Incidence, pattern and outcome of cardiovascular admissions at the Abia state university teaching hospital, Aba: a five year review.

The aim of this study was to determine the burden of cardiovascular disease (CVD) in Aba -a cosmopolitan town undergoing increased urbanization in the last decade. The study involved 756 case notes of patients with records of CVD between January 2008 and December 2012. Information extracted from each case note included age, sex, type of CVD, length of hospitalization and treatment outcome. The data obtained were analyzed using the Statistical Package for Social Sciences (SPSS). The student t-test was used and p<0.05 was considered as statistically significant. The mean age of the patients was 54 ±6.5 years with a slight male preponderance. The highest incidence of CVD was seen between the age ranges of 50 -59 years (25.80%). Majority (61-6%) of the patients were admitted on account of hypertension. Diseases associated with heart failure include hypertension (19.40%), cardiomyopathy (9.20%), anaemia (5.60%), rheumatic heart disease (2.70%) and valvular disease (1.5%). Mean duration in hospital was 10±6 days with 201 (26.60%) deaths. Majority of the dead patients (51.74%) were those with cerebrovascular accident resulting from hypertension. Most of the deaths occurred within 8 days of hospital stay. Thus CVDs constitutes a significant health burden in our community requiring urgent attention.Key words: Cardiovascular diseases, admissions, outcome, Aba

Incidence, pattern and outcome of renal admissions at the Abia state university teaching hospital, aba: a five year review

The aim of this study was to determine the burden of renal diseases in Aba -a cosmopolitan town in Nigeria undergoing increased urbanization in the last decade. The study involved 359 patient case notes with records of renal diseases between January 2009 and December 2013. Information extracted included age, sex, type of renal disease, length of hospitalization and treatment outcome. Data obtained were analyzed using the statistical package for social sciences (SPSS). The student t-test was used and p < 0.05 was considered statistical significant. The mean age was 53±5.5 years, while the highest incidence was recorded among those aged between 50 - 59 years (23.67%). Majority (56.82%) of the patients were admitted on account of chronic kidney disease with 45.58% of these associated with renal failure. Other associated diseases included nephritic syndrome (11.45), pyelonephritis (7.79%) glomerulonephritis (5.57%), urinary infection (3.06%) and renal stone (1.11%). Mean duration of hospital stay was 12 ± 5 days with 110 (30.64%) deaths. Majority of the dead patients (27.54%) were those with renal failure resulting from CKD. Most of the deaths occurred within 6 days of hospital stay. Thus renal diseases constitute a significant health burden in our community requiring urgent attention.Key words: Renal diseases, admissions, results, Ab

Medical Mortality in the Accident and Emergency Unit of the University Of Port Harcourt Teaching Hospital

Background: The quality of care in the emergency room is an indirect indicator of the standard of healthcare delivery in a given health institution. Mortality in the emergency room may result from various factors including incompetence of the attending junior physicians, delays in presentation and inadequate facilities. The aim of the study is to highlight the causes of mortality, age and sex distribution of the deaths and the duration of admission before death among medical cases in the accident and emergency unit of the University of Port Harcourt Teaching Hospital. Methods: A one year (January to December, 2005) clinical audit of all adult medical admissions in the accident and emergency department of the University of Port Harcourt Teaching Hospital (UPTH). Results: Of the 5304 admitted over the study period, 349 (6.8%) patients died. Two hundred and thirty three (66.8%) of these deaths were due to medical cases only. These medical deaths were made up of 126 males and 107 females giving a male to female ratio of 1.2:1. The presumed causes of deaths were stroke in 56(24.5%), HIV/AIDS in 53 (22.7%), sepsis in 20 (8.6%), while 14 (6.0%) died from meningitis. Ten patients (4.3%) died from diabetic ketoacidosis, and hepatic encephalopathy and tetanus were responsible for 10(4.3%) and 7 (3.0%) deaths respectively. Conclusion: In the period studied, medical mortality was high in the accident and emergency room of UPTH. The major causes of deaths were cerebrovascular accidents and HIV/AIDS. Keywords: accident and emergency, autopsy, death certification, medical mortalityNigerian Journal of Medicine Vol. 17 (2) 2008: pp. 184-18

Case Report - Analgesic nephropathy as a cause of end‑stage renal disease in a 55 year‑old Nigerian

Analgesic nephropathy is a subtle but significant cause of chronic renal failure. There is paucity of data on analgesic nephropathy in Nigeria. This case presentation is to highlight the need to have high index of suspicion in patients at risk of developing analgesic nephropathy. In March 2009 a 55‑year‑old businessman was referred to the renal unit on account of azotemia by the hematologist who had hitherto managed the patient as a case of refractory anemia. The patient had osteoarthritis for over 10 years and was managed with several analgesic drugs over the same period. He was found to have features suggestive of analgesic nephropathy and had end‑stage renal disease. He was commenced on appropriate therapy, and he had a live related kidney transplant six months later. Analgesic nephropathy is preventable and morbidity/mortality can be remarkably reduced with appropriate and prompt intervention

Ultrasonic measurement of the liver size in normal adult Nigerians at the University of Port Harcourt Teaching Hospital

Background: Clinically, liver size is estimated by palpation and percussion. However this method is not without limitation, which is overcome by use of ultrasound scan. The purpose of this study is to establish a normal range of liver size for adults in Nigeria through ultrasound imaging to assist in clinical evaluation of the liver and also to highlight factors influencing liver size in the adults. Methods: Measurement of the liver size of 255 adults were done using ultrasound scan. The largest craniocaudal and anterioposterior dimensions were taken at the midclavicular line. Height and weight of the patients were also recorded. Data was analysed using SPSS 14.0 for windows evaluation version. Results: Two hundred and fifty-five normal subjects who met the laid down criteria for normal liver were studied. The age range was 16 - 65 years with mean age of 34.68 ± 11.84 years. The mean craniocaudal dimension decreases as the age range increases while the mean anterioposterior dimension increases with age range. Weight was found to have better correlation for both craniocaudal and anterioposterior dimensions followed by height. Conclusion: Ultrasound measurement of liver size is non-invasive and enables direct visualization of the liver. The present study suggests that both the craniocaudal and anterioposterior dimensions should be measured when evaluating liver size with ultrasound scan. Gender and weight of patient should be taken into consideration when assessing the size of the liver using ultrasound scan as these factors affects the size of the liver. Keywords: Ultrasound, Liver size, Height, Weight, Ag

Causes of mortality among the elderly in a Nigerian hospital population

Background: In developing countries, increased life expectancy has led to a higher burden of cardiovascular diseases among the elderly.Aim: To determine the causes of mortality in patients aged >60 years, admitted in the medical wards of the University of Port Harcourt TeachingHospital (UPTH).Methods: The medical records of all patients aged 60 years and above admitted in the medical wards of UPTH from June 2002 to May 2006were reviewed.Results: A total of 300 deaths occurred in the elderly during the period. Diseases of the cardiovascular system were responsible for 149 (49.6%)deaths, with stroke alone accounting for 112(75.2%) of cardiovascular deaths. Infections were responsible for 48 (16%) deaths. Type 2 diabetesmellitus was responsible for 34 (11.3%) deaths while malignancies were responsible for 19 (6.3%) deaths. The interval between admission anddeath range between 1 to 55 days.Conclusion: Cardiovascular diseases are emerging as the leading cause of death in the elderly in developing countries improvement in healtheducation, early diagnosis, improved medical facilities for intervention and good dietary habits are suggested ways of reducing the death burde

Adult tetanus at the University of Port Harcourt Teaching Hospital: An analysis of 42 cases

Background: Adult tetanus is still common in Nigeria as in other developing countries where immunization programmes are poor. Recently, fee for service was introduced in tertiary medical institutions. Type of Study: Retrospective. Aim: To define the characteristics of cases of tetanus in adults admitted to the University of Port Harcourt Teaching Hospital (UPTH) from 1991 to 1995. Methods: Patients with features of tetanus were identified from ward records and the Medical Records Department. The case note were examined and analysed. The management was carried out in the general medical wards and consisted of anti-tetanus serum (ATS), crystalline penicillin, dextrose infusion, diazepam and metho carbarmol provided for by patients. Results: There were 42 patients: 26 males and 16 females. The ages ranged from 15 to 60 years (mean 29 years). The immunization history was poor. The commonest portal of entry was the lower limb (47.6%). The predominant social groups were students and fishermen. There was delay in the treatment of some of the patients as a result of which 25 cases had complications such as tachycardia, pneumonia and hypertension. Nine patients had multiple complications. Twenty-one patients died on admission. Eighteen deaths occurred within the first week of admission. Conclusion: The high mortality may reflect treatment delays and lack of intensive care unit facilities. Adequate campaign for anti-tetanus immunization should be embarked upon especially for the high risk students and fishermen. Port Harcourt Medical Journal Vol. 1(1) September 2006: 44-4

Clinical pattern of stroke in the University of Port Harcourt Teaching Hospital - a prospective study

Background: Stroke has been identified as a major cause of morbidity and mortality in the African. Aim: To determine the hospital frequency of stroke, identify associated risk factors, find out the  diurnal variation (if any), and access the morbidity and mortality pattern of stroke at the University of Port Harcourt Teaching Hospital (UPTH). Methods: A prospective study of patients admitted with stroke in the medical wards of the University of Port Harcourt Teaching Hospital (UPTH) from 1st  January 1996 to 30th  June 1997 within 14 days of onset was done. Data extracted via an interviewer structured questionnaire included age, sex, occupation, time and day of presentation, risk factors, stroke subtypes and outcome. Results: There were 100 cases of stroke admitted over the period. This gave a stroke frequency of 0.95% of hospital admissions, 8.40% of medical admissions and 41.00% of neurological   admissions.   The   mean   age  of patients was 58.0 ± 14.6 years. There were 46(46.0%) males and 54(54.0%) females. Stroke was found to have morning peaks and tended to occur more during the midweek and weekends. Clinically, cerebral infarction accounted for 52.0% of cases, followed by intracerebral haemorrhage 27.0%, and subarachnoid haemorrhage 8.0%. Unclassified subtype was 13.0%. Hypertension remained a predominant risk factor affecting 73.0% of all cases.  Of the total number of patients with stroke, 34 (34.0%) recovered with minimal disability, 27 (27.0%) recovered with moderate disability while 15(15.0%) were severely disabled. Twenty four (24.0%) of the stroke patients died. Conclusion: Stroke is a major cause of morbidity and mortality at UPTH. Detection of risk factors through health education and population screening should be encouraged.   Key words: Stroke, Adults, Clinical pattern, Prospective study, Port Harcour