University of Uyo Teaching Hospital

Introduction: Ovarian teratomas are ovarian tumors that originate from primordial germ cells. Struma ovarii (SO) is a very rare specialized monodermal variant of the mature cystic teratoma, which consists exclusively or predominantly of mature thyroid tissue and occurs most commonly in premenopausal women. Case Report: We hereby report the rare case of a 70-year-old postmenopausal woman who presented with vaginal bleeding and abdominal distention 20 years after the menopause. She was found to have a huge uterine mass, hemorrhagic ascites, and a left adnexal cystic mass with solid areas mimicking a malignancy. Histological analysis of the surgical specimens confirmed a SO coexisting with recurrent uterine fibroids. She had a total abdominal hysterectomy and bilateral salpingo-oophorectomy with a good outcome. Conclusion: Benign SO, a very rare variety of specialized monodermal teratomas, can coexist with ascites and large recurrent uterine fibroids several years after menopause, mimicking malignancy. Timely diagnosis and excision of both tumors via an abdominal hysterectomy and bilateral salpingo-oophorectomy resulted in a good outcome in our patient.

<b>Background</b><br /> Data from studies evaluating lung functions in individuals exposed to fumes generated during the preparation of roasted food items is lacking in the Nigerian setting. We aimed to evaluate the ventilatory functions of participants with direct exposure to smoke from roasted food and compared the findings with their counterparts (controls).<br /> <b>Methods</b><br /> We conducted a cross-sectional comparative study involving food vendors (cases) of smoked food and workers (controls) operating in the same vicinity but not directly exposed to the smoke. A spirometer was used to measure the forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEFR). Thereafter, the percentage predicted FEV1, FVC, and FEV1/FVC indices were used to determine ventilatory impairment in both cases and controls.<br /> <b>Results </b><br /> A total of 600 participants were enrolled, of which half (50.0%) were cases while the remaining 50.0% were in the control group. Respiratory symptoms such as coughing and wheezing, and the duration of presentation were higher in cases compared with the controls, with a statistically significant difference; <i>p</i> = 0.003, <i>p</i> = 0.001 and <i>p</i> = 0.011, respectively. In addition, impaired ventilatory functions were significantly higher in the cases compared with the controls (<i>p</i> <0.001). Similarly, a significant proportion of the food vendors with ≥ 5 years of exposure had obstructive and mixed patterns of lung defects and a lesser proportion with normal lung functions compared with those with < 5 years of exposure (<i>p</i> = 0.009). Likewise, the mean FEV1 (<i>p</i> <0.001), FVC (<i>p</i> <0.001), and PEFR (<i>p</i> = 0.005) were significantly higher in controls compared with cases.<br /> <b>Conclusion</b><br /> The direct exposure of food vendors to smoke may impair lung function. Driving awareness of this occupational hazard is very crucial as it is a common source of livelihood in the Nigerian setting.

To evaluate the impact of the coronavirus disease 2019 (COVID-19) lockdown on the demographic and clinical profile of patients presenting with ocular trauma. A retrospective comparative cross-sectional study of ocular trauma patients managed in the emergency department (ED) from 26 March 2020 to 31 June 2020 and the similar period in 2019. The differences in patients' data (age, presenting visual acuity, mechanism of injury, location of injury, class of trauma, presentation time post-injury and ocular interventions) were compared. There were 50 trauma patients pre-COVID-19 and 83 patients at lockdown with a trauma prevalence of 1.2% and 2.0%, respectively. The mean age of patients was 21.7 ± 18.8 and 21.1 ± 13.9 years pre-COVID-19 and at lockdown (P = 0.084). During lockdown, the proportion of children with eye injuries decreased from 58% to 50%, also patients with presenting visual acuity worse than 6/60 decreased from 70% to 60.3%. Regarding the mechanism of trauma, there was an increase in the percentage of domestic injuries, vegetative matter implicated and open globe injury (respectively from 44% to 62.7%, from 16% to 32.5% and from 36% to 41%). Injury-to-treatment time was longer during the lockdown. Presentation to the ED within 24 hours of injury reduced to 28.9% from 44% (P = 0.035). More patients (59%) were managed conservatively at lockdown compared to 46% pre-COVID-19 (P = 0.004). The number and prevalence of ocular injuries increased during the COVID-19 lockdown. Injuries were more severe, mainly domestic and vegetative matter was most implicated. Patients presented later to the hospital and were mostly managed conservatively during the lockdown.

ObjectiveTo assess the rate and identify risk factors for proliferative vitreoretinopathy (PVR) in Nigerian patients with rhegmatogenous retinal detachment (RRD).Methods and analysisMulticenter, prospective, cross-sectional study of consecutive RRD patients attending four ophthalmic clinics, recruited over a period of twelve months. Biodata, presenting complaints, symptom duration, best corrected visual acuity, extent of RRD, status of macular attachment, presence, and grade of PVR and fellow eye were assessed. Data was analyzed using SPSS version 22 (Pearson Chi-Square test, Mann-Whitney U test, Fisher’s Exact test, and logistic regression analysis).Results154 of 174 eyes with RRD were included in the final analysis, and 53/154 (34.4%) developed PVR. Twenty eyes (11.5%) had media opacity, and detailed retinal examination was not possible (diagnosed via B-scan ultrasound). 154 RRD was analyzed. Therefore, the rate of all PVR was53/154 (34.4%). Grades of PVR: Grade D: 27 eyes (50.9%), Grade C: 19 eyes (35.9%), Grade B: 5 eyes (9.4%), and Grade A: 2 eyes (3.8%). The rate of advanced PVR grades D + C is 46/154 (29.8%). Forty-six of 53 PVR eyes (86.6%) had vision 3/60 or less (p < 0.001). Risk factors associated with PVR were extremes of age, i.e., < 25 and >66 years (especially older age (>66 years)), previous intraocular surgery, longer symptom duration, and RD features including 4-quadrant involvement, total RD, macular involvement by RD, and presence of fellow eye RD. Gender, Myopia, and trauma were not risks for PVR.ConclusionPrevious reports of PVR rates in Nigerians may have been underestimated. A multi-pronged approach, including research into adjuvant pharmacotherapy, can reduce PVR rates and improve treatment outcomes.

To estimate the prevalence, describe causes and prescription needs of functional low vision (FLV) patients, and highlight the barriers these patients encounter to the uptake of multidisciplinary low vision rehabilitation (LVR) service. A mixed study design was adopted. Quantitative analysis consisted of a retrospective and cross-sectional review of 241 (FLV) patients managed at the National Eye Centre, Kaduna. Relevant data extracted from patient records were age, sex, occupation, best-corrected visual acuity, cause of low vision and low vision aids or rehabilitation prescribed. Qualitatively, 45 FLV patients were selected by systematic random sampling. Patient barriers to the uptake of LVR services were elicited through one-on-one interviews. The prevalence of FLV was 1.02% (95% confidence interval: 0.98-1.06). The mean age was 44.45 ± 20 years. One hundred and forty two (59%) were above 40 years old and 60.5% were unemployed. Major causes of FLV were glaucoma (31%), age-related macular degeneration (24%) and retinitis pigmentosa (12%). Prescription needs were magnifiers (29%), non-optical (23%) low vision aids, telescopes (17%), multiple aids (15%) and visual rehabilitation (28%). The uptake of LVRs was 67%. The most common barriers to LVR uptake were the cost of the device (97%), lack of family support (90%) and hesitancy using the device (84%). FLV was caused by progressively worsening diseases like glaucoma. The major patient barrier to assessing a multidisciplinary LVR service was financial constraint.

Dengue fever remains a significant public health concern, especially in low- and middle-income countries (LMICs) like Nigeria, where its prevalence is driven by a combination of socioeconomic and environmental factors. This study explores the application of machine learning (ML) techniques to enhance the diagnosis of dengue fever, with a focus on rule-based classifiers to provide greater transparency and interpretability in medical decision-making. The dataset comprised over 4,800 patient records obtained from secondary and tertiary healthcare facilities in the Niger Delta region of Nigeria, with contributions from 62 experienced physicians specializing in febrile illnesses. Two rule-based classifiers, RIPPER and PART, were employed to assess their effectiveness in predicting dengue fever cases using causative data. Both models demonstrated similar performance in accuracy, sensitivity and precision indicating their strength in accurately identifying true dengue cases, which is critical for timely intervention and treatment. This study will benefit the different public stakeholders as it underscores the potential of rule-based ML models to improve the accuracy of dengue fever diagnoses in LMICs, enhancing public health efforts and optimizing resource allocation in poorer African regions where dengue is endemic.

The rising cost of conventional antibiotics and the evolution of resistant microbial strains promote the search for effective and cheap novel plant-based antibiotic substitutes. Based on the foregoing, a study was carried out to investigate the antibacterial activity of the ethanolic leaf extracts of giant African Mistletoe (Phragmenthera capitata) growing on five different host trees against Escherichia coli and Staphylococcus aureus. Fresh leaves of Mistletoe were collected from specific host trees in peri-urban locations within Eket Local Government Area in Akwa Ibom State, Nigeria. The leaves were air-dried, pulverized, Macerated and Extracted using standard scientific protocol. Results indicated significant differences in antibacterial activity among mistletoe extracts from different host trees. The extract from C. sinensis exhibited the highest inhibition zones (4.33 mm for S. aureus and 11.33 mm for E. coli), while mistletoe from C. nitida had the least inhibition (2.67 mm and 3.33 mm, respectively). Phytochemical analysis revealed variations in secondary metabolite composition across host sources, with alkaloids present only in mistletoe from C. sinensis. These findings confirm that host diversity influences the antibacterial potency of P. capitata, supporting its ethnomedicinal use as a potential source of bioactive compounds for antimicrobial applications. However, this study recommends that future research efforts should be geared towards isolating the key bioactive compounds driving variations in antibacterial activity, exploring their mechanisms of action, and evaluating their potential for pharmaceutical applications.

Background: Public urination is a widespread sanitation challenge and public health concern with global occurrence and regional variation. Despite its prevalence, empirical data on its determinants and public attitudes remain limited, particularly in low-resource settings. This study aimed to assess the prevalence of public urination, examine public attitudes toward the practice, and identify socio-demographic and behavioural predictors of public urination among adults in Uyo, Nigeria. Methods: A descriptive cross-sectional study was conducted among 361 adults attending the General Outpatient Clinic at the University of Uyo Teaching Hospital, Nigeria, between September 1 and October 31, 2019. Data were collected using a structured questionnaire and analysed using Statistical Package for the Social Sciences (SPSS) Statistics version 17.0. Descriptive statistics summarized socio-demographic and behavioural characteristics and urination practices, while chi-square tests assessed associations between categorical variables. Statistical significance was set at p-value &lt;0.05. Logistic regression was employed to determine independent predictors of public urination and attitudes toward the practice, adjusting for potential confounders. Odds ratios and 95% confidence intervals were generated. Results: Public urination was highly prevalent, with 78.7% of respondents reporting the behaviour in the past six months. The most cited reasons for public urination were poor sanitary conditions of available toilets (46.8%) and the absence of public toilets (39.4%). A negative attitude toward public urination was reported by 80.9% of respondents, with women significantly more likely than men to disapprove of the practice (86.7% vs. 71.8%, p=0.001). In multivariable analysis, women were twice as likely as men to have a negative attitude toward public urination (aOR=2.00, 95% CI: 1.11–3.67, p=0.02), while rural residents had lower odds of negative attitudes compared to urban residents (aOR=0.45, 95% CI: 0.22–0.75, p=0.004). Employment in the private sector was associated with a higher likelihood of public urination (aOR=2.10, 95% CI: 1.10–3.90, p=0.02). Conversely, being married (aOR=0.48, 95% CI: 0.26–0.90, p=0.02) and having a negative perception of public urination (aOR=0.27, 95% CI: 0.10–0.71, p=0.008) were associated with lower odds of engaging in the behaviour. Conclusion: Public urination is a common practice in the study area, largely driven by inadequate sanitation infrastructure. While public disapproval of the behaviour is high, systemic barriers contribute to its persistence. Addressing this issue requires investment in public sanitation facilities, policy enforcement, and behavioural interventions to promote proper hygiene practices.

Background: The names that have been used for asystem offering histopathology, cytopathology, andautopsy services vary and include anatomicpathology, histopathology, morbid anatomy, andpathology. In 2016, we recommended the label'Anatomic Pathology' as the most appropriate name.This study aims to review the impact of ouradvocacy on the nomenclature of the discipline ofanatomic pathology government tertiaryinstitutions across Nigeria from 2016 to 2024. Methodology: In June 2024, we collated the namesgiven to the pathology departments that undertakethe services of histology, cytology, and autopsy aswas done in 2016. The data was analysed using theIBM SPSS (International Business MachinesCorporation, Statistical Product and ServiceSolutions) version 2022. The data obtained in 2024was compared with that of 2016 using chi squaretest. Results: Histopathology was the terminology usedby the highest number of institutions in both 2016(13; 40.6%) and 2024 (31; 50.0%). The mostimproved nomenclature was Anatomic Pathology,growing from 5(15.6%) to 19(30.6%) institutionsrespectively in 2016 and 2024. Anatomic Pathologywas the least favoured nomenclature in 2016 and thesecond most favoured in 2024. There was howeverno statistical significance of this change in the use ofthis terminology across geopolitical regions(anatomic pathology p = 0.734, histopathology p =0.503, morbid anatomy p = 0.545, and pathology p =0.686) or the years under study (p = 0.078). Conclusion: The advocacy for the use of 'AnatomicPathology' as the proper term for the laboratoriesoffering cytopathology, histopathology, and autopsyis a step in the right direction. This designation inaddition to being representative offers an expansionroom for accommodating the ever-dynamic field ofsurgical pathology in tandem with advancements inthe modern era.

BackgroundThe ability of people with diabetes to perform diabetes self-care activities may influence treatment outcomes.ObjectivesTo evaluate diabetes management self-efficacy (DMSE) and short-term glycaemic control among people with type 2 diabetes (PWT2D).MethodsThis was a cross-sectional survey of 238 PWT2D at the University of Uyo Teaching Hospital, Nigeria. DMSE was assessed using the Diabetes Management Self-Efficacy Scale—UK version (DMSES UK). Glycaemic control was assessed with fasting blood glucose (FBG). Data were analysed using SPSS v.25.0.ResultsThe median (IQR) self-efficacy score was 115 (91–125) out of 150. DMSE was highest for blood/urine sugar testing, hypoglycaemia correction, feet examination, and medication taking (median score = 10 out of 10). Only 6.3% and 11.3% of participants, respectively, reported high self-efficacy for adjusting their eating pattern/plan when stressed/anxious or when exercising more. The mean FBG was 8.5 ± 4.3 mmol/L, with 45% of participants having good glycaemic control (4.4–7.2 mmol/L). Participants’ sex (p = 0.001) and education (p = 0.031) were significantly associated with DMSE. DMSE showed a negative correlation with FBG (rs = − 0.68, p < 0.001).ConclusionEfforts to promote self-efficacy in healthy eating in various situations may improve glycaemic control in PWT2D, especially women and those with low levels of education.