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University of Port Harcourt Teaching Hospital

Articles by University of Port Harcourt Teaching Hospital

Pathological left ventricular hypertrophy and outflow tract obstruction in an infant of a diabetic mother: A case report

Published on: 3rd March, 2020

OCLC Number/Unique Identifier: 8560717043

Background: Infants of diabetic mothers (IDMs) are at increased risk of developing congenital anomalies including cardiac defects. Pathological left ventricular hypertrophy, asymmetrical septal hypertrophy and outflow tract obstruction is a rare but known cardiac comorbidity in infants of diabetic mothers. The severity of this condition in IDMs can vary from an incidental finding on echocardiography to an infant with severe symptoms of congestive heart failure and specific management of the condition varies. Aim: The aim of this article is to report this clinical entity in a Nigerian infant born to a mother with poor glycaemic control in pregnancy and highlight management. Case report: We report a term neonate who was diagnosed as a case of pathological left ventricular hypertrophy, asymmetrical septal hypertrophy and outflow tract obstruction delivered to a mother with gestational diabetics with poor glycaemic control in pregnancy. Child was treated successfully with β-adrenergic blocker and showed resolution of hypertrophy in follow-up echocardiography. Conclusion: Infants of diabetic mothers are very high risk infants. Pathological left ventricular hypertrophy in IDM have good prognosis. Early recognition and prompt intervention is advocated.
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Oral Clindamycin and Metronidazole in the treatment of bacterial vaginosis in pregnant black women: Comparison of efficacy and pregnancy outcome

Published on: 10th January, 2020

OCLC Number/Unique Identifier: 9272372469

Bacterial vaginosis (BV) is associated with adverse pregnancy outcomes with various treatment options. Objective: To compare the efficacy and effect on pregnancy outcome of Metronidazole and Clindamycin in women with bacterial vaginosis in Port Harcourt, Nigeria. Methodology: Randomized controlled study of 136 pregnant women diagnosed with BV at the University of Port Harcourt Teaching Hospital. A structured proforma was used to obtain socio-demographic characteristics and other relevant data. Treatment was with either oral Metronidazole or oral Clindamycin for seven days. A secondary test and evaluation of the effect on adverse pregnancy outcomes were determined. Data analysis was done using the SPSS statistical package version 22.0 Results: BV prevalence was 23%, with similar cure rates with both medications. The failure rates of clindamycin and metronidazole were 10.4% and 13% respectively (p = 0.639). The mean gestational age at delivery in the metronidazole treated group was 38.67 weeks ± 1.69 compared to 38.68 weeks ± 1.64 in the oral clindamycin group (p = 0.96). Pre-labour rupture of membranes and preterm delivery rates with both medications were similar (p = 0.73; OR 1.3; 95% CI 0.3-4.9) and (p = 0.73; OR 1.3; 95% CI 0.3-4.9) respectively. Conclusion: Both medications have comparable efficacy and similar pregnancy outcomes in the treatment of bacterial vaginosis in low-risk asymptomatic pregnant Nigerian women and thus can be used interchangeably.
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Is community based case detection of glaucoma relevant? Intraocular Pressure level and vertical Cup Disc ratio of participants at a screening programme in a rural setting in Nigeria

Published on: 12th November, 2018

OCLC Number/Unique Identifier: 7929242578

To determine the proportion of participants with elevated intraocular pressure and abnormal vertical cup disc ratio in a glaucoma screening event in a rural community in Nigeria. Methods: 242 eyes of 121 participants at a one-day screening programme were examined. Visual acuity was accessed using Snellen literate and illiterate charts, followed by a pen torch examination of the anterior segment. The posterior segment was accessed using a direct ophthalmoscope (Welch Allyn, USA). All participants had intraocular accessed using Keeler non contact tonometer and those with significant media opacity preventing view of the posterior pole had cycloplegic examination after dilatation with 1%Tropicamide drops. Data generated was expressed as percentages and means. Results: 121 participants (242 eyes) were examined. There were 42 males and 79 females giving a M:F ratio of 1:1.86. Age range of participants was 0-90years with a peak in the 5th decade. Mean age was 32 years. 79.3% of participants had normal visual acuity of 6/4 -6/18, while 9.5% had visual acuity worse than 6/60. 83% of eyes had intraocular pressure within normal level, <21mmHg, 12.4% within 21-30mmHg and 4.6% >30mmHg. 73.1% of eyes had Vertical Cup disc ratio (VCDR) <0.5, 10.7% had 0.5-0.7 and 6.6%>0.7. 9.6% of eyes could not be accessed due to media opacities. Conclusion: 6.6% of participants had suspicious discs and 4.6% participants had intraocular pressures above 30mmHg. Opportunistic screening for glaucoma remains one of the important modes of case detection for glaucoma in the developing climes and should be encouraged as a way to address the scourge of this blinding disease.
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Outcome of Trabeculectomy in Advanced Glaucoma in a tertiary hospital in Rivers State, Nigeria

Published on: 19th December, 2018

OCLC Number/Unique Identifier: 7985989438

Aim: To evaluate the outcome of Trabeculectomy in advanced glaucoma in a hospital in Rivers State, Nigeria. Methods: This was a non-randomized interventional study in which each patient served as its own control. Patients with advanced glaucoma and demonstrable field defects and Mean defect ≥-12 were included. The intervention employed was Trabeculectomy and IOP and visual acuity pre operative, as well as post op were collected and compared at pre- op, post -op day 1, one week, one month, 6 months. Data was analyzed using SPSS version 20. Results: Thirteen (13) eyes from ten (10) patients with advanced glaucoma were involved in the study. Mean age of study population was 53±19.62 years. Mean of mean defect was -19.05±5.23dB while mean of vertical cup disc ratio (VCDR) was 0.88±0.04. Mean of Pre- op Visual acuity (log MAR) was 0.46 and dropped to 0.72 first day post-op but improved over 6 months to 0.42. The mean of IOP pre-op was 24.15mmHg and dropped to 11.23mmHg (58.24%) over 6 months (p=0.001). Conclusion: Trabeculectomy still remains the gold standard surgical treatment for glaucoma. In our study it resulted in a 58.24% drop in IOP over 6 months with mean visual acuity maintained at pre-op levels after 6 months follow up. It therefore is effective and safe surgical intervention in advanced glaucoma.
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