Statistical Comparison of Clinical and Histologic Diagnoses of Breast Tumours in Public and Private Hospitals

Background: Breast cancer is the leading cause of cancer deaths in Nigerian women. Most cases present in late or advanced stages with consequent poor prognosis. There are also instances of false clinical diagnoses with resultant patient adversity. Population screening based on genetics is largely unavailable to the citizens. Therefore, early diagnosis is the immediate choice available to the health system.Methods: Retrospective data were collected including all open-breast-biopsies submitted to three histopathology laboratories. The clinical and histologic diagnoses for each sample were compared. Statistical estimate of the accuracy of clinical diagnoses of breast cancer by clinicians was calculated using histologic diagnoses as the reference standard, and by calculating the sensitivity, specificity, false rates and odds ratio. Diagnostic accuracies of clinicians working in public and private hospitals were also compared in terms of these rates.Results: Our result showed that the diagnostic accuracy of the doctors working in public hospitals is more sensitive than that of those working in private hospitals. The overall false positive rate in both hospital groups combined is found to be high. This is probably due to unavailability of modern radiodiagnostic facilities that may otherwise enhance clinical assessment and diagnoses. The doctors in the public hospital group are generally more efficient in breast cancer diagnoses than those working in private hospitals.Conclusion: The authors believe that better funding of the audited hospitals, regular training of the medical personnel and provision of modern radiodiagnostic facilities may probably enhance clinical accuracy of breast cancer diagnoses in these hospitals

Impact of parity and gestational age of mothers with hypertension on birth weight, red blood cells and mode of delivery of their babies

Background: Maternal factors are determinants of birth outcome which includes birth weight, haematological indices and mode of delivery of their babies. Objectives: To determine the impact of parity and gestational age of hypertensive mothers on some neonatal variables. Methods: A hospital based cross-sectional study of measurement of neonatal variables (birth weight, red blood cells and mode of delivery) among hypertensive mothers and their controls was conducted over a period of six months. Data were analyzed using the Statistical Package for Social Sciences program (SPSS), version 20. Results: There were statistically significant differences in means between the neonates of the hypertensive group and non-hypertensive group for maternal age (t =1.61, p = 0.002), baby weight (t =2.87, p < 0.001), haemoglobin (Hb) (t =4.65, p = 0.010) and packed cell volume (PCV) (t =4.75, p = 0.009), but none for gravidity (t =1.95, p = 0.927) For all subjects, there was poor correlation between gestational age and variables; birth weight , haemoglobin (Hb), packed cell volume (PCV), nucleated red blood cell (nRBC) and parity. Likewise, parity poorly correlated with variables; age, birth weight, Hb, PCV, and nRBC. There was a statistically significant association between mode of delivery and hypertension (\u3c72 =53.082, p <0.001) but none with having a family history of hypertension (\u3c72 =1.13, p = 0.287). Conclusion: Parity and gestational age of mothers with hypertension have no impact on birth weight and red cells when compared with their non-hypertensive counterparts. However, mothers of babies delivered by elective and emergency caesarean section were about 2-3 times more likely to be hypertensive than those that delivered through spontaneous vertex delivery

Preventive Measures of Vaso‑Occlusive Crisis Among Sickle Cell Disease Patients in South‑Eastern Nigeria: How Much Do Our Patients Know?

Background: Vaso‑occlusive crisis (VOC) is a feature of sickle cell disease (SCD), an inherited medical condition which is more common in Sub‑Saharan Africa especially Nigeria and is saddled with multi-systemic complications. Knowledge and practice of preventive measures of VOC by patients may reduce the risk of morbidity and mortality. Aim: The purpose of this manuscript is to determine the knowledge, attitude, and practice of the various preventive measures of VOC by patients and their relationship with their frequency of painful crisis. Materials and Methods: A cross-sectional descriptive survey was used. This study was conducted between August, 2018, and February, 2019. Participants were selected consecutively as they came for clinic consultations. Demographic characteristics and the knowledge, attitude, and practice of various preventive measures of VOC were obtained using a structured interviewer‑administered questionnaire. The analysis was performed using Statistical Package for the Social Sciences software version 23.0. Descriptive and inferential statistics were used with P < 0.05 which was considered statistically significant. Ethical clearance and informed consent were obtained before the commencement of the study. Results: A total of 154 SCD patients participated in the study and were made up of 73 (47.4%) males and 81 (52.6%) females, with a male‑to‑female ratio of 1: 1.1. Majority of the respondents (76.6%) had good knowledge of preventive measures toward VOC in SCD. This study also found that 59 (38.3%) participants had good practice of preventive measures toward VOC while 95 (61.7%) had fair practice. Majority (68% [40/59]) of those who had good practice of preventive measures were less likely to have more than three crises in a year compared to those who do not practice good preventive measures, though not statistically significant (OR = 2.489, P = 0558) (confidence interval = 0.480 – 0.637). Conclusion: Majority of the patients have good knowledge and practice of preventive measures of VOC and this appears to have reduced the frequency of their crisis in a year. Health education for sickle cell patients is an important tool that may reduce morbidity and mortality by reducing the frequency of crisis

Perception of people living with human immunodeficiency virus/acquired immunodeficiency syndrome toward human immunodeficiency virus infection: A single‑centre experience

Background: The prevention and control of human immunodeficiency virus (HIV) infection depend on the prevention of new infections as well as treating currently infected individuals. Adequate knowledge of HIV infection among person living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA) may be an important tool in reducing spread of the virus. Objective: The objective of the study was to evaluate knowledge and attitude of PLWHA on HIV infection. Methodology: This was a cross‑sectional study conducted at the Chukwuemeka Odumegwu Ojukwu Teaching Hospital. Knowledge of infection, spread, control, and effect was sought from HIV‑positive respondents using a structured questionnaire. Information about their attitude and beliefs was also obtained. Collected data were analyzed using the Statistical Package for Social Sciences for Windows, Version 21.0. Results: A total of 70 HIV‑positive patients, including 23 (32.9%) males and 47 (67.1%) females with a mean age of 37.7 years were participated. The overall knowledge on HIV transmission, clinical effects, complications, and controls was good in 15.7%, average in 72.9%, and poor in 11.4%. Knowledge of means of transmission was appropriate in majority of them. Majority of 66 (94.3%) patients showed a positive attitude to life. Conclusion: Most of the HIV‑positive patients had average knowledge on HIV, and majority had a positive attitude to life

Correlates of neutrophil/lymphocyte, platelet/lymphocyte, and platelet/neutrophil ratios of neonates of women with hypertensive disease of pregnancy with neonatal birth outcomes

Background: Studies have indicated neutrophil/lymphocyte ratio (NLR), Platelet/Lymphocyte ratio (PLR), and platelet/neutrophils ratio (PNR) to be inflammatory markers. The correlation of these values in infants of hypertensive mothers has not been investigated. Aim: To investigate the relationship between NLR, PLR, and PNR of neonates of women with hypertensive disease of pregnancy and neonatal APGAR scores and birth weight. Methodology: Cord blood samples of 200 neonates collected and the blood counts and ratios obtained. Results: NLR in the babies of the hypertensive mothers was 0.865 and 1.42 in the control group (p = 0.0001). PLR was 34.7 in the neonates of the hypertensive mothers and 62.4 in the control group (p = 0.0001). PNR did not differ significantly between the two groups,p = 0.418. Degree of hypertension had a direct relationship with NLR; SBP had a p value of 0.001 while the DBP had p = 0.002. The PLR had an inverse relationship with the degree of hypertension; SBP p value of 0.0001, while DBP was p = 0.0001. No significant association was observed between the ratios and neonatal birth weight (p ≥ 0.05); however, PNR and PLR were found to be significantly associated with the 1st (p = 0.045 and 0.030) and 5th (0.049 and 0.037) minute APGAR scores in the newborns. Conclusion: PLR and NLR in neonates of hypertensive mothers are found to be markedly lower than those of controls, the degree of which is affected by the severity of hypertension. Also, lower PLR is associated with lower APGAR scores. Therefore, severity of high blood pressure and lower PLR may be determinants of poor birth outcome