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Pattern of Referral of Obstetric Patients at a Tertiary Care Hospital in Southern Nigeria

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Advances in Reproductive Sciences 2024年第2期12卷 116-124页

作者： Osita Celestine John justina Omoikhefe Alegbeleye Department of Obstetrics and Gynaecology Faculty of Clinical Sciences University of Port Harcourt Port Harcourt Nigeria

Background: Health challenges that are difficult to manage at primary health centres should be referred to secondary health facilities, and if untreated, to the tertiary hospitals. A good referral should include the patient’s biography, such as age, gender, tribe, religion, occupation, medical history, the reason for the referral, treatments received, and clinical diagnosis. Objectives: To evaluate the referral patterns, indications for referrals, and feto-maternal outcomes for obstetric patients who were referred to the University of Port Harcourt Teaching Hospital. Materials and Methods: A prospective study of patients admitted to the Obstetric unit from January 1, 2021, to December 31, 2022. Data was collected from patients while on admission or clinic visits and recorded in an excel spread sheet. Data was analyzed with the Statistical Package for Social Sciences (SPSS) version 25. Results: Of the 3469 patients were admitted to the obstetric unit, 1476 and 1993 were admitted in 2021 and 2022, respectively. Most (70.35%) of the patients were in the 20-34 years age group, parity 1-4 was the most frequent (66.49%), while 85.39% of patients were booked. 10.46% of the booked patients were referred from other facilities, whereas 89.54% of patients were booked at our facility from the onset. Most common indications of referrals were previous caesarean section (CS) at term (40.09%) and hypertensive disorders of pregnancy (17.59%). The outcome for 2021 indicated 17 maternal deaths, 132 fetal deaths and 1010 live births, giving maternal mortality ratio (MMR) as 1810.44 per 100,000 live births and perinatal mortality ratio (PMR) of 130.7 per 1000 births respectively. In 2022, there were 17 maternal deaths, 130 fetal deaths and 1297 deliveries, giving a MMR of 1399 per 100,000 live births and a PMR of 100.2 per 1000 births. Conclusion: The pattern of referral among obstetric patients in this study shows that a lot of the patients do not get adequate care at the lower cadre o

关键词： Referral Pattern Obstetrics Southern Nigeria

Eclampsia: A Continuous Scourge in a Tertiary Hospital in Southern Nigeria

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 209-225页

作者： Celestine Osita John justina Omoikhefe Alegbeleye Department of Obstetrics and Gynaecology Faculty of Clinical Sciences University of Port Harcourt Port Harcourt Nigeria

Background: Eclampsia is responsible for over 50,000 maternal deaths with incidence of 1 death in about 100 - 1500 deliveries in developing nations. In sub-Saharan Africa, Nigeria accounts for the highest maternal mortality ratio of 512 deaths per 100,000 live deliveries and the highest neonatal fatality of 67 per 1000 live births. Factors such young age, nulliparity, multifetal gestation, unbooked cases, preterm delivery (<32 weeks), lack of proper access to antenatal care, poor hospital care, financial constraints and inappropriate diagnosis, have all been identified as risk factors promoting eclampsia. Objectives: In this study, we investigated the prevalence of eclampsia in Rivers State, Nigeria and established the correlation between social demographic factors and the feto-maternal outcomes among the eclampsia patients. Methodology: A prospective observational study using a detailed data sheet was conducted on 1244 pregnant women admitted at the Obstetrics and Gynecology Department of University of Port Harcourt Teaching Hospital, for 1-year duration. Data analysis was conducted using statistical packages for social sciences (SPSS) version 22. Results: Demography showed that age range (20 - 24) occurred in 40.7%, nulliparous mothers were dominant with 40.7% while 70.1% of the study population had secondary level of education. 27 cases of eclampsia were diagnosed from the 1244 pregnant women, which signified 2.13% prevalence among the studied population. The feto-maternal outcome showed that out of the 27 mothers, 19 were alive (70.4%) while 8 died (29.6%), while fetal outcome showed that 16 were alive (59.3%) and 11 died (40.7%). Only parity and education showed significant correlation at 0.01 and 0.05 levels respectively with maternal outcome. Conclusion: The prevalence of eclampsia with associated poor feto-maternal outcome rates is high in this study. Its contribution to the maternal and perinatal morbidities and mortalities necessitates the narrative of ecl

关键词： Eclampsia Preeclampsia Prevalence Maternal Fetal Mortality Booked Un-booked

The Effect of Uterine Artery Occlusion with Tourniquet on Ovarian Reserve during Open Myomectomy at a University Teaching Hospital in Southern Nigeria

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Advances in Reproductive Sciences 2024年第1期12卷 37-50页

作者： William Amebeobari Mube justina Omoikhefe Alegbeleye Ngozi Clare Orazulike Department of Obstetrics and Gynaecology University of Port Harcourt Teaching Hospital Rivers State Port Harcourt Nigeria

Background: The most common surgical treatment for symptomatic uterine fibroids, particularly in women with fertility concerns, is open myomectomy. Given the high vascularity of the uterus, haemorrhage during the procedure is a serious risk that is often mitigated with a uterine tourniquet. Aim and Objectives: To evaluate the effect of uterine artery occlusion with a tourniquet during open myomectomy on ovarian reserve using serial anti-Mullerian hormone (AMH) measurements. Materials and Methods: This was a prospective longitudinal study with a quasi-experimental design and a convenient sampling technique. The study enrolled 47 women who had abdominal myomectomy between September 1, 2021, and March 31, 2022, at the University of Port Harcourt Teaching Hospital. Blood samples were collected before anaesthesia was administered in theatre, on day two, and three months after open abdominal myomectomy for anti-Mullerian hormone assay. The data was collected using a semi-structured proforma, entered into an Excel spreadsheet, and analyzed using SPSS version 25.0 with a 95% confidence interval. Statistical significance level was set at 0.05. Results: The pre-surgery AMH mean value was 1.67 ± 1.44 ng/ml, while the values after using a uterine tourniquet at myomectomy on the second day and three months later were 1.22 ± 1.24 ng/ml and 1.59 ± 1.43 ng/ml, respectively. There was no statistically significant change in AMH levels, and there was no statistically significant relationship between blood loss and tourniquet time and AMH after open abdominal myomectomy. Conclusion: The use of a uterine tourniquet and blood loss during open myomectomy has no effect on ovarian reserve.

关键词： Uterine Tourniquet Open Abdominal Myomectomy Ovarian Reserve Anti-Mullerian Hormone Nigeria

An AI-empowered indoor digital contact tracing system for COVID-19 outbreaks in residential care homes

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Infectious Disease Modelling 2024年第2期9卷 474-482页

作者： Jiahui Meng justina Yat Wa Liu Lin Yang Man Sing Wong Hilda Tsang Boyu Yu Jincheng Yu Freddy Man-Hin Lam Daihai He Lei Yang Yan Li Gilman Kit-Hang Siu Stefanos Tyrovolas Yao Jie Xie David Man David H.K.Shum School of Nursing The Hong Kong Polytechnic UniversityHong Kong Special Administrative RegionChina Electronic and Information Engineering The Hong Kong Polytechnic UniversityHong Kong Special Administrative RegionChina Research Centre of Textiles for Future Fashion The Hong Kong Polytechnic UniversityHong Kong Special Administrative RegionChina Department of Land Surveying and Geo-Informatics The Hong Kong Polytechnic UniversityHong Kong Special Administrative RegionChina Department of Applied Mathematics The Hong Kong Polytechnic UniversityHong Kong Special Administrative RegionChina The Jockey Club School of Public Health and Primary Care The Chinese University of Hong KongHong Kong Special Administrative RegionChina Department of Rehabilitation Sciences The Hong Kong Polytechnic UniversityHong Kong Special Administrative RegionChina Department of Computing The Hong Kong Polytechnic UniversityHong Kong Special Administrative RegionChina Department of Health Technology and Informatics The Hong Kong Polytechnic UniversityHong Kong Special Administrative RegionChina Department of Nutrition and Food Studies George Mason UniversityUSA Tung Wah College Hong Kong Special Administrative RegionChina Mental Health Research Centre The Hong Kong Polytechnic UniversityHong Kong Special Administrative RegionChina

An AI-empowered indoor digital contact-tracing system was developed using a centralized architecture and advanced low-energy Bluetooth technologies for indoor positioning,with careful preservation of privacy and data *** analyzed the contact pattern data from two RCHs and investigated a COVID-19 outbreak in one study *** evaluate the effectiveness of the system in containing outbreaks with minimal contacts under quarantine,a simulation study was conducted to compare the impact of different quarantine strategies on outbreak containment within *** significant difference in contact hours between weekdays and weekends was observed for some pairs of RCH residents and staff during the two-week data collection *** significant difference between secondary cases and uninfected contacts was observed in a COVID-19 outbreak in terms of their demographics and contact *** results based on the collected contact data indicated that a threshold of accumulative contact hours one or two days prior to diagnosis of the index case could dramatically increase the efficiency of outbreak containment within RCHs by targeted isolation of the close *** study demonstrated the feasibility and efficiency of employing an AI-empowered system in indoor digital contact tracing of outbreaks in RCHs in the post-pandemic era.

关键词： COVID-19 Indoor contact tracing Contact pattern Outbreak containment Artificial intelligence

Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States

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World Journal of Gastroenterology 2011年第12期17卷 1600-1605页

作者： Geoffrey C Nguyen justina Sam Nitasha Anand Mount Sinai Hospital Division of Gastroenterology University of Toronto Faculty of MedicineTorontoOntario M5G 1X5Canada Division of Gastroenterology and Hepatology Johns Hopkins University School of MedicineBaltimoreMD 21205United States

AIM:To characterize the increasing incidence and geographic variation of acute ***:Using the nationwide inpatient sample (NIS) we identified a cohort who had been admitted with diverticulitis between 1998 and *** calculated age-,sex-,and region-specific rates of hospitalizations for diverticulitis over ***:The age-adjusted hospitalization rate for diverticulitis increased from 61.8 per 100000 to 75.5 per 100 000 between 1998 and 2005,and increased similarly in both ***-associated admissions were male-predominant in those younger than age 45 years but were female-predominant *** rates increased the most among those<45 years,while remaining unchanged for those≥65 *** 2005,the majority of hospitalized patients were<65 ***-adjusted rates of diverticulitis-associated hospitalizations were lower in the West(50.4/100000) compared to the Northeast(77.7/100000),South (73.9/100000),and Midwest(71.0/100000).CONCLUSION:Diverticulitis-associated hospitalizations have steeply risen,especially in young *** epidemiological trends vary by geographic region and warrant further investigation into potential dietary and environmental etiologies.

关键词： Diverticulitis Geographic variation Hospitalization Young adults

Comparative Analysis of Indoor Levels of Suspended Particulates and Nitrogen Dioxide a Few Hours later after an Asthmatic Attack

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Chinese Journal of Chemistry 2007年第11期25卷 1669-1674页

作者： UKPEBOR, Emmanuel Ehiabhi OKUO, James Majebi EKANEM, Victor James UKPEBOR, justina Ebehirieme Air Pollution Research Group Department of Chemistry University of Benin Benin City Nigeria Department of Pathology University of Benin/University of Benin Teaching Hospital PMB 1154 Benin City Nigeria

Suspended particulates （TSP） and nitrogen dioxide （NO2） are known respiratory irritants linked to asthma aggravation. This pilot study was designed to investigate the role of these pollutants on the frequency of asthmatic attack on two of the inhabitants of a household. The surveillance of TSP and NO2 in this household commenced a few hours later, after one of the occupants suffered an attack. The TSP load determination was done using a High Volume Gravimetric sampler and a light scattering method via a Haz-Dust 10 μm particulate monitor. Palmes Diffusion tubes for NO2 and a portable Crowcon Gasman toxic gas detector were utilized for NO2 screening. In the first day of monitoring in the living room, the in situ particulate sampler （Haz-Dust） recorded a mean TSP level of 26,000 μg·m^-3. A confirmatory test with the eight hour average Gravimetric sampler gave 25,833 μg·m^-3. With the use of the Gasman toxic gas detector for NO2, the NO2 concentration for the first few hours of sampling was lower than 188 μg·m^-3, the detection limit of this instrument. However, the exact NO2 concentrations for the 7 day monitoring after the attack were 27.50 μg·m^-3 （kitchen） and 12.03 μg·m^-3 （living room） as recorded by the Palmes diffusion tubes.

关键词： nitrogen dioxide total suspended particulate asthma

A Comparative Investigation of the Biodegradation Behaviour of Linseed Oil-Based Cross-Linked Composites Filled with Industrial Waste Materials in Two Different Soils

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Journal of Renewable Materials 2023年第3期11卷 1254-1268页

作者： Eglė Malachovskienė Danguolė Bridžiuvienė Jolita Ostrauskaitė justina Vaičekauskaitė Gailė Žalūdienė Biodeterioration Research Laboratory Nature Research CentreVilniusLT-08412Lithuania Department of Polymer Chemistry and Technology Kaunas University of TechnologyKaunasLT-50254Lithuania Laboratory of Bedrock Geology Nature Research CentreVilniusLT-08412Lithuania

The biodegradation of polymeric biocomposites formed from epoxidized linseed oil and various types of fillers(pine needles,pine bark,grain mill waste,rapeseed cake)and a control sample without filler was studied during 180 days of exposure to two types of forest soil:deciduous and *** weight loss,morphological,and structural changes of polymer composites were noticed after 180 days of the soil burial *** greatest weight loss of all tested samples was observed in coniferous forest soil(41.8%–63.2%),while in deciduous forest soil,it ranged between 37.7%and 42.3%.The most significant changes in the intensities of the signals evaluated by attenuated total reflectance infrared spectroscopy,as well as morphological changes determined by scanning electron microscopy,were assessed for polymer composite with rapeseed cake and specimen without filler in coniferous forest soil and are in a good agreement with weight loss *** significantly lower changes in weight loss,morphology,and structure of polymeric film with pine bark were noticed in both *** was suggested that fungi of Trichoderma,Penicillium,Talaromyces and Clonostachys genera are the possible soil microorganisms that degrade linseed oil-based cross-linked polymer ***,the novel polymer composites have the potential to be an environmentally friendly alternative to petroleum-based mulching films.

关键词： Polymer composites linseed oil industrial waste materials biodegradation soil burial

Delonix regia and Casuarina equisetifolia as passive biomonitors and as bioaccumulators of atmospheric trace metals

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Journal of Environmental Sciences 2010年第7期22卷 1073-1079页

作者： Emmanuel Ehiabhi Ukpebor justina Ebehirieme Ukpebor Emmanuel Aigbokhan Idris Goji Alex Okiemute Onojeghuo Anthony Chinedum Okonkwo Air Pollution Research Group Department of ChemistryUniversity of Benin Lancaster Environment Centre Lancaster University Department of Botany University of Benin Federal Ministry of Environment and Housing

The suitability of two common and ubiquitously distributed and exotic ornamental plant species in Nigeria-Delonix regia and Casuarina equisetifolia as biomonitors and as effective bioaccumulators of atmospheric trace metals （Cd, Pb, Zn and Cu） has been evaluated. Bark and leaf samples from these plant species were collected in June and July 2006 at five locations in Benin City. Four of the sampling sites were in areas of high traffic density and commercial activities, the fifth site is a remote site, selected to act as a control and also to provide background information for the metals. The plant samples were collected and processed using standard procedures and trace metals were determined using atomic absorption spectrometer. The bark of the plants was able to bioaccumulate the trace metals, especially Pb which originates from anthropogenic contributions in the city. The Pb range of 20.00-70.00 μg/g measured for the bark samples ofD. regia, exceeded the normal plant Pb concentration of 0.2-20.0 μg/g and most Pb data available in literature. The bark of the plants was observed to accumulate more metals compared to the leave, while D. regia was found to be slightly better than C. equisetifolia in trace metal uptake efficiency. Spatial variations in the distributions of Pb and Zn were significant （p 〈 0.05）, and the continuous use of leaded fuel in Nigeria was identified as the predominant source of Pb in the atmosphere.

关键词： passive biomonitors trace metals Delonix regia Casuarina equisetifolia

Knowledge, Attitude and Practice of Contraceptive Use among Women of Reproductive Age in Port Harcourt, Nigeria

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Advances in Reproductive Sciences 2023年第4期11卷 93-105页

作者： Terhemen Kasso justina Omoikhefe Alegbeleye Department of Obstetrics and Gynaecology University of Port Harcourt Port Harcourt Nigeria

Background: Low contraceptive use among all other factors have been implicated in rapid population growth seen in low and lower middle-income countries (LLMICs). This can be attributed to poor knowledge and attitude of the populace towards use of modern contraceptives. Aim: To determine the knowledge, attitude and practice of contraception among pregnant women attending ANC at the University of Port Harcourt Teaching Hospital (UPTH) in Port Harcourt, Rivers State, Nigeria from July 1 to August 31, 2021. Methods: This quantitative study was designed as a descriptive cross-sectional study that recruited 529 women. They were administered with a semi-structured questionnaire which was used to collect their data and responses. The data was analysed using Statistical Product and Service Solutions (SPSS) version 25. Results: According to the findings, 57.3% and 47.1% of the women had poor knowledge and negative attitude towards contraception respectively. About a tenth of the women (9.8%) utilised contraceptives of which 44.2% and 42.3% used the natural method and male condoms respectively. The study also revealed the major reason behind the low use as desire for more children (36.3%). Conclusion: The study showed that the women had poor knowledge and negative attitude towards contraceptives and this translated to poor contraceptive use. Hence, awareness campaigns should be intensified by health workers towards enlightening the populace on the different types, uses and benefits of modern contraceptives.

关键词： Attitude Contraceptive Knowledge Practice Reproductive Age