Background: Diabetes mellitus is a major cause of mortality and morbidity among in-patients in Nigeria. It may result from the acute metabolic complications or from the inexorable effects of chronic complications in the major organ systems. Objectives: This study was to determine the death rates and causes of death among in-patients with diabetes at an urban tertiary hospital in Port-Harcourt. Materials and Methods: The medical records of patients admitted with diabetes mellitus into the medical wards of the University of Port Harcourt Teaching Hospital from 1995-2004 were reviewed. The sources of data were the ward admission, death registers, death certificates and medical records. The annual and overall fatality rates were calculated from the available data. Results: During the period under review, 6,574 patients were admitted into the medical wards. Out of these, 686 (10.4%) were due to diabetes and its complications. The diabetic patients comprised of 428 (62.4%) males and 258 (37.6%) females giving a M:F ratio of 1.7:1. One hundred and eighteen of the diabetic patients died giving a case fatality of 17.2%. The main causes of death were diabetic ketoacidosis (DKA) (21.2%), diabetic mellitus foot syndrome (DMFS) (19.5%) and renal failure (12.7%). Diabetic emergencies accounted for 39.8% of all deaths. Conclusion: Diabetes mellitus is a significant cause of medical admissions in Port-Harcourt. The case mortality is very high especially from acute metabolic causes. There is a need for improved management of diabetes in Nigeria.

Situs inversus with dextrocardia is the complete inversion of position of the thoracic and abdominal viscera. It may be isolated or associated with malformations, especially cardiac or alimentary. It may be discovered in infancy because of associated anomalies but often remains asymptomatic and discovered by chance in adult life. We report a 69 year old Nigerian woman found to have dextrocardia with situs inversus totalis while presenting for treatment for a totally unrelated problem. Her chest radiograph was however erroneously marked by the radiographer as normal resulting in a wrong report. The findings from an electrocardiogram and echocardiography confirmed the location of the heart in the right hemithorax and an abdominal sonogram showed the liver and gall bladder on the left side of the abdomen while the stomach and spleen were located on the right side. This report underscores the need for routine screening by individuals so that such congenital anomalies can be identified and surgical diagnoses in such patients made correctly to prevent surgical complications.

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Background Obesity is becoming a global epidemic and the prevalence is increasing not only in the developed countries but also in developing countries like Nigeria. The main adverse consequences are cardiovascular diseases, type 2 diabetes and several cancers. Left ventricular hypertrophy (LVH) is a cardiovascular consequence of obesity and it is an independent risk factor for stroke, myocardial infarction and sudden death. It is therefore necessary to know to what extent obesity is responsible for the development of LVH and what measures of obesity are implicated. Method: A total number of two hundred and thirty (230) subjects were recruited for the study. One hundred and fifty (150) were obese while eighty (80) were non obese controls. Body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR) were measured and calculated as the case may be. Based on their BMI, the subjects were classified as obese and non obese. Blood pressure measurements on at least two occasions and fasting plasma glucose estimates were done to identify normotensive, normoglycemic subjects who were included in the study. Echocardiography was done on all subjects after physical examination. The Left Ventricular Mass was calculated using Devereux modified ASE cube formula and this was indexed to height 2 and to body surface area.Results BMI and WC were strongly correlated with all echocardiographic parameters with BMI having the strongest correlation with LVM/H 2 (r=0.708, p<0.001) in males and (r=0.799,p<0.001) in females. This was followed by WC (r=0.678, p<0.001) in males and (r=0.646,p<0.001) in females. WHR was weakly correlated with LVM/H 2 (r=0.213, P=0.040) in males and (r=0.218, p=0.011) in females.Conclusion and RecommendationBody mass index (BMI) and waist circumference (WC) had stronger correlations with echocardiographic determinants of left ventricular hypertrophy compared to Waist hip ratio (WHR) in this study. BMI and WC should therefore be the preferred measures of obesity for the assessment of the impact of obesity on left ventricular mass and hypertrophy.

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