Perception and attitude of theatre staff to preoperative HIV testing at the University of Port Harcourt Teaching Hospital

Objective:To elucidate the awareness and approach to pre-operative human immunodeficiency virus(HIV) testing and emphasis on the attendant components of HIV testing.Methods: The study was conducted at the theatres of the University of Port Harcourt Teaching Hospital among 123 nursing,anaesthetic,and operating staff.A descriptive cross sectional design was adopted with stratified sampling.The study instrument was a structured,self administered pro forma.Results:All respondents were all aware of HIV infection and all had transmission through infected blood and tissues(100.0%).88.6%had infection through needle stick injuries, 62.6%through vertical transmission,and 98.4%through blood transfusion.Sixty three percent of respondents correctly knew what preoperative testing was,while 58.5%were aware of the preoperative testing policy of the hospital.All respondents favoured the policy of preoperative testing.Attitudinal values to seropositive patients were not very different as 72.4%of respondents claimed they treated every patient as high risk,and all respondents used personal protective equipment.Conclusions:Routine HIV testing now represents a conventional means providing patients with knowledge of their HIV status.Such testing should be accompanied by informed consent,counselling,confidentiality,protection,and access to treatment.

Pattern and antibiogram of urinary tract infection at the University of Port Harcourt Teaching Hospital

Objective:To explore the prevalence,pathogenicity,and antibiotic susceptibility patterns of urinary tract infections at the University of Port Harcourt Teaching Hospital.Methods:Samples from 400 patients with a presumptive diagnosis of urinary tract infection including 250 non pregnant females and 150 males were used for this study.They were distributed into two groups: children aged 2 to 17(Croup A) and adults aged 18 to 75(Croup B).The standard wire loop and agar diffusion technique were employed for culture and susceptibility testing,respectively.Data obtained were analysed using SPSS,version 14.Results:30.0%of Group A and 41.0%of Group B had significant bacteriuria with 66.7%and 79.3%as females,respectively.The commonest isolates cultured were Escherichia coli(32.8%),Staphylococcus aureus(17.2%),and Klebsiella spp.(16.4%).About 76.6%of isolates were sensitive to the fluorinated quinolones,31.2%to the aminoglycosides,and 22.7%to the urinary antiseptic,nitrofurantoin.The isolates were nonsensitive to tetracycline(93.8%),cotrimoxazole(92.2%),and nalidixic acid(86.7%).Most isolates showed non-uniform sensitivity patterns to the cephaloporins(cefuroxime and ceftazidime). Pseudomonas spp.isolates were generally resistant to the fluorinated quinolones.Conclusion: Though the fluorinated quinolones are still largely effective for empirical therapy in urinary tract infections,the importance of prior sensitivity testing in checking the emergence of bacterial antibiotic resistance can not be overemphasized.

Asymptomatic bacteriuria in pregnancy in Port Harcourt

Objective:To determine the prevalence of asymptomatic bacteriuria in pregnancy,to consider the antimicrobial sensitivity patterns of involved uropathogens,to elucidate the safety profiles of antibacterial agents,and to evaluate the role of urinalysis in screening for asymptomatic bacteriuria.Methods:About 760 apparently healthy pregnant subjects attending the Antenatal Clinic of the University of Port Harcourt Teaching Hospital were randomly selected for this study.Urinalysis and microscopy,culture,and sensitivity tests were carried out on clean-catch midstream urine samples obtained from subjects.Biochemical reagent strips were used for urinalysis while the standard wire loop and agar diffusion technique were respectively employed for culture and susceptibility testing.Results:A total of 111 samples yielded moderate or severe growth on culture after 48 hours comprising 35,31,27,and 18 isolates of Staphylococcus spp.,Proteus spp.,Klebsiella spp.,and Escherichia spp,respectivehy.Urinalysis results were positive for the presence of nitrate reductase and leucocyte esterase activity in 17 urine samples of these 111 samples.The isolates showed a general sensitivity to the fluorinated quinolones and to Nitrofurantoin.Conclusions:The prevalence of asymptomatic bacteriuria is 14.6%, with the predominant organism being Staphylococcus spp.Drugs used for treatment should have excellent fetal safety profiles,and a rapid screening test with a high negative predictive value for asymptomatic bacteriuria would be ideal.

The effects of methanol extract of cleistopholis patens on the reproductive system of female Wistar rats

Objective:In Port Harcourt and its environs,extracts of Cleistopholis patens are used by traditional medicine healers for the treatment of menstrual irregularities and other gynaecological disorders.The objective of this study was therefore to determine the effects of orally administered methanol extract of the stem bark of Cleistopholis patens on the reproductive organs of non-pregnant albino(Wistar) rats.Methods:3g/kg(low dose) and 6g/kg(high dose) of the extract were administered orally,daily to two different groups of animals,respectively, over a period of 28 days.A third(control) group of animals received distilled water only,orally over the same period.Five animals from each of the groups were sacrificed on day 8,15 and 29.Venous blood samples and reproductive organs respectively were taken from each group of sacrificed animals for hormonal and histopathological analysis.Results:Results of the hormonal assay revealed a general increase in the levels of Follicle Stimulating Hormone(FSH),Luteinizing Hormone(LH),progesterone,and estrogen.The highest levels were noticed in the animals sacrificed on the 29th day(LH =5.48±0.04 IU/L;FSH =3.80±0.00 IU/ L;Progesterone =7.14±0.15 nmol/L;Estrogen = 0.168±0.002 nmol/L).These increases were statistically significant compared to those of the control animals(LH =2.90±0.00 IU /L;FSH = 1.28±0.02 IU/L; Progesterone = 3.80±0.00 nmol/L;Estrogen = 0.130±0.002 nmol/L;P【0.05),and were also dose dependent. Results of the histopathological studies showed presence of chronic inflammatory cells in the tissues of the fallopian tubes and uterus on the 29th day.However,no changes were observed in the ovaries.Conclusion: The administration of the extract produced a dose and time-dependent increase in FSH,LH,progesterone and estrogen levels.We postulate that these observed effects may have been induced by the phytoestrogens (known to have 1/1 000 th of the efficacy of natural oestrogens) in the extract.The hormonal and histopathological changes may explain the effects described by patients following ingestion of extracts of this plant in traditional medical practice.However,it remains to be determined if these effects are harmful or beneficial in disease conditions.