University of Port Harcourt Teaching Hospital

The regulation of lipid pathways throughout gestation significantly impacts foetal maturation, neonatal health, and the future cardiovascular risks faced by the mother. Both fatty acids and cholesterol serve as essential building blocks for healthy foetal growth. During a typical pregnancy, women undergo a sequence of metabolic shifts that modify their lipid profiles. The early stages are primarily anabolic, focusing on increasing lipid production and building adipose reserves to prepare for the high energy requirements of the foetus later in the term. By the third trimester, maternal physiology pivots to a catabolic state to break down these fat stores. This transition ensures a steady supply of nutrients for the growing foetus. In standard pregnancies, these adjustments typically manifest as a 50% rise in total cholesterol, a 30-40% increase in LDL, a 25% boost in HDL, and a doubling or tripling of triglyceride concentrations. However, disruptions in these lipid processes are closely linked to negative health outcomes for both mother and child. Research indicates a clear relationship between lipid imbalances (dyslipidaemia) and complications during the perinatal period or within the uterine environment. Furthermore, the theory of "developmental programming" suggests that the lipid conditions encountered in utero can dictate a child’s lifelong vulnerability to chronic illness. Because of these significant risks, it is critical to screen for lipid irregularities before conception. If pre-pregnancy data is missing, clinicians should prioritize screening during the first prenatal visit. Managing abnormal profiles requires consistent tracking and a multi-pronged strategy centred on nutritional changes, physical activity, and weight management. Although medication carries potential foetal risks, current evidence supports the use of carefully monitored, risk-adjusted pharmacological therapies for severe cases.

The introduction of significantly shorter, all-oral regimens has significantly shifted the management of drug-resistant tuberculosis (DR-TB) towards a more tolerable and patient-centred therapeutic approach that aims to enhance treatment adherence, clinical outcomes, and quality of life among patients. Nigeria has gradually adopted this all-oral, shorter regimen, but the impact of this regimen in programmatic settings has not yet been studied. In 2022, a longitudinal, two-armed cohort study was conducted to explore the effectiveness, safety, and feasibility of the all-oral shorter regimen in the programmatic management of RR/MDR-TB in Nigeria. Consenting and eligible RR/MDR-TB patients receiving the all-oral regimen (intervention group) in four states were consecutively enrolled and compared to those receiving the standard of care (SOC). Treatment effectiveness, proportion, and 95% confidence intervals of favourable and unfavourable outcomes were measured at the end of treatment and during follow-up (six and 12 months post-treatment). In total 383 Participants were followed monthly throughout the 9-12-month treatment phase and then reassessed at 6 and 12 months after treatment completion, giving a total possible observation period of up to 24 months (185 received the intervention and 198 the standard of care). At the end of follow-up, there was a higher but non-significant proportion of favourable outcomes among the intervention vs. SOC group (80% vs. 69.7%); a higher proportion of favourable outcomes was also noted at the end of treatment among intervention participants (81.1 vs. 76.8%). Around one third of patients reported at least one serious adverse event (SAE), with no significant differences between arms, and none were deemed related to the use of medication. Intervention participants reported greater improvements in health-related quality of life between baseline and four months compared to those receiving the SOC. These findings support the programmatic use of all-oral shorter treatment for RR/MDR-TB as a regimen that is effective, tolerable, safe, and associated with enhanced health-related quality of life for patients in Nigeria.

Aims: to assess the influence of shade tabs placement position on accuracy of tooth shade determination and to compare the shade selection ability of dental students, dental surgery technicians (DSTs), registrars and senior registrars (SRs). Study Design: Cross-sectional Place and Duration of Study: Department of Restorative Dentistry, University of Port Harcourt Teaching Hospital, between December 2005 and January 2026 Methodology: Six participants each from among: dental students, DSTs, registrars and SRs were requested to match shade A1, B2 and C2 in a bench setting using vita Classical. They were divided into two groups, A & B. In group A, the shade tab being matched is placed by the side of the reference shade tab on the shade guide while in group B the shade tab is placed parallel and close to the edge of the chosen shade tab. The percentage of correct response for each shade and the median for each group were obtained. The median (IQR) was compared between the two groups (Mann-Whitney t-test). P was set at 0.05. Results: Two students in group A and none in group B correctly identified shade A1. One student in group A identified each of B2 and C2. Two DSTs (66.67%) in group A and 1 in group B, identified shade A1. One DST in group A identified shade B2. Two registrars in group B identified shade A1 and two in group A identified B2. In group B, all the SRs identified shade A1 and one identified shade B2. In group A, 1 identified C2 correctly. There was no statistically significant difference in the median percent score of correct response between the groups (P=0.378). Conclusion: Shade tab placement position did not make a statistically significant impact on the final results. The students and SRs performed better in group A and B respectively.

Breast cancer is the leading cancer among Nigerian women and is commonly diagnosed at an advanced stage; yet the everyday realities that influence patient outcomes and well-being remain underexplored. Understanding the lived experiences of Nigerian breast cancer patients is critical for developing culturally appropriate, supportive, and palliative care services. To explore the lived experiences, needs and coping strategies of women living with and beyond breast cancer in Nigeria. Qualitative study using a constructivist-interpretivist paradigm. Semi-structured, in-depth interviews were conducted online via Microsoft Teams, audio and/or video-recorded, and transcribed verbatim. Data were analysed inductively using the Framework Method, with double coding to ensure rigour. Twenty-eight women (aged 29-63years; mean 42years) receiving care at two oncology centres were purposively sampled between June 2024 and March 2025. Most had stage II or III disease and had lived with cancer for at least 6-12months. Four inter-linked themes described the women's experiences: (1) "For several months, I saw myself like a ghost amongst people"-emotional, physical, economic and social upheaval following diagnosis; (2) "But I have to talk to myself, I need to encourage myself to keep going"-personal, spiritual and peer-based coping resources; (3) "I just know that there should be a lot more awareness" of the care continuum-structural, financial and informational barriers, including catastrophic out-of-pocket costs and fragmented care pathways; (4) "It is the emotional trauma"-reframing illness, personal growth and an expressed desire to support other patients. Across the themes, women stressed unmet psychosocial needs, reliance on faith communities, and the paucity of formal peer-support or counselling services. Participants reported navigating a complex interplay of financial toxicity, systemic delays, and profound psychosocial distress, and many described drawing on spiritual practices, self-encouragement, and peer connections to cope; several also expressed a desire to support other women by sharing advice or lived experience while going through the care pathway. Strengthening palliative and supportive care in Nigeria should prioritise: (1) financial-protection mechanisms to reduce treatment abandonment; (2) streamlined referral/navigation systems; and (3) integrated psychosocial and peer-support interventions that acknowledge spiritual coping. Further research should investigate survivor-led support models and assess the effectiveness of culturally tailored communication training for oncology teams.

An antimicrobial stewardship programme (AMS) aims to combat antimicrobial resistance and healthcare-associated infections (HCAIs). While studies in developed countries show AMS's effectiveness in reducing AMR and HCAIs, its impact in African countries, given differing socioeconomics, remains unclear. To review the impact of AMS on HCAIs, antibiotic prescriptions, cost of antimicrobial procurement, and compliance with diagnostic measures for detecting resistant HCAIs in African countries. Two reviewers (S.S. and U.C.) searched databases like CINAHL, Medline, and PubMed for studies on AMS interventions in African countries, focussing on their impact on healthcare-associated infections (HCAIs) and antibiotic prescriptions. We excluded studies on outpatients, children, or those not in English and conducted a meta-analysis using data collected from changes in HCAIs before and after intervention using a random-effects model. The search identified 1153 studies, of which 14 were included in the review, while four eligible studies were included in the meta-analysis. Thirteen of the 14 studies were designed using pre- and post-study methods, and one study employed a case-control method. AMS interventions effectively reduce antibiotic consumption, the cost of antibiotic procurement, and improve diagnostic measures for the detection of resistant microorganisms. The forest plot suggested a 34% reduction in HCAIs. In Africa, AMS interventions, whether combined or single, reduce HCAIs and antibiotic prescriptions in healthcare settings. Surgical antibiotic prophylaxis lowers HCAIs in hospitals by one-third. However, findings are cautiously generalised due to the varied quality of studies and the limited number of African countries involved.

Background: Obstructive sleep apnea (OSA) affects approximately 1 billion adults globally, yet remains underdiagnosed, particularly in resource-limited settings. Physician knowledge and practice patterns are critical determinants of detection rates. This study assessed the knowledge, attitude, and practice (KAP) of physicians regarding OSA in two tertiary institutions in Nigeria. Methods: A cross-sectional survey was conducted among 73 physicians at the University of Port Harcourt Teaching Hospital and Rivers State University Teaching Hospital between April and September 2025. A Structured Questionnaire assessed OSA knowledge (symptoms, risk factors, diagnostics), attitudes toward screening, and clinical practice patterns. Descriptive statistics and chi-square tests were used for analysis. Results: Among 73 respondents (General Practice 31.5%, Internal Medicine 24.7%, other specialties. 43.8%), 95.9% had heard of OSA, but only 63.0% correctly identified polysomnography as the gold standard diagnostic test. While 60.3% rated their awareness as Good or better, only 16.4% received formal OSA training, and merely 6.8% felt adequately trained to manage OSA patients. Despite this, 84.9% expressed interest in continuing medical education (CME). Only 28.8% routinely or occasionally screened for OSA, and 35.6% had ever made an OSA diagnosis. The predominant challenges were lack of patient awareness (31.5%), limited access to sleep laboratories (26.0%), and lack of physician training (24.7%). Notably, 82.2% believed OSA is underdiagnosed, and 87.7% considered screening Very or Extremely important. Conclusion: Significant knowledge-practice gaps. exist among physicians regarding OSA. While awareness is moderate, formal training is severely lacking, resulting in suboptimal screening and diagnostic practices. The high interest in CME suggests that structured educational interventions could substantially improve OSA detection and management in similar settings.