Background: The aim of this study was to assess the compliance with directly-observed therapy short course (DOTS)-regimen and recovery from pulmonary tuberculosis among clients of infectious Diseases Hospital, Ikot Ekpene, Nigeria. Methods: A descriptive design was used for the study and a total of 100 pulmonary tuberculosis patients who came for medical checkup between August and September 2021 were studied using convenience sampling technique. The instrument used for data collection was a researcher constructed questionnaire with 20 items grouped into sections A and B. Section A, elicited information on the demographic data of the respondents while section B focused on the level of compliance and recovery rate of the patients. Data was analyzed using descriptive statistics of percentages on frequency tables and chart while Pearson product Moment Correlation formula was used to analyse the results at 0.05 level of significance. Results: Findings from the study revealed that majority (72.2%) of the patients had knowledge, 70.6% complied with DOTS regimen and 68.2% recovered from pulmonary tuberculosis. There was no significant relationship between patient’s knowledge of the disease and compliance with DOTS. Conclusion: It is therefore recommended that adequate information should be given to all pulmonary tuberculosis patients on the need for strict compliance with DOTS in order to recover completely from the infection after treatment.

BACKGROUND:Bronchiectasis is often considered an orphan disease in developed societies. This may not be the case with low-income countries. Currently there is a paucity of data on the pattern and presentation of this condition in Nigeria.OBJECTIVE:This study was undertaken to determine the frequency and pattern of presentation of bronchiectasis in a tertiary healthcare facility in Uyo, South-South, Nigeria.METHODS:We carried out a three-year prospective study of adult patients aged between 15-85 years diagnosed with bronchiectasis in the University of Uyo Teaching Hospital in Uyo, Nigeria between 2016 and 2019.RESULTS:Eighty-two patients were identified from the clinic register. Out of these, 76 were recruited into the study; made up of 44(57.9%) males and 32 (42.1%) females. The average age of the patients was 49.7 ± 14.1 years. Sixteen (21.1%) of the patients were HIV positive. Forty-four (57.9%) patients had previously been treated for pulmonary tuberculosis. Majority of the patients; 72 (94.7%) had chronic productive cough. Sixty-four (84.2%) had at least one episode of exacerbation within the last 12 months while 36(47.4%) had a severe exacerbation requiring hospitalisation. Hospitalisation was associated with several factors with the strongest contributor being the presence of respiratory distress on physical examination (OR 15.4 p= 0.002).CONCLUSION:Bronchiectasis is not an uncommon disease amongst our patients. A previous history of pulmonary tuberculosis is the commonest associated predisposing medical condition. There is a high rate of exacerbation among these patients with respiratory distress as the strongest predictor of hospitalisation.

Background: Corona virus disease 2019 (COVID-19) is a global pandemic that affects all age groups. Infected asymptomatic children can transmit the disease to vulnerable adults with co-morbidities resulting in severe disease in the latter. There are few reports of COVID-19 in children in Sub-Saharan Africa in general and in Nigeria in particular.Aim: To determine the prevalence, symptoms and risk factors for COVID-19 in Southern Nigerian children.Methods: This was a one-year retrospective cross-sectional study between April 2020 and March 2021. Data of all children tested for COVID-19 was extracted from the Epidemiology unit of Akwa Ibom state ministry of health. All patient identifiers were omitted and data was analyzed using STATA version 13.Results: Two hundred and fifty five children (2.25%) out of a total of 11,289 people were tested for COVID-19. Fifty -four children (0.47%) of the total number of persons tested for COVID-19 were positive. Twenty one percent of the 255 children tested were positive for COVID-19. Two hundred and fifty- four (99.6%) of children that were tested had a positive history of contact with a confirmed COVID-19 case. Five (9.3%) of COVID-19 positive children were symptomatic. The commonest symptoms seen were Fever (90.9%), Anosmia (63.6%) and Aguesia (36.4%). Increasing age (15 years and above) was significantly associated with COVID-19 positivity (p=0.000). In addition, the presence of symptoms was significantly associated with COVID-19 positivity (p=0.04).Conclusion/Recommendation: The prevalence of COVID-19 in Southern Nigerian children is low. Majority of the children have asymptomatic disease. Increasing age is significantly associated with COVID-19 positivity. We recommend increased COVID-19 testing in the general children population.

BACKGROUND:Bronchiectasis is characterized by chronic symptoms and impaired physical activity. Anxiety and depression usually complicate chronic illness. Thus, underdiagnosis of psychological distress in bronchiectasis may lead to increased morbidity and mortality. AIMS:The aim of this study is to evaluate the impact of physical illness on psychological distress and its association with health-related quality of life (HRQOL). SUBJECTS AND METHODS:This is a cross-sectional study of adults with bronchiectasis. Patients completed a study questionnaire, the hospital anxiety and depression scale and the World Health Organization quality of life brief (WHOQOL-BREF) questionnaire. Physical examination was conducted on all participants. RESULTS:103 patients were recruited for this study: 54 males (52.4%) and 49 females (47.6%). The average age of the patients was 49.12 ± 14.37 years. The most common predisposing factor for bronchiectasis amongst the patients was previous pulmonary tuberculosis (51 patients, 49.5%). Chronic productive cough, which was reported by 98 of the subjects (95.15%), was the most common symptom. 89 subjects (86.41%) reported episodes of shortness of breath, 82 (79.61%) reported at least one episode of exacerbation, while 52 subjects (50.49%) were hospitalized for bronchiectasis in the previous 12 months. 23 subjects (22.3%) had anxiety and 32 (31.1%) had depression. Anxiety and depression were significantly associated with indicators of severe disease. The subjects recorded low HRQOL scores across all domains. Psychological distress displayed a significant negative association with all the quality-of-life domains except between anxiety and social interaction. CONCLUSION:Symptoms of depression and anxiety are common among patients with bronchiectasis and these symptoms have a negative impact on HRQOL.

BACKGROUND AND OBJECTIVES:Coronavirus disease 2019 (COVID-19) is a global pandemic. Older people and those with poorly controlled co-morbidities have higher risk of mortality. This study was conducted to highlight the clinical features, challenges of management and outcome for the patients we have seen in our centre over the past one year.METHODS:This was a retrospective cross-sectional study involving all patients admitted in the COVID-19 Isolation unit of University of Uyo Teaching Hospital (UUTH) from June, 2020-May, 2021. Clinical and laboratory information were obtained from the patient case notes. Ethical clearance for the conduct of the study was obtained from the Ethics committee, UUTH, Uyo. Data was analysed with STATA version 13.RESULTS:Thirty-three (37.9%) patients were COVID-19 PCR positive. The mean ± SD age of COVID-19 PCR positive patients was 57.3 ± 13.4 years with majority (69.7%) being above 50 years. There was a male preponderance (75%). Eleven (34.4%) patients died while 21(65.6%) were discharged. The highest co-morbidity associated with COVID-19 mortality was diabetes mellitus (7 out of 11; 63.6%). There was a poor uptake of supportive investigations for the management of COVID-19 patients. A raised body temperature (P=0.0006), a low SPO2 (0.00004), high respiratory rate (0.0009) on admission and shorter duration of admission (0.0002), were associated with mortality.CONCLUSION:The presence of co-morbidities, fever, low SPO2 and high respiratory rates on admission are associated with increased mortality from COVID-19 disease. A paucity of supportive investigations was a major challenge to COVID-19 management. We therefore recommend the strengthening of our laboratory capacity.

INTRODUCTION:The fifth metatarsal diaphyseal fracture is a common fracture. However, clear consensus about the treatment is lacking. Unlike the avulsion fracture or Jones' fracture, literature available on the treatment and long-term outcome of the diaphyseal fracture is scarce.The purpose of this study is to demonstrate a substantial number of conservatively treated patients with persistent pain and to evaluate metatarsal shortening and displacement within this group.METHODS:In this retrospective study, 106 patients who had experienced a fifth metatarsal diaphyseal fracture were included and evaluated. The minimum follow-up period was three months. FAAM, AOFAS and NRS scores were used as outcome measurements for function and pain. Length and displacement were analysed on plain X-rays.RESULTS:At least 11% of the patients who received conservative treatment for their fifth metatarsal diaphyseal fracture had persistent pain at least 3 months after initiation of conservative treatment. No relationship has been found between the length of the fifth metatarsal and the FAAM (r( Petrisor et al., 2006) 2 = 0,051), AOFAS (r( Petrisor et al., 2006) 2 = 0,009) and NRS (r( Petrisor et al., 2006) 2 = 0,001). Furthermore, there was no association between patients with a shorter fifth metatarsal and FAAM, AOFAS, NRS, displacement and BMI.DISCUSSION AND CONCLUSION:The finding of persistent pain in at least 11% of all patients at long-term follow-up confirms our hypothesis on long-term symptoms. However, the results suggest that these persistent symptoms are not related to metatarsal shortening or displacement.

Background: Obstructive sleep apnoea syndrome (OSAS) is a highly prevalent disorder, associated with decreased quality of life and increased cardiovascular morbidity. An intimate relationship exists between obesity and the development of OSAS and type 2 diabetes mellitus. This study aimed to measure the risk for OSAS and determine its clinical correlates among type 2 diabetics in Nigeria. Methods: To determine the risk for OSAS, the Berlin questionnaire was administered on type 2 diabetics other clinical parameters such as blood pressure, lung function and anthropometry were also measured. Glycemic control was assessed with HbA1c measurement. Results: One hundred and fourteen patients were recruited for this study. There were 63 females and 51 males. The average age of the patients was 55 ± 10.6 years. Fifty five (48.2%) of the patients had a high risk for OSAS. Patients with a high risk for OSAS had significantly higher BMI (28.9 ± 4.3 vs. 26.4 ± 3.6 kg/m2, p = 0.001) significantly higher systolic BP 146.7 ± 27.4 vs. 135.0 ± 22.8 mmHg, p = 0.014) and significantly higher diastolic BP (85.9 ± 15.5 vs. 79.4 ± 10.8 mmHg, p = 0.011). There was an increase in neck circumference (37.0 ± 3.7 vs. 35.9 ± 2.7 cm) and a reduction in percentage of predicted FEV1 (94.2 ± 27.0 vs. 102.2 ± 25.2 %) associated with a high risk for OSAS but these were not statistically significant. Patients with a high risk for OSAS were more likely to have poorly controlled BP (67.3 vs. 45.8%, χ2= 3.3, p = 0.021) and poorer glycaemic control (z=-4.412, p =<0.001) Conclusion: A lot of our type 2 diabetes mellitus patients have a high risk for OSAS and this risk has a negative influence on blood pressure and glycemic control.

Background: Burning of biomass is widely used by the rural poor for energy generation. Long term exposure to biomass smoke is believed to affect lung function and cause respiratory symptoms. Materials and Methods: Women with long term occupational exposure to burning firewood were recruited from a rural fishing community in Nigeria. A questionnaire was used to obtain information on symptoms of chronic bronchitis and spirometery was performed to measure lung function. Data obtained from the subjects was compared with that from healthy controls. Results: Six hundred and eighty six women were recruited for this study made up of 342 subjects and 346 controls. Sixty eight (19.9%) of the subjects had chronic bronchitis compared with eight (2.3%) of the controls (χ2 = 54.0, P < 0.001). The subjects had lower values for the lung function as well as the percentage predicted values (P < 0.05). Fish smoking and chronic bronchitis were significantly associated with predicted lung volumes. Conclusion: Chronic exposure to biomass smoke is associated with chronic bronchitis and reduced lung functions in women engaged in fish smoking.

Introduction: The HIV/AIDS pandemic still ranks one of the foremost causes of death in developing world. The present prevalence of HIV/AIDS is 5.0% for Sub-Saharan Africa and the Nigerian figure is 3.01%. The rate of infection of a previously non-infected individual in this sub-region is set at 160,000 individuals daily. With such a high prevalence, it of importance that caregivers and particularly medical doctors arm themselves with sufficient knowledge of postexposure prophylaxis.Design: Cross sectional descriptive study.Participants: The study took place among 81 doctors in a tertiary health institute in Nigeria, the University of Calabar Teaching Hospital.Methodology: A semi-structured questionnaire was administered to the subjects using a random sampling method. These questionnaires highlighted their departments, ages and ranks. Their levels of knowledge and indications for PEP as well as their attitudes to this procedure using a modification of the Likert Attitude Scale were also assessed. There were 15 attitude parameters and each attracted a maximum score of 5 points with a total of 75 points. Respondents were scored and the attitude scores were graded thus; negative attitude - <35 points; bare positive – 36 – 50 points; positive – 51 – 65 points; super-positive - >65 points. The subjects were also given an opportunity to suggest ways of improving on the practice of PEP in their various practices.Results: This showed that the knowledge of PEP was satisfactory, however only about half of the respondents mentioned specific indications for PEP. The doctors’ source of information about PEP was also too medically oriented and not broadminded enough for his position as the decision maker / head of the medical team. Respondents attitude towards PEP was positive and very important suggestions were made for better implementation of PEP.Conclusion: The knowledge of PEP is satisfactory in UCTH, Calabar and issues that need to be addressed in our practice border on of information dissemination and measures aimed at increasing the awareness of PEP in our society.KEYWORDS: Knowledge, Attitude, Post-Exposure Prophylaxis Knowledge, Attitude and Practice of post-exposure prophylaxis to HIV

BACKGROUND AND OBJECTIVES: The morbidity and mortality pattern in persons with Diabetes mellitus(DM) is not well documented in Uyo. This study therefore set out to determine the morbidity and mortality pattern amongst patients with Diabetes Mellitus at the University of Uyo Teaching Hospital Uyo, Nigeria over four consecutive years (June 2004 to June 2008). Methods:This study was a retrospective study. Data were obtained from the records in the medical wards registers. The records included admission and discharge records as well as outcome of the individual cases. Data extracted included age, sex, indication for admission and outcome. Results:A total of 407 patients with diabetes mellitus (DM) were admitted during the period under review. Uncontrolled DM was the commonest indication for admission accounting for 253(62.2%) of the total admissions. Hyperglycaemic emergencies (diabetic ketoacidosis and hyperglyceamic hyperosmolar state) accounted for 76(18.7%) of the total admissions.The overall mortality rate in the diabetic patients was 33(8.1%). Hyperglycaemic hyperosmolar state(HHS) was the commonest cause of death accounting for 8( 24.2%) of the total deaths recorded. The fatality rate for HHS was 8(30.3%) and for Diabetic ketoacidosis was 5( 10.2%,). Conclusion:Diabetes mellitus is an important cause of morbidity and mortality in Uyo. Adequate diabetic education needs to be given to diabetic patients to enable them cope with their illness to prevent the poor outcome associated with the disease.

Biomass is heavily depended on for domestic energy use by people in developing countries. Combustion of these materials produces a lot of smoke. Exposure to this indoor air pollution has been linked to a number of respiratory disorders. The aim of our study was an assessment of the long-term respiratory effects of indoor air pollution. A survey was conducted in the riverine areas of the Niger Delta of Nigeria among 521 fishermen exposed to indoor air pollution from burning firewood and 545 matched controls. Exposure was determined by the product of the average daily duration of time spent close to the fire and the number of years (hours–years). A modified British Medical Research Council (BMRC) questionnaire was used to obtain information on respiratory symptoms and spirometry was performed on the participants. The frequency of chronic respiratory symptoms was significantly higher among the exposed fishermen compared with the control subjects. Chronic bronchitis was significantly associated with an obstructive venti latory pattern. Logistic regression analysis showed an increased risk for chronic bronchitis among exposed fishermen (OR 8.7; 95% CI 4.7–16.3, p<0.001); women were six times more likely than men to develop chronic bronchitis (OR 6.6; 95% CI 2.5-17.8, p< 0.001); and cigarette smokers were five times more likely than non-smokers to develop chronic bronchitis (OR 5.0; 95% CI 1.8–13.8, p<0.05). The results of this survey showed an association between exposure to indoor air pollution and chronic respiratory disorders. Cigarette smoking aggravated this association.

The aim of this study was to determine the morbidity and mortality pattern amongst patients with diabetes mellitus (DM) at the University of Uyo Teaching Hospital Uyo, Nigeria over four consecutive years (June 2004 to June 2008). This study was a retrospective study. Data was obtained from the records register in the medical wards of the hospital. These records registers included admission and discharge records as well as outcome of the individual cases. Data extracted included age, sex, indication for admission and outcome. A total of 407 patients with DMwere admitted during the period under review. Uncontrolled DM was the commonest indication for admission accounting for 62.1% of the total admissions. Hyperglycaemic emergencies (diabetic ketoacidosis and hyperosmolar non-ketotic coma (Honk)) accounted for 18.7% of the total admissions. The overall mortality rate was 8.1%. HONK was the commonest cause of death accounting for 24.2% of the total deaths recorded. The mortality rate of diabetic ketoacidosis was 10.3%, while for HONK it was 30.3%. DM is an important cause of morbidity and mortality in Uyo. Adequate health/diabetic education needs to be given to diabetic patients to enable them take care of their illness to prevent the poor outcome associated with the disease.      Key words: Outcome, morbidity, mortality, diabetes, Uyo.

The effect of administration of honey and fanta drink on the histopathology of male and female wistar albino rats was studied. This current study was carried out to determine the possible changes in the histopathology of the male and female wistar rats after honey and fanta drink administration.. Thirty wistar albino rats, 13 females and 17 males were used. These were divided into 3 groups as follows: (a) A control group which was given rat feed and water, (b) rats given rat feed plus fanta drink and water (c) rats given rat feed, water, and 17.0g/kg body weight pure honey.The results showed a healthier mucosa of the stomach in the male and female wistar rat fed with honey. However, the lungs, ileum, ovary and testis had no significant changes, although these organs in the rats were all seen to be in healthy conditions. No necrosis was observed in the kidneys, there was also a small fatty change observed in the liver of the male wistar rat which fed on honey. The intake of honey, and fanta drink in this study had no negative effect on the histopathology of the male and female wistar albino rats, although honey had a more positive result. A more significant result may be seen if honey, and fanta drink administration lasts longer than five weeks.

Background: Diabetic patients are prone to obstructive sleep apnea (OSAS). OSAS has also been shown to be associated with increased cardiovascular morbidity and mortality. There is a paucity of data on this condition among diabetics in Nigeria. This study was carried out to determine the risk of OSAS among diabetics in Nigeria. Methods: Diabetics attending the medical outpatient clinic of a tertiary hospital in South Eastern Nigeria were recruited into this survey. A modified version of the Berlin Questionnaire was used to determine the risk for OSAS and also obtain demographic data. Anthropometric and spirometric measurements were also obtained from all subjects. The survey was conducted over a 4 months. Results: 114 diabetics were randomly recruited for this survey, 54 (47.4%) female sand 60 (52.6%) males. 66 (57.9%) of the subjects were hypertensive. The average age of the subjects was 55.5 years and the average duration of diabetes was 7.5 years. 63(55.3%) of the subjects were found to have a high risk for OSAS. there was no gender difference in the risk for OSAS. A high risk for OSAS was associated with increased BMI, increased neck size, hypertension, alcohol use and reduced PEF. The factors that significantly predicted a high risk for OSAS were a history of hypertension (OR 55), alcohol use (OR 9), increasing BMI (OR 2) and poor BP control (OR 2). Conclusion: OSAS is often not diagnosed among patients with diabetes and the strong association between a previous history of hypertension and OSAS may be the reason for the increased risk of cardiovascular death among diabetics.

OBJECTIVE:The objective of the study was to assess the public health burden of hypertension in the rural communities in southeastern Nigeria (Niger Delta region of Nigeria).DESIGN/SETTING:The study was a cross-sectional study in three rural communities in the Cross River and Akwa Ibom States of Nigeria. Demographic, anthropometric information, prior history of hypertension or stroke in each participant or their parents was obtained with a questionnaire. Height, weight, systolic blood pressure (SBP), and diastolic blood pressure (DBP) of respondents were measured by standard methods, and body mass index calculated.RESULT:The N of respondents was 3869; 1608 (41.6%) males, 2261 (58.4%) females; 1120 (29.0%) Efiks, 1877 (48.5%) Ibibio/Annangs, and 872 (22.5%) Obolos. Mean SBP and DBP were significantly higher in males than in females (P < .001). Prior awareness of hypertension was 2.8%. The overall prevalence of hypertension was 914 (23.6%); 31.2% males and 18.1% females (P < .001). The prevalence of hypertension in the ethnic groups was 479 (25.5%) among Ibibio/Annangs; 287 (25.6%) among the Efiks and 130 (14.9%) among the Obolos. Prehypertension occurred in 17.2% of total population, 17.5% males and 16.9% females (P = .66).CONCLUSION:Hypertension is already a major public health burden in rural communities of these two states, despite a very low incidence of obesity and cigarette smoking.

Introduction: Toxic effects of air pollution can lead to psychiatric symptoms such as anxiety and changes in mood and behaviour. Objectives: To examine the relationship between anxiety and depression with exposure to indoor air pollution and respiratory symptoms. Methods: 521 fishermen and women from a fishing community in the Niger Delta region of Nigeria who were chronically exposed to firewood smoke completed the Hospital Anxiety and Depression Scale (HADS) and a modified British Medical Research Council Questionnaire (BMRC) for other respiratory symptoms. Lung volumes were measured with a spirometer. Results: 71 (13.6%) subjects had symptoms of anxiety while 72 (13.8%) had depression and 53 (10.2%) had a combination of anxiety and depression. Anxiety symptoms was significantly more common among women. Symptoms of anxiety and depression were significantly more common among subjects with airway obstruction and subjects with chronic bronchitis. There was no significant association between symptoms of anxiety and depression and age. HADS scores correlated significantly with levels of exposure to indoor air pollution. Conclusion: Symptoms of anxiety and depression are common among people with long term exposure to indoor air pollution and they usually go undiagnosed due to low accessibility to proper health facilities. They should be routinely screened for psychiatric morbidities.