78.9%) under-fives were studied. Their plasma glucose levels ranged from 1.0-12mmol/l with 19(5.1%) children among whom were 15(78.9%) under-fives being hypoglycaemic (plasma glucose-1.0-2.4mmol/l, mean 1.4 + 0.2mmol/l). All cases of hypoglycaemia were detected by both methods of estimation. The commonest diseases diagnosed in the study population, irrespective of the plasma glucose level, were malaria, anaemia and diarrhoea. Overall, 49 (13.2%) children of whom 7(14.3%) were hypoglycaemic died. Hypoglycaemia was associated with longer hospital stay and higher mortality rate (36.8%) (p=0.001).Conclusion: Hypoglycaemia, detectable by bedside glucometer test, significantly increases morbidity and mortality associated with common childhood diseases. There is therefore a need for its prevention, early diagnosis and prompt management in all paediatric care settings, especially in resource-limited countries, as recommended in the Integrated Management of Childhood Illness algorithm.Keywords: Hypoglycaemia; Post-neonatal; Paediatric emergencies; Nigeria

Antioxidant status of type 2 diabetic patients in Port Harcourt, Nigeria

Context: Oxidative stress has been implicated in the pathogenesis of type 2 diabetes mellitus (T2M) and its complications. Aims: This study was conducted to determine and compare total antioxidant status (TAS), vitamin C and E levels in T2DM patients and healthy control subjects. Settings and Design: Fifty‑five previously diagnosed DM patients aged between 34 years and 70 years and 50 control subjects aged between 35 years and 69 years were consecutively recruited into this study. Materials and Methods: Blood pressure (mmHg), body mass index (kg/m2), concentrations of plasma glucose (mmol/l), lipid profile (mmol/l), TAS (mmol/l), vitamins C (µmol/l), and E (µmol/l) were determined in all participants. Statistical Analysis Used: Statistical Package for Social Sciences (SPSS) version 11.0 was used for statistical analysis. Results: The mean plasma TAS (1.18 ± 0.27 mmol/l), vitamin C (26.59 ± 7.39 µmol/L) and vitamin E (15.33 ± 4.05 µmol/l) of T2DM patients were significantly lower (P=0.0001 for all) than those of controls (1.58 ± 0.28 mmol/l, 43.56 ± 6.86 µmol/l, 31.22 ± 6.20 µmol/l respectively). TAS had a positive correlation with vitamin E (r=0.588; P=0.013) but no correlation with vitamin C (r=−0.387; P=0.139) among diabetics. Conclusions: TAS, vitamin C and E levels are reduced in T2DM patients compared with those of controls.Keywords: Total antioxidant status, type 2 diabetes mellitus, vitamin C, vitamin ENigerian Journal of Clinical Practice • Jan-Mar 2012 • Vol 15 • Issue

Alcohol-related hypoglycemia in rural Uganda: socioeconomic and physiologic contrasts

Hypoglycemia is a rare but important complication seen in patients who present with alcohol intoxication. In a study by Marks and Teale, less than one percent of people with alcohol intoxication who presented to an American emergency department were hypoglycemic [1]. It is even more rare to see an intoxicated patient, who had been eating appropriately prior to or during the intoxication, present in a hypoglycemic coma. However, our analysis of the first 500 patients seen in a newly opened five-bed Emergency Department (ED) at Nyakibale Karoli Lwanga Hospital in rural southwestern Uganda, revealed multiple intoxicated patients who presented in hypoglycemic coma within hours of eating a full meal. Three of these cases are summarized and discussed below

Correlation between HIV viral load and aminotransferases as liver damage markers in HIV infected naive patients: a concordance cross-sectional study

Abnormalities in liver function tests could be produced exclusively by direct inflammation in hepatocytes, caused by the human immunodeficiency virus (HIV). Mechanisms by which HIV causes hepatic damage are still unknown. Our aim was to determine the correlation between HIV viral load, and serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) as markers of hepatic damage in HIV naive infected patients

Prevalence and burden of HBV co-infection among people living with HIV:A global systematic review and meta-analysis

Globally, in 2017 35 million people were living with HIV (PLHIV) and 257 million had chronic HBV infection (HBsAg positive). The extent of HIV-HBsAg co-infection is unknown. We undertook a systematic review to estimate the global burden of HBsAg co-infection in PLHIV. We searched MEDLINE, Embase and other databases for published studies (2002-2018) measuring prevalence of HBsAg among PLHIV. The review was registered with PROSPERO (#CRD42019123388). Populations were categorized by HIV-exposure category. The global burden of co-infection was estimated by applying regional co-infection prevalence estimates to UNAIDS estimates of PLHIV. We conducted a meta-analysis to estimate the odds of HBsAg among PLHIV compared to HIV-negative individuals. We identified 506 estimates (475 studies) of HIV-HBsAg co-infection prevalence from 80/195 (41.0%) countries. Globally, the prevalence of HIV-HBsAg co-infection is 7.6% (IQR 5.6%-12.1%) in PLHIV, or 2.7 million HIV-HBsAg co-infections (IQR 2.0-4.2). The greatest burden (69% of cases; 1.9 million) is in sub-Saharan Africa. Globally, there was little difference in prevalence of HIV-HBsAg co-infection by population group (approximately 6%-7%), but it was slightly higher among people who inject drugs (11.8% IQR 6.0%-16.9%). Odds of HBsAg infection were 1.4 times higher among PLHIV compared to HIV-negative individuals. There is therefore, a high global burden of HIV-HBsAg co-infection, especially in sub-Saharan Africa. Key prevention strategies include infant HBV vaccination, including a timely birth-dose. Findings also highlight the importance of targeting PLHIV, especially high-risk groups for testing, catch-up HBV vaccination and other preventative interventions. The global scale-up of antiretroviral therapy (ART) for PLHIV using a tenofovir-based ART regimen provides an opportunity to simultaneously treat those with HBV co-infection, and in pregnant women to also reduce mother-to-child transmission of HBV alongside HIV

Comparison of red cell cholinesterase and plasma cholinesterase activities in early detection of organo-phosphorus toxicity in exposed industrial workers in Port Harcourt, Nigeria

No Abstract. Nigerian Journal of Medicine Vol 15 (3) July-September: 314-31

Knowledge, attitude and practice of aspects of laboratory safety in pathology laboratories at the university of Port Harcourt Teaching Hospital, Nigeria

Objective: To assess current knowledge, attitudes and practice of aspects of laboratory safety in pathology laboratories at the University of Port Harcourt Teaching Hospital in view of perceived inadequacies in safety practices in clinical laboratories in developing countries. Materials and Methods: Sixty (60) self- administered questionnaires were distributed to all cadres of staff in four (4) different laboratories (Chemical Pathology, Haematology, Blood bank and Medical Microbiology) at the Hospital.Result: Gross deficiencies were found in the knowledge, attitudes and practice of laboratory safety by laboratory staff in areas of use of personal protective equipment, specimen collection and processing, centrifuge – related hazards, infective hazards waste disposal and provision and use of First Aid Kits.Conclusion: Issues peraning to laboratory safety are not yet give adequate attention by both employers and employees in developing countries in this ear of resurgence of diseases such as HIV/ AIDS and Hepatitis Band C, is emphasized. Nigerian Journal of Clinical Practice Vol. 8(2) 2005: 102-10

Plasma glucose in a reference population in Port Harcourt, Nigeria

Background: Reference intervals are important in the analysis of results obtained for patients in the Hospital. These intervals tend to change as population demographics change. Globally, there has been an increase in the prevalence of diabetes and a change in the criteria set in diagnosing this disease. Since we have used the same reference intervals since 1984, it became imperative to review the reference intervals in use in our Hospital, the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. Methods: A total of 605 patients from the Out-Patient department and the Hospital community randomly following informed consent. Five milliliters (5mls) of blood was collected into fluorides oxalate bottles between 9.00-11.00 a.m. after an overnight fast for the determination of plasma glucose. The samples were assayed daily within two hours of collection. Serum glucose was determined using the glucose oxidase method (Randox Laboratories-Antrim UK). Results: The reference interval covering the central 95th centile as determined by non-parametric methods was 3.0-5.7 mmol/L (95% confidence interval-2.7-3.2 and 5.6-5.8 mmol/L) for the entire study population, while that for males was 2.9-6.3 mmol/L and that for females was 3.3-5.6 mmol/L. Conclusion: It is essential to review reference intervals periodically as changes may occur due to changes in population demographics. Keywords: Reference intervals, Plasma glucose, Reference population.Port Harcourt Medical Journal Vol. 2 (3) 2008: pp. 228-23