Uchenna Onubogu - Academia.edu (original) (raw)

Papers by Uchenna Onubogu

International journal of health sciences and research, Apr 15, 2024

Introduction: Cushing's syndrome, a rare endocrine disorder may result from exogenous administrat... more Introduction: Cushing's syndrome, a rare endocrine disorder may result from exogenous administration of steroids. Case Report: E.P, 4 years old female presented to RSUTH at 3 years 7 months with complaints of speech delay and difficulty standing from sitting position. She had left convergent squint, Grade 3/6 systolic murmur and proximal muscle weakness. Initial diagnosis was 'Duchenne muscular dystrophy and Acyanotic congenital heart disease'. Echocardiography revealed Atrial and Ventricular Septal Defects. Creatine kinase was normal. She was placed on tabs prednisolone, furosemide, spironolactone and physiotherapy; counselled and booked for follow-up in 2 weeks. She defaulted from follow-up and continued to give Prednisolone. Five months later, she presented to the Cardiology clinic with excessive weight gain and breast development. She had moon face, truncal obesity, and elevated BP. She was referred to the Endocrinology clinic where, in addition, cushingoid appearance, hirsutism, acanthosis nigracans, a hump, striae, with a left convergent squint were noted. Breast was Tanner stage 2. Diagnosis was Cushing's syndrome secondary to Steroid Abuse, Stage 2 hypertension, Premature thelarche? Diabetes mellitus? Pituitary tumour. Brain MRI and abdominal USS were normal. HbA1c was elevated, insulin, C-peptide and Adrenocorticotropic hormone (ACTH) levels were reduced. Other hormonal indices were normal. She was given tabs Amlodipine and Prednisolone stopped. She steadily improved. Six months later, her blood pressure and sugar had normalized. Conclusion: Cushing's syndrome though rare may occur secondary to steroid abuse. Strict compliance to doctor's prescription and follow up cannot be over emphasized.

Health, 2024

Background: Workers spend a significant amount of time in the workspace. Involvement of a spouse ... more Background: Workers spend a significant amount of time in the workspace. Involvement of a spouse in a doctor's workplace can take different forms and come with different intentions. Objectives: The survey aimed to determine the prevalence and extent of spousal involvement in physicians' workplaces as well as the outcome of such involvement on doctor' swell-being, productivity, and relationship with colleagues. Methods: This cross-sectional online survey on spousal involvement in the workplace of doctors was conducted among 83 responding doctors from July to August 2023. Results: Among the respondents, 60 (72.3%) had witnessed a doctor's spouse being involved in the workplace. The most common reason for spousal involvement in the workplace was to protect the spouse from what they perceived as a threat 34 (54.0%). Spouse's ignorance of boundaries in the workplace (OR: 6.09 (95% CI: 1.70, 21.79) P: 0.003) and exertion of control by the spouse (OR: 11.2 (95% CI: 2.26, 56.41) P: 0.002) were significantly associated with higher odds of inappropriate spousal involvement in the workplace, while expression of love for spouse with acts of kindness was significantly associated with a lowered odd of inappropriate spousal involvement (OR: 0.11 (95% CI: 0.03, 0.36) P: 0.0001). Conclusion: Spousal involvement in the workplace is relatively common. Ignorance of the boundaries of the workplace and exertion of control by the spouse were significant enablers of inappropriate spousal involvement in the workplace of doctors. The establishment of workplace policies that define the limits of spousal involvement in the doctor's workplace can foster a healthy workspace environment, enhance doctors' well-being, and improve patient care.

Journal of the American College of Cardiology

European Journal of Nutrition & Food Safety

Background: Exclusive breastfeeding (EBF) provides all an infant requires for optimal growth and ... more Background: Exclusive breastfeeding (EBF) provides all an infant requires for optimal growth and development in the first six months of life. Although most babies are breastfed in Nigeria, only 23% are exclusively breastfed. This study was carried out to ascertain the knowledge, practice and problems associated with EBF amongst mothers attending the Rivers State University Teaching Hospital (RSUTH). Methods: A 5-month cross sectional study was carried out in the Paediatric outpatient clinic (POPC) of RSUTH. A total of 343 mothers were randomly recruited and a pre-tested structured questionnaire administered after obtaining informed consent. Results: Ninety eight percent of the mothers had heard of EBF, 88% knew of its content and 80.2% knew that the duration of EBF was for 6 months. Only 46.4% exclusively breastfed their babies for 6 months and about 66% of participants knew of its benefits to both mother and child. Breastfeeding was commenced within 1 hour of delivery by 40.8% of m...

Nigerian Journal of Paediatrics, 1970

Background: Bacteraemia is the presence of viable bacteria in the circulating blood. The most com... more Background: Bacteraemia is the presence of viable bacteria in the circulating blood. The most common manifestation of bacteraemia is fever. Untreated bacteraemia can progress in 10% of children to focal infection and sepsis which can be fatal. Knowledge of the organisms implicated in causing bacteraemia would help in the right choice of antibiotics while awaiting blood culture results.Objective: This study determined the prevalence and aetiology of bacteraemia among febrile non neonatal, under–five children seen in the Children’s Clinic of the University of Port Harcourt Teaching Hospital.Method: Febrile Children, aged 29 days to < 60 months, who presented in the outpatient clinic and whose parents gave consent were recruited from September 2010 to January 2011. Information on their weight, bio-data, and blood culture results were collected and analysed.Result: A total of 362 children (M:F 1.1:1) were studied. Bacteraemia was found in 32 (8.8%) children. The prevalence rate of ba...

European Scientific Journal ESJ, 2020

Cerebral palsy is a common neurological problem that causes significant disabilities in children.... more Cerebral palsy is a common neurological problem that causes significant disabilities in children. Aim: To describe the clinical profile of children with cerebral palsy in Port Harcourt as well as to identify risk factors and its' impact. Methods: This was a 2 years prospective cross-sectional study in the Paediatric neurology clinic of the Rivers State University Teaching Hospital Nigeria. Children diagnosed with cerebral palsy and those whose parents gave consent were consecutively recruited into the study while their clinical information including laboratory findings was entered into a standard proforma. Results: Among the 296 children seen in the neurology clinic, 141(47.6%) had cerebral palsy. They were aged 6 months to 14 years, with a mean age of 3.07±3.5years and a M: F ratio of 1.6:1. They were mostly term babies 86(61.0%), delivered vaginally107(75.9%) by unqualified attendants 74(52.5%) with normal birth weight 61(43.3%) and 62(52.9%) had microcephaly. The common identifiable risk factors for cerebral palsy were perinatal asphyxia 65(46.1%), past history of meningitis 48(34.0%) and neonatal jaundice 31(22.0%) while the common co-existing neurologic disorders were seizure disorders 47(46.1%) and speech impairment 21(20.6%). Spastic quadriplegia 50(35.5%) was the most frequent type of cerebral palsy seen and it was significantly associated with a past history of perinatal asphyxia P=0.03 and prematurity 0.008. Only 11(44.0%) of the 25 children who were eligible to attend school did so, out of which 9(81.8%) performed poorly. Conclusion: Cerebral palsy is a major cause of neurodisability in Port Harcourt and its common risk factors are preventable.

Cardiology in the Young, 2018

BackgroundAlthough transthoracic echocardiography is the dominant imaging modality in CHD, optima... more BackgroundAlthough transthoracic echocardiography is the dominant imaging modality in CHD, optimal utilisation is unclear. We assessed whether adherence to the paediatric Appropriate Use Criteria for outpatient transthoracic echocardiography could reduce inappropriate use without missing significant cardiac disease.MethodsUsing the Appropriate Use Criteria, we determined the indication and appropriateness rating for each initial echocardiogram performed at our institution during calendar year 2014 (N=1383). Chart review documented ordering provider training, patient demographics, and study result, classified as normal, abnormal, or abnormal motivating treatment within a 2-year follow-up period. We tested whether provider training level or patient age correlated with echocardiographic findings or appropriateness rating.ResultsWe found that 83.9% of echocardiograms were normal and that 66.7% had an appropriate indication. Nearly all abnormal results and all results motivating treatmen...

Nigerian Journal of Paediatrics, 2016

Background: Kangaroo Mother Care (KMC) has been proven to significantly improve growth, reduce mo... more Background: Kangaroo Mother Care (KMC) has been proven to significantly improve growth, reduce mortality and morbidity in low birth weight infants. The impact of KMC in newborn care is expected to be greatest in Africa due to limitations in health care. Objective: The aim of this study was to determine the proportion of Nigerian health workers rendering paediatric care who practice KMC in their institution, and identify some challenges affecting the practice of KMC in Nigerian health institutions. Method: A cross sectional study of the participants at 45 th annual scientific conference of the Paediatric Association of Nigeria was conducted. Result: A total of157 respondents 122(77.7%) doctors and 35 (22.3%) nurses were studied. 84 (53.5%) practiced KMC. The reasons for not practicing KMC were lack of policy reported by 43 (58.9%) and inadequate place for the mothers to stay 30(41%).The level of practice was significantly higher among respondents that worked in facilities that care for sick neonates (p = 0.049), have functional incubators (p = 0.014) and practice KMC (p < 0.001). Conclusion: Hospitals should have a written KMC policy and provide KMC wards in order to improve implementation of KMC practice in Nigeria.

Nigerian Journal of Paediatrics, 2013

Background: Acute Lymphoblastic Leukaemia in children commonly presents with osteo articular mani... more Background: Acute Lymphoblastic Leukaemia in children commonly presents with osteo articular manifestations that may mimic Juvenile Idiopathic Arthritis. This may create considerable diagnostic difficulty and lead to delay in commencing appropriate treatment. Case: An eight year old boy who presented with multiple joint pains and swellings of two months duration, had an elevated Rheumatoid factor and X-ray findings suggestive of Juvenile Idiopathic Arthritis. A blood film and bone marrow aspirate however, confirmed the diagnosis of Acute Lymphoblastic Leukaemia for which he was managed. Conclusion: This report emphasizes the need for a high index of suspicion in children presenting with osteo articular manifestations of Acute Lymphoblastic Leukaemia in order to make a prompt diagnosis and institute treatment.

Italian Journal of Pediatrics, 2010

Background: Infants born to diabetic women have certain distinctive characteristics, including la... more Background: Infants born to diabetic women have certain distinctive characteristics, including large size and high morbidity risks. The neonatal mortality rate is over five times that of infants of non diabetic mothers and is higher at all gestational ages and birth weight for gestational age (GA) categories. The study aimed to determine morbidity and mortality pattern amongst infants of diabetic mothers (IDMS) admitted into the Special Care Baby Unit of University of Port Harcourt Teaching Hospital. Methods: This was a study of prevalence of morbidity and mortality among IDMs carried out prospectively over a two year period. All IDMs (pregestational and gestational) admitted into the Unit within the period were recruited into the study. Data on delivery mode, GA, birth weight, other associated morbidities, investigation results, treatment, duration of hospital stay and outcome were collated and compared with those of infants of non diabetic mothers matched for GA and birth weight admitted within the same period. Maternal data were reviewed retrospectively. Data were analyzed using SPSS 16.0. Results: Sixty percent of the IDMs were born to mothers with gestational diabetes, while 40% were born to mothers with pregestational DM. 38 (74.3%) were born by Caesarian section (CS), of which 20 (52.6%) were by emergency CS. There was no significant difference in emergency CS rates, when compared with controls, but non-IDMs were more likely to be delivered vaginally. The mean GA of IDMs was 37.84 weeks ± 1.88. 29 (61.7%) of them were macrosomic. The commonest morbidities were Hypoglycemia (significantly higher in IDMs than non-IDMs) and hyperbilirubinaemia in 30 (63.8%) and 26 (57.4%) respectively. There was no difference in morbidity pattern between infants of pre-gestational and gestational diabetic mothers. Mortality rate was not significantly higher in IDMs Conclusions: The incidence of macrosomia in IDMs was high but high rates of emergency CS was not peculiar to them. Hypoglycaemia and hyperbilirubinaemia were the commonest morbidities in IDMs. Referring women with unstable metabolic control to specialized centers improves pre-and post-natal outcomes. Maternal-Infant centers for management of diabetes in pregnancy are advocated on a national scale to reduce associated morbidity and mortality

Nigerian Journal of Paediatrics, 2014

Background: More than 97% of febrile infants and young children have self-limiting viral infectio... more Background: More than 97% of febrile infants and young children have self-limiting viral infection and therefore, would not require antibiotics. Over prescription of antibiotics increases antibiotics exposure and development of resistance among patients. There is need to evaluate empiric antibiotic prescription in order to limit its use to only febrile children with bacterial infection. Aim and Objectives: The aim of this study was to determine the prevalence of empiric antibiotic prescription among febrile underfive, post neonatal children presenting in the children outpatient clinic of the University of Port Harcourt teaching hospital. Method: Febrile Children aged 29 days to <60 months who presented in the outpatient clinic were recruited from September 2010 to January 2011. Their weight, biodata, symptoms, Physician's diagnosis, and names of antibiotic prescribed were entered into a predetermined proforma and analysed. Result: A total of 362 children with male to female ratio of 1.03:1 were studied. Two hundred and eighty three (78.2%) febrile children received empiric antibiotic prescriptions. The most frequent antibiotic prescribed was amoxicillin 80 (28.3%). Children aged 1-12months received the highest number of prescriptions 113 (80.7%). There was no significant relationship between age, temperature level, weight for age, number of symptoms and frequency of antibiotic prescription (p>0.05). Upper respiratory tract infection (83.7 %) and diarrhea (55.9%) were significantly associated with empiric antibiotic prescription (P=0.05 and 0.002 respectively). Conclusion: Empiric antibiotic prescription for febrile under-five children is a common practice in UPTH. Physicians should therefore reduce the frequency of antibiotics prescription in febrile children unless there is clinical evidence of bacterial infection.

The Pan African medical journal, 2023

Journal of Pediatrics, Perinatology and Child Health, 2020

Background: Asthma, the commonest respiratory disorder globally is often a cause of emergency roo... more Background: Asthma, the commonest respiratory disorder globally is often a cause of emergency room visits, school and work absenteeism thus affects the quality of life of children and their caregivers. Objective: To assess the pattern of asthma severity and level of control among children attending the respiratory

Nigerian Journal of Clinical Practice

Pediatric Emergency Medicine Journal

Asian Journal of Pediatric Research

Background: Neonatal mortality rate is an important indicator which does not only reflect the ove... more Background: Neonatal mortality rate is an important indicator which does not only reflect the overall health of a child and well-being but also assesses the social and economic development of a country. Aim: The study was carried out to determine the pattern and factors associated with neonatal mortality. Methods and Materials: It was a retrospective study carried out in the Special care Baby Unit of the Rivers State University Teaching Hospital from January 2016 to December 2020. Results: Of 2,944 neonatal admissions, 358 died giving a mortality of 12.2% with male preponderance (M:F ratio of 1.5:1). Majority of the neonates who died were admitted within the first 24 hours of life 289(80.7%) and were delivered via Caesarean section 195(54.4%). Most deaths occurred in the first 7 days of life 189(52.8%). The commonest cause of mortality was neonatal sepsis 183 (51.1%) followed by perinatal asphyxia 178(49.7%) and prematurity 176(49.2%). Most mortalities occurred between 4.00pm and 7....

Asian Journal of Cardiology Research, Dec 9, 2020

Open Journal of Pediatrics

Introduction: In Nigeria, children with acquired and congenital heart diseases (CHD) lack timely ... more Introduction: In Nigeria, children with acquired and congenital heart diseases (CHD) lack timely access to corrective surgeries due to scarcity of cardiac surgical centers and high cost of care; hence they are placed on diuretic therapy for prolong periods for symptomatic relief of the ensuing heart failure. Electrolyte imbalances such as hypokalemia and hyponatremia are known complication of diuretic therapy and have an adverse effect on morbidity and mortality of these children. Considering the risk posed by diuretics, and the inherent risk for renal injury due to hypoperfusion from heart failure, it becomes imperative to monitor their electrolyte, urea and creatinine levels for early intervention and a better outcome. Aim: To determine the serum electrolytes, urea and creatinine values of children with cardiac pathologies in heart failure and make comparison with healthy controls. Methodology: This was a prospective case-control study of children with cardiac pathologies on diuretic therapy for heart failure and their age and sex matched healthy controls. Biodata, echocardiography diagnoses and blood samples for serum electrolytes, urea and creatinine were obtained and comparison made. Results: There were 83 (50%) Subjects and 83 healthy Controls with age range from 2 days to 16 years. Majority of the study population were less than 1year of age. Acyanotic CHD was the commonest cardiac pathology detected in 55 (66.3%), while acquired heart diseases constituted 3.6% of cases. Subjects had significantly lower levels of sodium (p = 0.0001), potassium (p = 0.0001) and bicarbonate (p = 0.004); and higher levels of urea (p = 0.014) and creatinine (p = 0.002). Among Subjects, the Mean sodium and bicarbonate levels were lowest in those with cardiomyopathies while Mean potassium level was lowest in those with cyanotic CHD. There were significant intergroup differences in Mean serum creatinine (p = 0.000). Conclusion: Children on diuretic therapy for heart failure had comparatively lower levels of serum electrolytes, urea and creatinine.

Clinical Ethics, 2019

A 4-day-old female was admitted into a Nigerian Hospital, with neonatal tetanus, jaundice, and se... more A 4-day-old female was admitted into a Nigerian Hospital, with neonatal tetanus, jaundice, and sepsis. Four days into the treatment, her clinical condition continued to deteriorate. The family requested to be discharged against medical advice on the grounds that the outcome of continued treatment may not be favorable with the possibility of neurological disability and the financial burden of continued treatment which could lead to catastrophic financial consequences for the rest of the family members. This is in line with the utilitarian moral principle in which, decisions are made based on the maximum number of individuals who would benefit from the outcome in spite of the fact that some individuals may be harmed by such decisions. The doctor's opinion was that continuing the child's treatment and protecting the child's right to survival could only happen with the baby remaining in hospital care. This is in line with the deontological ethical theory which judges an action based on it being morally correct irrespective of its actual consequence. The ethical issue arising here is, how appropriate is it to make decisions in the best interests of the child when the overall cost of that decision is weighing heavily on the interests of the larger society which in this case is the family. In conclusion, while professional medical ethics is the same in most countries, implementation of what is in the child's best interests varies according to the provisions made available by each country.