Medical causes of death in a teaching hospital in South-Eastern Nigeria: A 16 year review.

BACKGROUND: Most developing regions of the world are undergoing gradual epidemiological transition resulting in high burden of both communicable and noncommunicable diseases. This affects the pattern of death in this region. OBJECTIVE: The objective of this study is to determine the causes of death in the medical wards of the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, South-East Nigeria from 1995 to 2010. MATERIALS AND METHODS: Data were collected retrospectively from January 1995 to December 2010. STATISTICAL ANALYSIS USED: Statistical Package for Social Sciences (SPSS Inc. Chicago, IL, USA) version 17.0 was used. Simple descriptive statistics were done. Student's t-test was used to compare means of continuous variables, while Chi-square test was used to test significance of differences between two proportions. RESULTS: The mortality rate was 22.8% (6250/27,514) admissions. The male to female ratio was 1.7:1. Infections (20.2%) were the most common cause of death. However, chronic kidney disease was the single most common disease entity causing death (12.3%). Other important causes of death in order of prevalence were cerebrovascular accident (10.5%), acquired immune deficiency syndrome and tuberculosis either alone or as co-infection (10.3%), heart failure (8.8%), chronic liver disease (7.0%), septicemia (6.5%), respiratory failure (5.3%), diabetes mellitus (4.6%), cardiac arrhythmias (2.9%), and primary liver cell carcinoma (2.7%). There were few deaths from tetanus, malaria, typhoid fever, and coronary artery disease. CONCLUSION: Mortality is high in our medical wards and reflects the emerging trend of mixed disease spectrum comprising communicable and noncommunicable diseases.

Pattern of cancer deaths in the medical wards of a teaching hospital in South East Nigeria.

BACKGROUND: Cancers are emerging public health problems in developing countries like Nigeria. The epidemiological shift and aging population make cancers a challenge. OBJECTIVE: We set out to describe the pattern of death due to cancer in our medical ward. The hospital is one of the premier hospitals covering the South East zone of Nigeria. MATERIALS AND METHODS: We retrospectively reviewed the case notes and death certificates of all who died of cancer in our adult medical wards for 16 years (January 1995 to December 2010). STATISTICAL ANALYSIS USED: Statistical Package for Social Sciences (SPSS Inc. Chicago, IL) version 17.0 was used. RESULTS: Twenty seven thousand, five hundred and fourteen patients were admitted into the medical wards. Six thousand, two hundred and fifty died. Out of the 6250 deaths, cancers accounted for 7.6%. Male to Female ratio was 2.4:1. The mean age at death was 43.7 ± 17.4 years. The mean age at death in both sexes was similar (42.9 ± 17.5 for men and 45.7 ± 17.0 years for women), P = 0.109. Primary liver cell carcinoma was the most common cause of death among men (40.8%), while cancer of hematopoietic organ was the most common in women (48.7%). The overall fatality rate was 1.7% (477/27 514) of medical admissions. Younger and middle age groups were most commonly affected in both sexes. CONCLUSION: Since the most productive age groups were affected, governments in developing countries should as a matter of urgency put in place adequate cancer preventive and curative services.

Intra-cardiac masses in adults: a review of echocardiogram records at two echocardiographic laboratories in Enugu, South-East Nigeria.

BACKGROUND: Transthoracic echocardiography (TTE) is an excellent initial diagnostic technique used to evaluate and diagnose cardiac masses, even though transoesophageal echocardiography (TEE) provides superior image resolution and better visualization of cardiac masses, especially in patients with suboptimal transthoracic echocardiographic studies. TTE is the clinical procedure of choice for identification of left ventricular thrombi. TTE has greater than 90% sensitivity and greater than 85% specificity for detection of left ventricular thrombi and is probably superior to the sensitivity and specificity of TEE, especially for apical thrombi. AIMS: The study aimed to identify the common types of cardiac masses and their commonest locations in the heart. MATERIALS AND METHODS: We did a retrospective review of our echocardiogram reports from May 2003 to July 2012 to identify the frequency of intra-cardiac masses in adults, as well as the gender distribution and commonest location of these masses. RESULTS: There were 2,814 echo examinations in adults over this period, comprising 1,661 males (59.1%) and 1,153 females (40.9%). Intra-cardiac masses were found in 20 of these patients representing 0.7% of the study population. Thrombi were the commonest masses noted in our study, and there were more masses in the atria than in the ventricles. The left heart chambers also had more masses than the right heart chambers. There was no sex difference in the frequency of cardiac masses. CONCLUSION: Intra-cardiac masses are rare, and transthoracic echocardiography is still valuable in the diagnosis and initial characterization of cardiac masses.

Electrocardiographic findings in sickle cell cardiovascular autonomic neuropathy.

BACKGROUND: There is a lack of data on the relationship between cardiovascular autonomic neuropathy (CAN) and electrocardiographic parameters in sickle cell anaemia. AIMS AND OBJECTIVES: The purpose of the study was to compare the electrocardiographic findings in adult sickle cell anaemia patients with CAN with those of patients without this complication. METHODS: A cross sectional study was done using 62 consecutively recruited sickle cell anaemia patients who met the inclusion criteria for the study. Cardiovascular autonomic dysfunction was determined based on abnormal values in at least two of five non-invasive tests: Valsalva manoeuver, heart rate variation during deep breathing, heart rate response to standing, blood pressure response to sustained hand grip, and blood pressure response to standing. The subjects were subsequently evaluated with electrocardiography. RESULTS: Sickle cell anaemia patients with CAN had statistically significantly increased P-wave duration (p < 0.001), PR-interval (p < 0.05) and QTc dispersion (p < 0.05) compared with patients without CAN. Significantly increased frequencies of Q waves and first degree atrio-ventricular block were found in patients with CAN than in those without CAN (p = 0.026, p = 0.014, respectively). Significant correlations were noted between the severity of CAN [number of abnormal autonomic function tests (AFT)] and (1) P-wave duration (p = 0.008), (2) PR- interval (p = 0.013). Significant association was found between the number of abnormal AFT and (1) presence of Q-waves, and (2) degree of anaemia (haematocrit class). CONCLUSION: Electrocardiographic features consistent with atrio-ventricular and ventricular repolarization abnormalities are associated with CAN in sickle cell anaemia. Further studies are required to evaluate the prognostic implications of these findings in sickle cell patients with cardiovascular autonomic dysfunction.

Cardiac arrhythmias in recently diagnosed hypertensive patients at first presentation: an electrocardiographic-based study.

Various forms of cardiac arrhythmias have been documented in hypertensive subjects, and hypertension is an important risk factor for the development of atrial and ventricular arrhythmias and sudden death. Electrocardiography at rest easily documents significant arrhythmias in patients, and this study was carried out to determine the types and frequency of arrhythmias in hypertensive subjects at first presentation in the Hypertension Clinics of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. The study was hospitalbased and retrospective in nature. The resting 12lead ECG reports of 346 consecutive hypertensive subjects seen at the Hypertension clinics of the UNTH Enugu over a 14 month period were retrieved from the case files and studied. Other information obtained from the case files included the age and gender of the subjects. The mean age of the subjects was 57.3 years. Ninety-five of the subjects had arrhythmias representing 27% of the study population, out of which fifty-five were males (57.9%) and forty were females (42.1%). However 26.9% of all the male subjects had arrhythmias while 28.2% of all the females had arrhythmias. Multiple ventricular ectopics, sinus tachycardia, sinus bradycardia and atrial fibrillation were the most prevalent arrhythmias. This study showed that a significant proportion of hypertensive subjects present initially with significant rhythm disturbances.

Blood pressure correlates in orthopaedic and plastic patients at a regional orthopaedic hospital in Nigeria.

BACKGROUND: Raised blood pressure is a significant surgical risk factor. Post operative complications are worse in both orthopaedic and plastic patients when there is associated hypertension. There has not been any known study on blood pressure variables in patients presenting at the National Orthopaedic Hospital Enugu, Nigeria. This informed the need for the authors to evaluate the blood pressure correlates in patients presenting at this hospital. METHODS: Patients attending the outpatient clinics of the hospital, between June 2003 and September 2004, were recruited into the study. Their biodata, demographic and clinical characteristics were recorded under standard conditions. Their blood pressure awareness indices, lifestyle habits and co-morbid conditions were evaluated. Structured questionnaires were used with self administered screening done. RESULTS: Two hundred and eighteen patients with mean age 41.4 (+/- 17.2) years, were screened, Fifty three percent of them were hypertensive, with 87% of these presenting as orthopaedic cases. While 68% irregularly or never checked their blood pressure, those who took alcohol had 54.5% among them, with hypertension. CONCLUSIONS: This study has shown a high prevalence of hypertension among patients presenting at the study centre. There is also a high degree of association between the lifestyle habits and level of blood pressure. The implications of this for surgical outcome are highlighted.

Left ventricular diastolic function in a predialysis patient population.

BACKGROUND: Diastolic dysfunction is common in chronic kidney disease (CKD) accounting for 40%-66% of cardiovascular complications. OBJECTIVE: To determine the prevalence of and factors associated with left ventricular diastolic dysfunction (LVDD) in adult Nigerians with CKD at presentation and to compare findings with those of hypertensive patients with normal renal function. METHODS: Eighty-six consecutive patients with CKD were studied, comprising 43 hypertensives and 43 age- and sex-matched healthy subjects as controls. Clinical, laboratory, and echocardiographic variables were measured. RESULTS: Left ventricular diastolic dysfunction was present in 62.8% of CKD patients, 79.1% of hypertensive patients and 25.6% of normal controls (p<0.001). There was a positive correlation between left ventricular diastolic function (LVDF) and systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), severity of SBP, severity of DBP in CKD patients but not in hypertensive patients. There was a negative correlation between LVDF and age in CKD patients and hypertensive patients. Linear multiple regression analysis showed age as the only predictor of LVDD. CONCLUSION: There is a high prevalence of diastolic dysfunction in CKD patients at first presentation to a nephrologist in Nigeria.

Left ventricular systolic function in a Nigerian pre-dialysis patient population with chronic kidney disease.

AIMS AND OBJECTIVES: This study evaluates left ventricularsystolic function (LVSF) and factors affecting it in CKD patients at first presentation, using two dimensional echocardiography. PATIENTS AND METHODS: One hundred consecutive patients with CKD who were presenting to the medical outpatient and renal clinics of university of Nigeria teaching hospital, Enugu for the first time, who satisfied the study criteria were screened. Eighty six patients completed the study. Forty-eight sex matched hypertensive patients with normal renal function and forty-six age and sex matched subjects (with normal blood pressure and renal function) were selected as controls. Clinical and laboratory parameters and echocardiographic indices were measured. RESULTS: Left ventricular systolic dysfunction (LVSD) was present in 13 (15.1%) of CKD patients and 4 (8.3%) of hypertensive patients (p < 0.001). The mean fractional shortening in CKD patients (35.1 +/- 10.4%) was significantly lower than the hypertensive patients (40.1 +/- 9.8), p = 0.008. Positive correlation was found between fractional shortening (FS) and estimated glomerular filtration rate, haemoglobin level, CKD stage, diastolic blood pressure, serum albumin and systolic blood pressure.(r = 0.281, P < 0.001; r = 0.277, p < 0.001; r = 0.270, p = < 0.001; r = 0.237; P = 0.001; r = 0.230, p = 0.002; and r = 0.199, p = 0.007) respectively. Left ventricular mass index and mean arterial blood pressure, correlated negatively with LV systolic function (r = -0.315, P < 0.001; and r = -0.223, P Stepwise multiple regression analysis showed that of all the factors that correlated with LVSF. CONCLUSION: This study has shown that LVSF is impaired in a significant number of our CKD patients at presentation.

Medical practice in the face of economic meltdown: peculiar challenges in Nigeria and other developing countries.

BACKGROUND: The impact of the global economic meltdown on every sector of economic activity has been enormous, especially in the developing countries. Medical practice in these nations has been particularly challenged and stretched under this milieu. This paper thus sets out to evaluate the phenomenon of economic meltdown with its effects on the developing countries, the challenges it poses to medical practice, with Nigeria as a case study, and makes suggestions to address this scenario. METHOD: A review of the literature on economic meltdown with particular emphasis on the effect on medical practice, was done, with focus on the developing countries, and specifically Nigeria. Literature search was conducted using the Medline, Google search engine, the media, as well as national and localjournals. RESULTS: The definition and historical perspectives of global economic meltdown, as well as the geographical location of the developing countries, are set out. The peculiar economic challenges and those in the medical practice, with the concomitant glaring effects in the developing nations, with particular reference to the Nigerian situation, are outlined. Specific measures to adopt in addressing these challenges are suggested in this paper. CONCLUSION: The peculiar challenges of the global economic meltdown on medical practice in the developing world, and in Nigeria particularly, must be addressed wholisticaly involving every sector of the economy, with fundamental policy and structural changes put in place.

Prevalence of hypertension and its complications among medical admissions at the University of Nigeria Teaching Hospital, Enugu (Study 2).

BACKGROUND: To evaluate the prevalence pattern of hypertension and its complications among medical admissions and compare the findings with those of a previous study conducted at the University of Nigeria Teaching Hospital, Enugu. METHOD: A review of all the admissions into the medical wards of the University of Nigeria Teaching Hospital, Enugu, between December 1998 and November 2003, was done. RESULTS: Of the 7399 patients admitted during the period, 1360 (18.4%) had hypertension related diseases. These were 798 (58.7%) males and 562 (41.3%) females, giving a male: female ratio of 1.4:1. There was a progressive increase in the age-specific prevalence of hypertension cases with advancing age, but presenting with only 6 (0.4%) patients in the over 90 years age group. Hypertensive congestive heart failure accounted for 26.5% of the cases and 46.1% of the hypertensive complications. Myocardial infarction was documented in 7 patients. Hypertension with its complications, contributed more than two thirds (69.6%) of the cardiovascular system admissions. CONCLUSION: The prevalence of hypertension, with its complications, is increasing, when compared with a previous study. This calls for a multifaceted approach aimed at ensuring the achievement of better blood pressure control, so as to obviate the attendant complications.

Haematological assessment of occupational exposure to lead handlers in Enugu urban, Enugu State, Nigeria.

OBJECTIVE: To determine blood levels of lead and its effects on haematological parameters among occupational lead handlers in Enugu, Enugu State, Nigeria. In developing countries, rapid industrialisation has lead to an alarming demand for lead. Furthermore, the burden of lead toxicity is greatly underestimated. Hence, the need to assess the unavoidable toxic effects of lead as done in this study. METHODS: Blood lead levels were measured by atomic absorption spectrometry (AAS) in eighty one (81) male subjects from three manufacturing companies, all located in Enugu metropolis, Nigeria. Thirty (30) staff of the industries not directly involved in lead handling served as control group I, while twenty (20) apparently healthy individuals from within the same locality not involved in lead handling served as control group II. Haematological values, blood lead levels and blood pressure (BP) were established using standard procedures. Statistical Analysis System (SAS) software was used to analyze the results. P value of < 0.05 was taken as significant. RESULTS: Mean blood levels were 7.00 +/- 0.07 microg/dl in test subjects; 3.00 +/- 0.19 microg/dl in control group I and 2.00 +/- 0.04 microg/dl in the control group II. There were significant statistical differences (p < 0.05 for each) in haemoglobin (Hb), packed cell volume (PCV), reticulocyte, total white blood cell (WBC), monocyte, autohaemolysis without glucose, and systolic and diastolic pressure between subjects and control group I. There were also significant differences (p < 0.05 for each) in the mean levels of Hb, PCV, reticulocyte, eosinophil, monocytes and systolic and diastolic pressures between the test subjects and control group II. There were however, no statistically significant differences (p > 0.05) in the means of other parameters. Basophilic stipplings were not observed in the red cells of those directly exposed to lead. CONCLUSIONS: It is suggested, therefore, that comprehensive and preventive measures towards exposure to lead in work places, and routine haemotological investigations be included in the bio-monitoring of the health status of lead workers.

Case fatality among hypertension-related admissions in Enugu, Nigeria.

OBJECTIVE: To determine the case fatality rate and ultimate causes of death among patients with hypertension-related conditions admitted to an urban tertiary hospital, METHOD: A five-year review of hypertension-related admissions into the medical wards of the University of Nigeria Teaching Hospital, Enugu, between 1995 and 1999, was undertaken. RESULTS: 7220 patients were admitted into the medical wards during the period under review. Of these, 445 (6.2%) were due to hypertension-related causes. Of the later, 285 (64%) were males while 160 (36%) were females. One hundred and ninety one of the hypertension-related admissions died, giving a case fatality of 42.9%. The mean age at death was 54.8+/-15.8 years (53.5+/-15.9 years for males; 57.2+/-15.4 years for females, t=2.47, df=189, p=0.117). Sixty six percent of these were males while thirty four percent were females. Eighty six (45%) of the deaths occurred during acute hypertensive crises such as cerebrovascular accidents, hypertensive encephalopathy, and acute renal failure. Other important complications leading to death were congestive cardiac failure, accounting for thirty three cases (17.3%); and chronic renal failure 32 (16.8%). In twenty one (11%) hypertension-related admissions, the causes of death were not documented. CONCLUSION: Hypertension, with its related complications, constitute a major cause of morbidity and mortality in our medical wards. The case fatality rate is very high and often mostly avoidable complications were responsible. There is need to further study the determinants of these avoidable causes of death.

Prothrombin time, activated partial thromboplastin time and other haematological parameters among non-diabetic hypertensive patients.

OBJECTIVES: To screen non-diabetic hypertensive Nigerian patients with a view to determining their haematological and coagulation profiles. SUBJECTS AND METHODS: Thirty (30) consecutive non-diabetic hypertensive patients, aged 20-60 years and 30 age and sex-matched, apparently healthy subjects, were investigated for some haematological and coagulation parameters, blood pressure, pulse, body weight, height and body mass index. RESULTS: There were statistically significant differences (p < 0.05), in some haematological parameters, blood pressure, body mass index and height in the total number of patients studied when compared with the total control group. The separate genders each showed statistically significant differences in both haematological parameters and blood pressure (P < 0.05) when compared with their corresponding control groups. In addition, haematological values, body mass index and height showed statistically significant differences (p < 0.05) when the male and female patients were compared. Overall, 25 (83.33%) of the patient's blood films were normochromic and normocytic. CONCLUSION: It appears that hypertension has adverse effects on haematological parameters. We therefore recommended that coagulations studies should be included in the investigation work-up of hypertensive patients.

Work attitudes and perceptions of South Eastern Nigerian health workers.

BACKGROUND: Poor work attitudes and disposition affect productivity and health care services adversely. OBJECTIVE: To evaluate the work attitudes and perceptions of health workers in South Eastern Nigeria in one of the biggest Federal Teaching Hospitals in Nigeria. METHODS: Stratified random sampling of 384 middle and senior manpower staff and use of a self-administered questionnaire. RESULTS: Most respondents agreed that patient care should be a joint effort, as well as to working together with other members of the health care team. Of the respondents, 242 (63%) were dissatisfied with the service delivery. CONCLUSION: The results of this study reinforce the importance of research based actions and concepts that would improve health care service delivery. The study has potentially enlightened researchers about attitudinal and perceptual dispositions of black health professionals. There is need for future broadbased, cross cultural and longitudinal work among health workers.

The prevalence and correlates of hypertension in a Theological College in Africa.

BACKGROUND: The Theological College is a peculiar setting. This is due to the nature of the job, studies, attitudinal leaning (faith) and influence. There has been no known work to date done on the cardiovascular status in institutions of this nature-both in the country and in the continent of Africa. This formed the basis for evaluating the prevalence of hypertension and its correlates in one of the foremost theological colleges in Africa, the Trinity Theological College, Umuahia. METHOD: The entire constituent working-student population in the sandwich program of August 2004 at the Trinity Theological College, Umuahia, were recruited in the study. Their biodata, demographic distribution, anthropometry, pulse rate and blood pressure measurements were recorded under standard conditions. Their lifestyle habits were evaluated. Structured questionnaires were used with self administered screening done by medical doctors. RESULTS: Eighty five subjects, with mean age 43.7 (+/- 9.9) years, were screened. The prevalence of hypertension was found to be 28.3%. Only 8 subjects admitted being known hypertensives, out of whom 6 were on treatment. Fifty three percent (45) of them checked their blood pressure irregularly, while 28 (33%) never did. Twenty six respondents (31%) admitted taking extra table salt, while 39 (46%) never engaged in any form of exercise. CONCLUSION: The prevalence of hypertension in this community is higher than that of the general Nigerian population. There is a great need for adequate health education especially with regard to regularity of blood pressure check and lifestyle modification, in the Theological Colleges, given the influence they wield in the larger society.

One year echocardiographic study of rheumatic heart disease at Enugu, Nigeria.

BACKGROUND: Rheumatic heart disease is one of the commonest causes of heart disease in Nigeria. Previous studies on rheumatic heart disease in Nigeria were either clinical or retrospective echocardiographic studies. This study was aimed at determining the burden of chronic rheumatic mitral valve disease, pattern of valvular involvement, severity and associated valvular lesions, using echocardiography. PATIENTS AND METHODS: Between May, 2004 and April 2005, patients with symptomatic rheumatic heart disease, seen in the cardiac clinics of University of Nigeria Teaching Hospital, Enugu, were recruited for the study. The patients were investigated non-invasively with M-mode, Two-dimensional, Pulsed wave, Continuous wave and colour flow Doppler echocardiographic techniques in order to assess the mitral and other intracardiac valves for evidence of rheumatic heart disease. RESULTS: There were a total of 55 patients, 39 (70.9%) females and 16 (29.1%) males with a mean age of 29.34 +/- 11.57 years. Mitral valve disease was found in 54 (98.2%) and isolated aortic valve disease in 1 (1.8%) of cases. Mitral regurgitation occurred in 64.8%, mixed mitral valve disease in 25.9% and pure mitral stenosis in 9.3%. Mitral valve disease was associated with aortic valve disease in 33.3%, with tricuspid valve disease in 24.1% and with functional pulmonary incompetence in 9.3% of cases. CONCLUSION: Rheumatic heart disease in Nigeria is essentially a disease of the mitral valve as seen elsewhere in the world. Echocardiography should be done routinely for patients with rheumatic heart disease to facilitate accurate diagnosis and definitive treatment.

The pattern of admissions into the medical wards of the University of Nigeria Teaching Hospital, Enugu (2).

OBJECTIVE: To study the pattern of medical admissions at the University of Nigeria Teaching Hospital (UNTH), Enugu, with a view to determining the disease trend and providing a comparative analysis with the previous study conducted in the same centre in the preceding five-year period. METHOD: A review of admissions into the medical wards of the UNTH, Enugu, over the five year period between December, 1998 and November, 2003, was done using the register of admissions and discharges; as well as a review of the case file where necessary. RESULTS: The patients admitted during the period numbered 7399, with age range of 15 to 102 years. There were 4324 (58.4%) males and 3075 (41.6%) females, with a male to female ratio of 1.4:1. Disorders of the cardiovascular system accounted for 1389 (18.8%) of the admissions, and those of the central nervous system 1178 (15.9%) while HIV-related disorders accounted for 501 (6.7%) respectively. Non-communicable diseases accounted for 4493 (60.3%) of the cases while communicable diseases accounted for 2906 (39.3%). There were more admissions in the wet season (April to September), with 56.8%, while the month of December cumulatively recorded the least admission rate. The mean hospital stay was 15.5 (+/- 15.4) days. CONCLUSION: The study shows an increasing trend in medical admissions at the UNTH, Enugu, with non-communicable diseases and male gender preponderance, while 53% of those affected are in the 30 60 years range. Serious efforts at revamping the health sector services and facilities, and particularly, national and local strategies to combat non-communicable diseases, are emphasized.

HIV/AIDS perception and sexual behaviour among Nigerian University students.

OBJECTIVE: To evaluate the knowledge and perception of undergraduate students of the University of Nigeria with regards to HIV/AIDS and determine their sexual behaviour. MATERIALS AND METHODS: This was a cross sectional descriptive study. Pre-tested structured questionnaires were administered to the students to collect relevant information on their sociodemographic characteristics, HIV/AIDS awareness, sexual behaviour, willingness to screen and disposition to people living with HIV/AIDS RESULTS: Five hundred and seventy nine students between 16 to 40 years of age responded, out of 600. Majority (55%) heard about HIV/AIDS through the media. Seventy two percent believed viruses cause HIV/AIDS but 27% thought it was God's anger or witches. Forty four percent were (genitally) sexually active or engaging in pre/extramarital sexual intercourse and only two-thirds of these used condoms for these purposes. Ninety one percent of those not using condoms simply did not like it or admitted it was unavailable. More than 70% had never had a HIV screening test, mostly due to reluctance or fear. Ninety two percent would lovingly care for a HIV/AIDS patient. CONCLUSION: Information on HIV/AIDS and sexual behaviour to this vulnerable and most economically important group is still inadequate, as reflective of the society. Appropriate information, education and communication strategies must be packaged towards these students, with efforts made to reinforce their positive trends.

Biochemical and haematological assessment of workers exposed to some petroleum products in Rnugu Urban, Rnugu State, Nigeria.

BACKGROUND: Exposure to petroleum product(s) occurs during extraction, refining, transportation and utilisation. Surprisingly, this relatively common hazard has received little public recognition. We therefore studied the adverse effects of petroleum products among occupationally exposed liquefied petroleum gas and histochemical workers in Enugu Urban, Nigeria. METHODS: Eight industries/departments were surveyed. Sixty workers were tested for some biochemical and haematological parameters (phosphatases, transaminases, complete blood count, erythrocyte sedimentation rate), were analysed, using standard methods. Also, 30 age and sex-matched apparently healthy subjects served as the control group. RESULTS: When the test and control results were compared, there were statistically significant differences (p < 0.05) in: (1) haematocrit, reticulocytes, erythrocyte sedimentation rate, platelet, lymphocyte, monocyte, alkaline phosphatase, aspartate transaminase, alanine transaminase among liquefied petroleum gas workers and (2) haemoglobin, haematocrit, erythrocyte sedimentation rate, platelets, neutrophil, lymphocyte, monocytes, acid phosphatases and alkaline phosphatase among histochemical workers. Overall, there was statistically significant decrease (p < 0.05) in most of the parameters among the test subjects when compared with the control group. Blood films of the workers revealed mild to moderate hypochromia, anisocytosis and poikilocytosis while the controls were normocytic and normochromic. CONCLUSION: We conclude that exposure to petroleum products adversely affects biochemical and haematological parameters. Hence, improved working conditions are recommended.

Electrocardiographic findings in a cross-sectional study of human immunodeficiency virus (HIV) patients in Enugu, south-east Nigeria.

BACKGROUND: Electrocardiographic (ECG) abnormalities are prevalent in subjects with human immunodeficiency virus (HIV) infection. In this study, three groups of subjects were investigated and the prevalence of ECG abnormalities was analysed. METHODS: A cross-sectional study was carried out on adults between November 2010 and November 2011 at the University of Nigeria Teaching Hospital, Enugu, Nigeria. One hundred HIV-infected patients on highly active anti-retroviral therapy (HAART), 100 HIV-infected HAART-naïve patients and 100 HIV-negative controls were recruited. Twelve-lead electrocardiograms were done on all subjects. Data were analysed using the chi-squared, Student's t-, one-way ANOVA and Duncan post hoc tests. RESULTS: Left-axis deviation was seen in 15 (16%) of the HIV-positive subjects on HAART, 10 (13.7%) of the HAART-naïve subjects and eight (21%) of the controls (p = 0.265). Eight (11%) subjects with left ventricular hypertrophy (p < 0.001) and two (2.7%) with ST-segment elevation were found among the HIV-positive HAART-naïve subjects (p = 0.134). Prolonged QTc interval was seen in 17 (18.2%) of the HIV-positive patients on HAART, 12 (16.4%) of the HIV-positive HAART-naïve patients and four (10.5%) of the controls (p = 0.012). CONCLUSION: The prevalence of ECG abnormalities was higher in the HIV-positive patients on HAART (93%) and the HIV-positive HAART-naïve patients (73%) compared to the controls.