Knowledge, Attitude and Practice of General Medical Practitioners In Port Harcourt Towards The Prevention Of Mother-To-Child Transmission of HIV.

Background: Pregnant women living with HIV infection are at risk of transmitting HIV to their babies. Most of this transmission occurs during labour and delivery and during breast feeding. About 45% of all deliveries are conducted in private clinics. This study aims to access the knowledge, attitude and practice of general medical practitioner in Port Harcourt toward the prevention of mother-to-child transmission of HIV.Methods: A questionnaire survey was carried out on two hundred and twenty four private medical practitioners in Port Harcourt. Data  management was carried out using ® SPSS 15 for windows statistical software.Results: Only 50% of respondents had read the national guideline on PMTCT while 48.2% had three or more sources of information on PMTCT. Majority of the respondents (95.5%) identified prevention of HIV in the pediatric age group as the primary aim of PMTCT. Labour was identified by 80%of respondents as the time of transmission of MTCT of HIV while 48.2% preferred a specialist unit for HIV positive pregnant women. Forty two percent would screen pregnant women without consent. About half (46.6%) do not offer antenatal or delivery services to HIV positive women. Of the doctors that offer those services 58.7% could name 2 or more drugs to prevent MTCT of HIV during pregnancy. Of the respondents, 74% would offer HIV positive women elective caesarean section. Most of the respondents (89.3%) agreed that their knowledge, attitude and practice of PMTCT was deficient and 90.1% were willing to attend an update course.Conclusion: The Private General Practitioners were not well informed on practical aspects of prevention of MTCT of HIV/AIDS. They showed a discriminatory attitude towards HIV positive pregnant women.Key words: Private Practitioners, HIV, PMTCT

The Impact of Galactorrhoea on Infertility In Port Harcourt.

Background: Infertility is a major global problem and is regarded as a social stigma in the Nigerian society. At least one in every ten couples of reproductive age has infertility. Galactorrhoea is one of the complaints often associated with infertility. Its relationship with amenorrhoea and infertility is well established. The objective of this study is to determine the incidence and contribution of galactorrhoea to female infertility and to determine any correlation between galactorrhoea and hyperprolactinaemia.Methods: A descriptive prospective study involving 186 consecutive patients presenting with infertility at the University of Port Harcourt teaching Hospital between 1st January 2009 and 30th June 2009. All patients presenting with infertility at the gynaecological clinic of the University of Port Harcourt Teaching Hospital between 1st January 2009 and 30th June 2009 were included in this study. Data was collected based on a protocol developed for the study. Data collected was entered into a spread sheet ® using SPSS 14.0 for Windows statistical software which was also used for analysis.Results: Galactorrhoea was present in 101 (54%) of the infertile patients. Only 58% of the patients who had galactorrhoea were aware they had galactorrhoea. Galactorrhoea was associated with menstrual abnormalities in 37.8% of the patients, 17% had amenorrhoea while 20.8% had oligomenorrhoea. Hyperprolactinaemia was found in 55% of the study population, 76.9% of these had galactorrhoea while 80% o f all patients with galactorroea had hyper prolactinaemia. Galactor rhoea (with  hyperprolactinaemia) was the only abnormality found in 16.1% of the study population and in 29.7% of those with anovulation.Conclusion: There is a high incidence of galactorrhoea (54%) and hyperprolactinaemia (55%) amongst infertile women as seen in this study. 16.1% of the study population had galactorrhoea (with hyperprolactinaemia) as the only abnormal finding. Most patients with galactorrhoea would also have Hyperprolactinaemia.There is a positive correlation between galactorrhoea & hyper prolactinaemia, not all women with hyperprolactinaemia had galactorrhoea and vice-versa.Keywords: Galactorrhoea; infertility; Nigeria

Sero-Epidemiology of HIV Infection among Abandoned Babies in Port Harcourt, Nigeria

Background: HIV infection is endemic in Nigeria and is an important cause of infant mortality and morbidity. This study was undertaken to determine the sero-epidemiology of HIV among abandoned babies in Port Harcourt, Nigeria. Methods: One hundred and forty (n = 140) consecutively recruited abandoned babies mean age 11.5 \ub1 24.1 weeks made up to 79 males and 61 females, referred to the HIV screening unit from motherless babies home in Port Harcourt for pre-adoption HIV screening within a five years period (1999 - 2003) were screened for HIV using the WHO approved immunocomb HIV I & II kits (Organics, Israel) - an enzyme linked immunosorbent assay for the quantitative and differential diagnosis of HIV in serum or plasma. Initially reactive samples were continued using Genscreen HIV 1 & 2 (p24) antigen test (Bro Rad, France). Results: HIV was detected in 19(13.6%) of babies tested. Sero-prevalence was highest in babies 9 - 16 weeks (25.0%). Males accounted for the highest infection burden (57.9%) compared to (42.1%) for females. Data indicated that the prevalence of HIV declined from 12.5% in 1999 to 8.3% in 2000 and increased subsequently to 20% in 2001 but declined steadily to 16.1% in 2002 and 14.3% in 2003. HIV-1 accounted for the predominant viral subtype among babies sero-positive for HIV (89.5%). Chi square analysis indicates that symptom at abandonment was an independent risk factor for HIV infection among abandoned babies (\u3c72 = 40.97; p = 0.0001). Conclusions: This study demonstrates a high prevalence of HIV among abandoned babies in Port Harcourt. This calls for an urgent need for government, non governmental organization and faith-based organization to critically examine the issue of child abandonment and HIV infection by initiating care and support programme aimed at providing knowledge and information which emphasizes a combination of behavioural and social changes and providing a youth-friendly health services to control the HIV scourge.Fond: L'infection de VIH est end\ue9mique au Nig\ue9ria et elle est une cause importante de la mortalit\ue9 et de la morbidit\ue9 infantiles. Cette \ue9tude a \ue9t\ue9 entreprise pour d\ue9terminer la s\ue9ro-\ue9pid\ue9miologie de VIH parmi les b\ue9b\ue9s abandonn\ue9s \ue0 Port Harcourt, Nig\ue9ria. M\ue9thodes : Cent quarante (n = 140) b\ue9b\ue9s abandonn\ue9s et cons\ue9cutivement recrut\ue9s avec l'\ue2ge moyen de 11.5 \ub1 24,1 semaines faisant 79 m\ue2les et 61 femelles envoy\ue9s pour un test de VIH pr\ue9-adoption d'une maison pour les b\ue9b\ue9s abandonn\ue9s \ue0 Port Harcout au cours d'une p\ue9riode de cinq ans (1999 - 2003) ont \ue9t\ue9 examin\ue9s pour VIH en utilisant des kits d'immunocomb VIH I et II approuv\ue9 par OMS (Orgenics, Isra\uebl); une enzyme li\ue9 \ue0 l'analyse d'immunosorbant pour le diagnostic quantitatif et diff\ue9rentiel de VIH dans le s\ue9rum ou le plasma. Au commencement des \ue9chantillons r\ue9actifs ont \ue9t\ue9 continu\ue9s avec l'utilisation de VIH de Genscreen 1 et 2 (p.24) examen de l'antig\ue8ne (Bro rad, France). R\ue9sultats : HIV a \ue9t\ue9 d\ue9tect\ue9 dans 19(13,6%) des b\ue9b\ue9s examin\ue9s. la S\ue9ro-pr\ue9dominance \ue9tait la plus haute dans les b\ue9b\ue9s ages de9 - 16 semaines (25,0%). Les m\ue2les ont repr\ue9sent\ue9 la population la plus affect\ue9e par le fardeau d'infection (57,9%) compar\ue9 \ue0 (42,1%) pour des femelles. Les donn\ue9es ont indiqu\ue9 que la pr\ue9dominance de VIH a diminu\ue9 de 12,5% en 1999 \ue0 8.3% en 2000 et ont augment\ue9 plus tard \ue0 20% en 2001 mais a diminu\ue9 solidement \ue0 16,1% en 2002 et \ue0 14.3% en 2003. VIH-1 a repr\ue9sent\ue9 le sous-type viral pr\ue9dominant parmi les b\ue9b\ue9s s\ue9ropositifs pour VIH (89.5%). L'analyse de chi-carr\ue9e indique que le sympt\uf4me \ue0 l'abandon \ue9tait un facteur de risque ind\ue9pendant pour l'infection de VIH Parmi les b\ue9b\ue9s abandonn\ue9s (x2 = 40,97 ; p = 0,0001). Conclusions : Cette \ue9tude d\ue9montre une forte pr\ue9sence de VIH parmi les b\ue9b\ue9s abandonn\ue9s \ue0 Port Harcourt. Ceci r\ue9clame un besoin pressant de gouvernement, des organisations non gouvernementales et des organizations religieuses d'examiner critiquement la question de l'abandon d'enfant et l'infection dee HIV en lan\ue7 ant les programmes de soin et de soutien vis\ue9s \ue0 fournir la connaissance et l'information et les informations qui soulignent une combinaison des changements sociaux et comportementaux et qui fournissent des services de sant\ue9 amicaux aux jeunes \ue0 la lutte ontre le fl\ue9au de VIH.

Maternal exposure to carbon monoxide in the first trimester (7-13+6 weeks) of pregnancy in the core Niger Delta

Background: Irrespective of the fact that the Niger Delta was known for its environmental pollution, neither organized environmental assessment nor human biomonitoring, including that of carbon monoxide (CO) had been performed in the region. The aim of the study therefore was to establish the severity of maternal impact on exposure to CO in the first trimester of pregnancy by quantifying the exhaled CO concentrations (ECOC) and to assess the effect of maternal age, body mass index (BMI) and parity on the severity of the impact.Methods: The study was of cross-sectional design carried out at the Rivers State University Teaching Hospital (RSUTH) in Rivers State. 490 consecutive pregnant women in the first trimester were recruited from the antenatal clinic from January 2021 to January 2022. Gestational age was estimated with the aid of ultrasound scan. Demographic, social and obstetric characteristics were taken. Exhaled carbon monoxide concentration (ECOC) was measured with the aid of a smokerlyzer. Data was analyzed, using the statistical package for social sciences (SPSS) version 25.0 (Armonk, NY) software. Ethical approval was obtained from the RSUTH ethics committee.Results: The mean value of ECOC 3.25±2.51 ppm was more than that obtained in other studies. Out of the total 490 patients that were assessed, 335 (68.37%) had mild impact from CO exposure (ECOC=1-3 ppm), 129 (26.33%) – moderate impact (ECOC=4-6 ppm) and 26 (5.31%) had severe impact (ECOC=more than 6 ppm). Moderate and severe impacts were more prominent in women of age groups 25-39 years and the differences in various age groups were statistically significant [X2=20.671, p<0.036, 95% CI (0.032, 0.040)]. Patients with higher BMI were more likely to have moderate and severe impact than those with lower BMI- 6 (33.33%) and 4 (22.22%) out of the 18 patients with class III obesity had moderate and severe impacts respectively. The differences in the impact at various BMI were statistically significant [X2=20.671, p<0.001, 95% CI (0.001, 0.002)]. There was inverse relationship between parity and the severity of the impact and the differences in various parity groups were statistically significant [X2=10.580, p<0.012, 95% CI (0.101, 0.113)]. There was also a paradoxical finding of 3 smokers having only mild impact.Conclusions: The mean value of ECOC 3.25±2.51 ppm was more than that obtained in other studies in non-pregnant women. Mild, moderate and severe impact from maternal CO exposure were established with the moderate and severe impact more prominent at maternal ages of 25-39 years, at higher BMI and at lower parity

The environmental impacts of palm oil in context

Delivering the Sustainable Development Goals (SDGs) requires balancing demands on land between agriculture (SDG 2) and biodiversity (SDG 15). The production of vegetable oils, and in particular palm oil, illustrates these competing demands and trade-offs. Palm oil accounts for 40% of the current global annual demand for vegetable oil as food, animal feed, and fuel (210 million tons (Mt)), but planted oil palm covers less than 5-5.5% of total global oil crop area (ca. 425 Mha), due to oil palm’s relatively high yields5. Recent oil palm expansion in forested regions of Borneo, Sumatra, and the Malay Peninsula, where >90% of global palm oil is produced, has led to substantial concern around oil palm’s role in deforestation. Oil palm expansion’s direct contribution to regional tropical deforestation varies widely, ranging from 3% in West Africa to 47% in Malaysia. Oil palm is also implicated in peatland draining and burning in Southeast Asia. Documented negative environmental impacts from such expansion include biodiversity declines, greenhouse gas emissions, and air pollution. However, oil palm generally produces more oil per area than other oil crops, is often economically viable in sites unsuitable for most other crops, and generates considerable wealth for at least some actors. Global demand for vegetable oils is projected to increase by 46% by 20509. Meeting this demand through additional expansion of oil palm versus other vegetable oil crops will lead to substantial differential effects on biodiversity, food security, climate change, land degradation, and livelihoods. Our review highlights that, although substantial gaps remain in our understanding of the relationship between the environmental, socio-cultural and economic impacts of oil palm, and the scope, stringency and effectiveness of initiatives to address these, there has been little research into the impacts and trade-offs of other vegetable oil crops. 65 Greater research attention needs to be given to investigating the impacts of palm oil production 66 compared to alternatives for the trade-offs to be assessed at a global scale

Obstructed Labour, Barriers and Bridges in the Niger Delta Region of Nigeria

An eleven-year retrospective analysis of all cases of obstructed labour at the University of Port Harcourt Teaching Hospital was carried out between 1989 and 1999. During this period, a total of 19,246 deliveries were conducted while 684 cases of obstructed labour were recorded, giving an incidence of 3.5%. Unbooked patients constituted 69.2% of cases and 62% of the patients were primigravida. Cephalo pelvic disproportion was the commonest cause of obstructed labour [45%]. Of this number 7.7% had Caesarean section previously. The main mode of relieving the obstruction was Caesarean delivery [81%], laparotomy for ruptured uterus was performed in 13% of patients and destructive operation was done in about 6% of cases. The commonest complication found in this study was sepsis affecting about 91% of cases. The maternal mortality ration was 81.8 per 1000 while perinatal mortality was 250 per 1000. NQJHM Vol. 14 (1) 2004: pp. 21-2

Human bite and human immune deficiency virus (HIV) transmission

Background: The concentration of human immune deficiency virus (HIV) in the saliva of a carrier is low. As a result, human bite is not considered the traditional route of HIV infection transmission. Aim: To report a case of HIV sero-positivity following a human bite. Setting: University of Port Harcourt Teaching Hospital, Port Harcourt. Case report: A 30-year-old HIV sero-negative woman who became sero-positive following a bite by a known HIV infected commercial sex worker is presented. Both were engaged in a physical fight over a disagreement. Conclusion: This case highlights the possibility of HIV infection through human bite. Keywords: Human bite, Saliva, Transmission, Human immune deficiency virus Port Harcourt Medical Journal Vol. 2 (1) 2007: pp. 88-8

Pathology of vaginal cancers in Port Harcourt, Nigeria. A 14-year study of 15 cases.

Background: Primary malignancies of the vagina are rare as most are metastatic lesions. This study documents a 14-year experience in a tertiary institution in South Southern, Nigeria. Design and Setting: A retrospective study of clinical presentations including anatomic sites and histopathologic diagnosis of cancers of the vagina in the University of Port Harcourt Teaching Hospital (UPTH). Methodology: The tissues received for histologic diagnosis were fixed in 10% formal saline, processed and embedded in paraffin wax. Microtome sections of the tissue (3 5 microns) were taken and mounted on glass slides and stained with hematoxylin and eosin (H & E) stains. Cases in which both the slide and blocks could not be traced were excluded from the study. Results: A total of 2389 malignancies were diagnosed during the period under review of which 344 were gynaecological. Fifteen cases of vaginal cancers satisfied the criteria for the study, constituting 0.63% and 4.36% of the total and gynaecological malignancies respectively. Five cases (33.33%) occurred in children below the age of 20 years, while 10 cases (66.67%) were in adults. The peak incidence was in the group 0 9 and 60-69 years. Irregular vaginal bleeding was the commonest clinical presentation and the upper posterior vaginal wall was the commonest anatomic site. The most frequent histological type was the non-keratinizing squamous cell carcinoma while FIGO stage 111 (46.67%) cancer was the commonest stage at presentation. Conclusion: Vaginal cancers are rare in this environment but they contribute to high morbidity and mortality among women of all ages as the disease is diagnosed at an advanced stage. Keywords: Vaginal cancers; Southern Nigeria; squamous cell carcinoma; vaginal bleeding.Nigerian Journal of Clinical Practice Vol. 10 (4) 2007 pp. 330-33