Secondary Infertility in Port Harcourt: Pattern and Socio-Dermographic Relationship

Author(s):  
Emmanuel Okwudil Oranu ◽  
Gregory Ifechukwude Oyiana

Background: Secondary Infertility is viewed as a social stigma, especially in Nigeria, due to the high premium placed on procreation. Observation suggests that this condition is on the increase in our environment. Hence, the need to determine the pattern and the relationship between the socio-demographic factors with infective causes of this condition; which will subsequently allow the tailoring of the individual investigation and subsequent treatment. Objective: To determine the prevalence and pattern as well as the relationship between the socio-demographic factors with infective causes of secondary infertility among women who attended the gynaecological clinic of the University of Port Harcourt Teaching Hospital (UPTH) between January 2012 and December 2016 Methods: This is a retrospective descriptive study design, based on findings from the folders, admission and outpatient registers, of infertile couples presenting at the gynaecology clinic of the University of Port Harcourt Teaching Hospital, over a five-year period (January 2012 – December 2016). Data were collected from all documented and laboratory findings. The data extracted from the case records were the socio-demographic characteristics of the patient, the duration of infertility as well as the causes. They were analyzed using SPSS version 20. Results: The mean age of women was 33.14±4.93 years. The prevalence of secondary infertility was 12% of all outpatient gynaecological consultation. The mean duration of secondary infertility was 3 years. The infective causes of secondary infertility [recurrent pelvic inflammatory disease(PID), sexually transmitted infections(STI), post abortal sepsis, puerperal sepsis, HIV/AIDS, mumps orchitis were commoner among the 31-40 years’ category, (45.8%), the infective causes were also commoner among women with primary level of education, (62.5%, p-value=0.001) as well as women who were self-employed (49%, p-value=0.041). Recurrent pelvic inflammatory disease was identified in majority of cases (37.1%). Abnormal semen analysis, hyper-prolactinaemia and uterine fibroid, also contributed significantly to infertility; 18.5%, 19.7% and 24.3% respectively. Conclusion:  Infective causes are at the root cause of secondary infertility; the more educated the couple, the higher their socioeconomic status, the lesser the impact of infection on secondary infertility.

Author(s):  
Barinaaziga S. Mbeera ◽  
Susanna O. Akwuebu ◽  
A. C. U. Ezimah ◽  
Nancy C. Ibeh ◽  
Evelyn M. Eze

Aim: The aim of this study was to assess some haemostatic parameters in sickle cell anaemia subjects in Rivers and Bayelsa States. Study Design: This study is a cross-sectional observational study. Place and Duration of Study: This study was carried out at the University of Port Harcourt Teaching Hospital, Rivers State, and the Federal Medical Centre, Yenagoa, Bayelsa State, between the months of February and August, 2020.  Methodology: A total of four hundred and fifty (450) subjects with age range of 1-50 years were randomly selected. There were about 200 registered patients (adults and children alike) at the sickle cell clinics of the University of Port Harcourt Teaching Hospital, and the Federal Medical Centre, Yenagoa, with an average of 4 new patients per month. The sample size was obtained using a prevalence of sickle cell anaemia of 2% and the sample size was calculated using Cochran sample size formula. Five milliliters (5ml) of venous blood sample was withdrawn from the peripheral vein in the upper limb of subjects using a standard venipuncture technique. The sample was rocked gently to mix and kept at room temperature and the haemostatic parameters (vWF, FVIII, D-dimer, L-arginine, fibrinogen, ADAMTS13) were assayed quantitatively with Bioassay Technozym kit using Microplate Reader (Labtech microplate auto ELISA plate reader, an IS0 13485:2003 CE and WHO compliance Co., Ltd. Shanghai International Holding Corp. GmbH; Europe) calibrated to a wavelength of 450 nm with strict adherence to the manufacturer's instructions, while PT and APTT were analysed with Fortress reagent and Uniscope SM801A Laboratory using water bath.Data management and statistical analyses were conducted using Statistical Analyses System SAS 9.4 (SAS Institute, Cary, North Carolina, USA) and p values less than .05were considered statistically significant. Results: The results showed the mean comparison of haemostatic parameters in sickle cell anaemia and control subjects. The comparison of haemostatic parameters showed significant(p<.05) increasesand decreases inVaso-Occlusive Crisis (VOC) and steady state respectively compared with the control group. There was statistically significantreduction in the mean comparison of L-Arginine (p<.01) in VOC) condition than steady state in relation to the control group in our study population, while D-Dimer, ADAMTS13 were also significantly reduced statistically (p<.01) in VOC condition than steady state compared with the control group. However, the mean FVIII inhibitor, Fibrinogen, PT (INR) and APTT were significantly higher (p<.01) in VOC than steady state when compared to controls with normal haemoglobin (HbAA).Correlations of haemostaticparameters by sickle cell anaemia subjects’ condition showed more significant positive correlations in VOC than steady state. Conclusion: This study showed a heightened hypercoagulability in Sickle Cell Snaemia(SCA)subjects, and further pave way for better understanding particularly the diagnostic variables underlying SCA, specific to each subject condition (steady state and VOC). Subjects with SCA, particularly during VOC, undergo significant haemostatic alterations that increase their risk of developing coagulation activation-related complications. Thus, though selected markers of coagulation were significantly different between the subject conditions, they were often significantly higher in the SCA.


Author(s):  
B. A. Alex-Hart ◽  
D. LongJohn

Background: Tetanus still causes significant morbidity and mortality amongst children in Nigeria despite decades of immunisation with tetanus vaccine. Objectives: To determine the prevalence, case fatality rate and predictors of fatality amongst school age children treated for tetanus at the University of Port Harcourt Teaching Hospital. Materials and Methods:  This was a retrospective study of all children aged 4 to 17 years treated for tetanus at the University of Port Harcourt Teaching Hospital between January 1, 2009 and December 31, 2019. Data was obtained from the case notes and ward registers. Socio-demographic characteristics, presenting complaints, incubation period, onset interval, number of Diphtheria, Pertussis and Tetanus (DPT) vaccine received at infancy, treatment outcome, duration and cost of hospital stay were obtained, entered into a spread sheet and analysed with SPSS version 20. Results are presented in tables and percentages. The level of significance was set at P value <0.05. Results:  During the period under review, there were 53 children aged 4 to 17 years treated for tetanus, accounting for 0.3% of the total admission. The mean age was 10.79±3.35 years. There were 33 (62.26%) males and 20 (37.74%) females. Majority 26 (49.06%) of the children were of low socioeconomic class. The commonest 28(52.8%) route of infection was broomstick injury. Majority 32(60.3%) of the children were not immunised in infancy. The mean incubation period was 7.34±4.21 days and the mean onset interval was 8.87±10.44 hours. The two most common symptoms were generalized spasms 49 (21.03%) and trismus 47 (20.17%). Short incubation period (≤4 days) and short onset interval (≤4 hours) were significantly associated with higher death rates (p=0.0002; p=0.012).  Patients with short incubation period of ≤4 days and short onset interval of≤ 4 hours are more likely to die (p=0.0002; p=0.012). Conclusion: There was a high tetanus case fatality rate amongst school age children at University of Port Harcourt. Short incubation period and onset interval were associated with higher mortality. Booster doses of TT containing vaccines should be administered to primary and secondary school children in Port Harcourt to curb the menace.


Author(s):  
N. I. Paul ◽  
B. A. Alex- Hart ◽  
R. O. Ugwu

Background: Tuberculosis (TB) is a leading cause of death in young children and the risk of progression from infection to disease is higher in the very young especially among those with Human Immunodeficiency Virus (HIV) infection. This study therefore aimed to examine the method of TB diagnosis and how common HIV infection is among children 0-5 years with tuberculosis at the University of Port Harcourt Teaching Hospital (UPTH). Methods: Information of children aged 0-5 years from 1st January, 2011 to 31st December 2014 were retrieved from the TB register of the Directly Observed Treatment Short course (DOTS) clinic of UPTH. This included the age, sex, HIV status, Sputum AFB status, method of diagnosis of tuberculosis and the treatment outcome of the patients. Ethical approval for the study was obtained from the Research and Ethics committee of the University of Teaching Hospital. Results: Three hundred and thirty five children were treated for TB and 179 (53.43%) of them were aged 0-5 years. There were 93 (51.96%) males and 86 (48.04%) females, with male: female ratio of 1.08:1.  Their mean age was 1.96 ±1.45. The sputum or gastric lavage of 21 (11.73%) were positive for acid fast bacilli (AFB). The common method of TB diagnosis was clinical/ radiological method and this constituted 158 (88.27%) of the patients with TB. Ninety (50.28%) children with TB were less than one year of age and there was no statistical significant relationship between age and method of TB diagnosis (x2 = 2.78, p = 0.249). More males 93 (51.96%) than females 86 (48.04%) had TB but more females 13 (61.90%) than males 8 (38.10%) were AFB positive, however, these were not statistically significant. (x 2  = 1.26 p-value = 0.262). Seventy two (40.22%) of the children with TB were HIV positive. One hundred and thirty five (75.42%) of the children recovered following treatment while 44 (24.58%) were referred to Dots centres closest to the patients. No child died. Conclusion: The prevalence of TB among under-fives especially among infants is high. Clinical and radiological methods were the common methods of TB diagnosis. HIV prevalence among children with TB was lower than expected by the authors, however, the treatment outcome was good. Re-training of clinicians to improve their expertise on clinical diagnosis of TB and a more in depth search of TB in the community among children 0-5 years who are HIV sero-negative with persistent cough is advocated.


2021 ◽  
Vol 6 (3) ◽  
pp. 097-106
Author(s):  
Nweke Praise-Craig Ogochukwuka ◽  
Adjene Josiah Obaghwarhievwo ◽  
Odigie Mike Osagie

Visual impairment, also known as loss of vision is the decreased ability of a subject to see to a degree. It is a global concern that is likely to escalate with prolonged life expectancies with increasing attention in the realm of eye care. In this study, the prevalence of visual impairment among patients attending the University of Port Harcourt Teaching Hospital, Rivers state, Nigeria was investigated. The study accessed a total of 7, 345 case notes of ethically sourced, visually impaired subjects who visited the hospital within five years (2015 - 2019) in the target study area. For each year accessed, records were grouped according to participants’ age and gender, then matched with the type and causes of visual impairment in the study area. At the end of data collection, Results were passed through the graph pad prism (version 8.1), and subjected to statistical measure of central tendencies to obtain the average records and prevalence levels for collected variables, while setting confidence interval at a 95%. Differences in means across groups were also confirmed with the One-way analysis of variance (ANOVA), while setting a p value less than 0.05 as statistically significant. Following analysis, study found a statistically significant increase (p < 0.05) in cases of visual impairment for 2019 as compared other year records, even though there was an inconsistent attenuation for the various years compared, with moderate vision having an apparently higher record than other visual impairments. Severe cases came second with 2018 having the highest cases than others but, with moderate impediments. Also, a significant increase (p < 0.05) was seen in refractive error as compared to other causes of visual impediments. We recommend similar but more molecular approach to visual impairments within study area, and more.


2013 ◽  
Vol 5 ◽  
pp. OED.S12672
Author(s):  
Kagmeni Giles ◽  
Moukouri Ernest ◽  
Domngang Christelle ◽  
Nguefack-Tsague Georges ◽  
Cheuteu Raoul ◽  
...  

We assessed the outcomes of the use of anterior chamber foldable lens for unilateral aphakia correction at the University Teaching Hospital of Yaounde. In this retrospective, non-comparative, consecutive case series study, we reviewed the records of patients who underwent an operation for aphakia correction by the means of injection of an angular supported foldable lens between January 2009 and December 2011 in the University Teaching Hospital Yaounde. Student's paired t-test was carried out to compare preoperative and postoperative visual acuity (VA) and intraocular pressure (TOP). P-values less than 0.05 were considered statistically significant. Twenty-one patients were included in the study; twelve were male (57.1%) and nine were female (42.9%). The mean age was 55.38 ± 17.67 years (range 9–75 years). The mean follow-up duration was 5.95 ± 3.14 months (range 2–12 months). The mean logMAR visual acuity was 1.26 ± 0.46 pre-operatively and 0.78 ± 0.57 post-operatively ( P = 0.003). The change in intraocular pressure was not statistically significant. Complications included intraocular hypertension (over 21 mmHg) in 3 patients (14.3%) and macular edema, pupillar ovalization, and retinal detachment in one patient each. The results indicate that injection of an angular support foldable lens in the anterior chamber is a useful technique for the correction of aphakia in eyes without capsular support. More extended follow-up, however, and a larger series of patients are needed to ascertain the effectiveness and safety of this procedure.


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