Profile and outcome of medical emergencies in a tertiary health institution in Port Harcourt, Nigeria

Medical emergencies are a daily occurrence in medical practice. The profile and outcome medical emergencies are a reflection of the prevailing pattern of disease and the responsiveness of the healthcare system. This study seeks to evaluate the pattern and outcome of medical emergencies presenting to the university of Port Harcourt teaching hospital (UPTH); Port Harcourt.METHODS: A retrospective study of medical records of the accident and emergency unit of UPTH was assessed over a twelve month period (June 2008 May 2009).RESULTS: A total of 7246 patients presented to the emergency room; with 1256 (17.3) medical emergencies. Infectious diseases accounted for 274 (21.8) of emergencies while non-communicable diseases in the cardiovascular 195 (15.5); renal 105 (8.4); neurological 224 (17.8); endocrine 163(13.0) and gastrointestinal/ hepatobiliary 163(13.0) systems were the other prevalent emergencies. The crude mortality rate was 127 deaths (10.2). The major contributors to mortality were HIV/AIDS related infectious diseases (22.4); hypertension related heart disease (18.4) and stroke (15.7). Other contributors to mortality were renal failure (8.8); diabetic emergencies (8.8); chronic liver disease (12.8) and haematological malignancies (9.6).CONCLUSION: The spectrum of medical emergencies and the pattern of mortality indicate a mixed disease burden of infective and non-communicable diseases; with cardiovascular and cerebrovascular diseases and HIV/AIDS related infectious as the most significant contributors. There is need for action to improve on the responsiveness of our healthcare systems to cope with this trend of disease pattern in our emergency rooms and reduce mortality from medical emergencies

Vitiligo: a Hospital-Based Study in Southern Nigeria

Background: Vitiligo is an acquired pigmentary disease characterized by loss of the pigment producing cells (melanocytes) of the skin; hair and mucous membranes (lips and genitalia); with subsequent development of white patches. The aim of this study was to evaluate the epidemiological pattern of vitiligo in Port Harcourt; south-south Nigeria. Methods: This was a prospective study of 82 cases of vitiligo seen in the dermatological clinic of the University of Port Harcourt Teaching Hospital (UPTH); Port Harcourt; Nigeria from May 2005 to April 2009. All ages were included in this study. Data was analysed using the SPSS version 15. Descriptive statistics in the form of the frequency and percentage were used. Chi square was used to test relationship between variables. P0.05 was considered statistically significant. Results: There were a total of 1;652 dermatological disorders during the study period. Eighty two patients had vitiligo giving a prevalence of 4.96. There were more females 45(54.9) than males 37(45.1) giving male: female ratio of 0.8:1. Vitiligo is commoner from the age of 20 years to 30 years (32.9). The head and neck region was the most common site of onset of the lesion and accounted for 28of cases. Generalized vitiligo [29(35.4)] was the most frequently found pattern of distribution. Positive family history was found in 6 cases (7.3). Eighteen (22.0) patients suffered from other diseases such as thyroid dysfunction [8(9.8)]; anaemia [4(4.9)]; atopic dermatitis [2(2.4)]; diabetes mellitus [1(1.2)]; anxiety disorder [1(1.2)]; collagen vascular disease [1(1.2)] and oligomenorrhoea [1(1.2)]. Conclusion: The pattern of vitiligo seen is similar to that reported from other parts of the world. There is also need to look for associated disorder in any case of vitiligo

Predictive Value of Seborrheic Dermatitis for HIV infection in Lagos; Nigeria

Background: Cutanenous lesions with high frequency in HIV/AIDS patients such as Kaposi's sarcoma; herpes zoster and generalised pruritic papular eruption have unequivocally proven valuable in Africa and elsewhere as predictive signs for HIV infection. Reports have associated a high prevalence of seborrheic dermatitis in HIV infected persons. Aim: To evaluate the predictive value of seborrheic dermatitis in the diagnosis of HIV/AIDS infection in Lagos University Teaching Hospital (LUTH) skin clinic.Methods: A prospective case-control study was conducted at the skin clinic of the Lagos University Teaching Hospital (LUTH) over a 23-month period (April 2001- February 2003). One hundred and eighteen patients with clinically diagnosed seborrheic dermatitis and one hundred and nine controls were tested for HIV seropositivity. Statistical analysis was performed using EPI info version 6.0. P values 0.05 was considered statistically significant. Results: Eleven patients with seborrheic dermatitis were HIV seropositive with a positive predictive value (PPV) of 9.3. Only one (0.9) of the control group was seropositive. It was also found that patients with seborrheic dermatitis who were seropositive were mainly in the older age group (40-59 years) and had more widespread lesions. Conclusion: Seborrheic dermatitis has significant positive predictive value for HIV/AIDS infection and corroborates existing literature. Routine screening of persons over 40 years of age with seborrheic dermatitis or those with widespread lesions is recommended

Prevalence of skin diseases in Nigerian Children: - (The University of Port Harcourt Teaching Hospital) Experience

Background: Skin diseases are frequently encountered in the tropics and are a serious cause of morbidity, disfigurement and distress in all age groups. The aim of this study is to determine prevalence and common dermatological conditions encountered in UPTH. Methods: Children aged 0-16 years attending the dermatology clinic in UPTH from June 2005 to November 2007 were prospectively studied. Results: A total of 1,226 skin disorders were seen, 247 (20.1%) were children aged 0-16 years. Skin disorder was commoner in females 139(56.3%) than males 108(43.7%). Papular urticaria 36(14.6%), atopic dermatitis 34(13.8%) and tinea 31(12.6%) were the most commonly observed childhood skin diseases. Conclusions: Skin diseases such as papular urticaria and atopic dermatitis are important dermatological problems in our environment. Implementation of public health policies and improvement in personal hygiene would reduce the prevalence of skin diseases in Nigerian children