Determinants of Blood Pressure Control among Hypertensive Patients Attending a Rural Teaching Hospital in Southern Nigeria

Hypertension (HTN) is the commonest cardiovascular risk factor in sub-Saharan Africa. It is a global public health threat, often associated with significant morbidities and mortality with rising prevalence both in rural and semi-urban areas of economically disadvantaged countries. Aim: This study aimed to assess the determinants of blood pressure control among patients with hypertension receiving care at the Irrua Specialist Teaching Hospital in Southern Nigeria. Patients and Methods: A cross-sectional study of 502 consenting hypertensive adults receiving care at the Irrua Specialist Teaching Hospital, Irrua in Edo State, South-south Nigeria. A pre-tested semi-structured interviewer-administered questionnaire was used to collect data which was analyzed using SPSS version 21 and the level of significance was set at P < 0.05. Results: Five hundred and two participants (226 males, 276 females) completed the study with a mean age of 52.98 ± 12.82 years. Optimal blood pressure control was found in 15.5% of the study participants. Blood pressure control was significantly associated with being married (OR 1.549, CI: 1.040­2.309), having a monthly household income of over N50,000 (OR 1.691, CI: 0.999-2.863), engaging in physical activity (OR = 1.537, CI: 0.989-2.388), and not being obese evidenced by a normal Waist Hip Ratio (OR = 2.276, CI: 1.555-3.332). Conclusion: Blood pressure control to target goal was low in the study population and achieved only in less than one­fifth of respondents on antihypertensive therapy. Numerous socio-demographic and lifestyle variables were shown to be associated with blood pressure control. Physicians should emphasize medication adherence and lifestyle modification approaches in hypertensive adults.

A review of the role of infections in the aetiology of haemolysis in patients with sickle cell diseases: pathogenesis, management, and prevention

Background: Sickle cell disease (SCD) is associated with chronic haemolysis, immuno-suppression and susceptibility to infections, which may trigger infection-associated haemolysis (IAH). SCD patients are vulnerable to anaemic effect of IAH due to vicious interaction between pre-existing 'inherited' chronic haemolysis and 'acquired' IAH. IAH in SCD manifests as febrile haemolytic crisis with clinical and laboratory features of severe anaemia or pancytopenia. Clinico-pathological perspectives of IAH in SCD are fragmented. This review presents a comprehensive but concise overview of pathogenesis, management and prevention of IAH in SCD. Methodology and results: Online literature search using search terms such as 'sickle cell disease, viral, bacterial, parasitic, fungal, infections, hyperhaemolytic crisis, haemophagocytic syndrome, severe anaemia, pancytopenia' in various combinations was done on PubMed/Medline, Google, Google-Scholar and Bing. Overall, 112 relevant publications were retrieved, which included 109 peer reviewed journal articles, 2 World Health Organization (WHO) technical reports, and 1 edited text book. A range of bacterial (Bartonella spp, Mycoplasma spp., Mycobacterium avium complex), viral (Dengue, SARS-CoV-2, Parvovirus-B19, Cytomegalovirus, Epstein-Barr virus), parasitic (Plasmodium spp., Babesia spp.), and fungal (Histoplasma spp.) infections were associated with IAH in SCD. There are two broad types of IAH in patients with SCD; infection associated extra-medullary haemolysis (IAEMH) and infection associated intra-medullary haemolysis (IAIMH). While IAEMH is associated with severe anaemia due to intravascular haemolysis caused by red cell invasion, oxidative injury, auto-antibodies, and/or pathogen-haem interaction, IAIMH is associated with haemophagocytic tri-lineage destruction of haematopoietic precursors in the bone marrow. Conclusion: Various microbial pathogens have been associated with IAH in SCD. SCD patients with fever, severe anaemia or pancytopenia should be investigated for early diagnosis and prompt treatment of IAH, which is a lifethreatening haematological emergency for which transfusion therapy alone may not suffice. Prompt and sustainable termination of IAH may require therapeutic combination of transfusion, anti-microbial chemotherapy, and immune modulation therapy. SCD patients should also receive counselling on hygiene, barrier protection against vectors, routine chemoprophylaxis for locally endemic diseases, and immunization for vaccine-preventable infections as a long-term preventive strategy against IAH.

Deferral patterns of voluntary blood donors at the National Blood Transfusion Service, North East zonal centre, Maiduguri

Appropriate donor selection in an important step in ensuring safe supply of blood and blood products. In this study deferral patterns of voluntary non-renumerated blood donors were determined at the North-Eastern Zonal Centre of the National Blood Transfusion service. The study was conducted between April 2007 and April 2009; and it involved the administration of a structured questionnaire. A total of 4032 voluntary blood donors were recruited; seven hundred and thirteen (17.7) were temporarily deferred. The commonest reasons for deferral were low haemoglobin; self-deferral; high blood pressure; low weight and high risk behaviour. Other reasons are use of certain medications; low blood pressure and failed venopuncture. Gender analysis showed that more females were deferred for low haemoglobin and more males were self-deferred. Following donor recall; 146 of the 173 donors temporarily deferred came back to donate. These consisted of 113 deferral due to low haemoglobin; 30 self-deferred and 3 induced in risky behaviour. Effective education or counseling; the old tradition of giving haematinics and good dietary advice to those with low haemaglobin values; improved the safety and availability of blood and blood products. Donors who are self-deferred and those involved in high risk bahviour should never be persuaded to donate blood. There is also the need for a review of operational guidelines with regards the uniform acceptable cut-off point of 12.5g/dl haemoglobin value for males and females

Abdominal Tuberculosis in Surgical Practice in Northern Nigeria

Background: Abdominal tuberculosis is a common complication of pulmonary tuberculosis. With the rising incidence of HIV; tuberculosis has become a major public health problem particularly in developing countries. Methods: This is a retrospective study involving patients whose surgical specimens were processed at the central histopathology laboratory of the Ahmadu Bello University Teaching Hospital (ABUTH) Zaria - Nigeria; between January1975 to December 2006. Results: There were 68 males and 49 females; aged 12-70 years (mean 28.6yrs 11yrs). While paroxysmal dry cough was present in about 20 patients; abdominal pain and distension were very common. Concomitant pulmonary tuberculosis was confirmed in 15 patients (14). The findings at Surgery in 66 patients are presented in fig.2. Multiple deposits on the peritoneum and momentum were the commonest findings (48.7and 26.2) respectively. Conclusion: Abdominal tuberculosis is not uncommon and there is need to establish an early less invasive diagnostic protocol

Lung Hamartomas in Alexandra

Background: Lung hamartomas are rare tumours with compressive effects on lung parenchyma and bronchi. This is a report of our experience in the management of this condition. Methods: We retrospectively studied the records of patients with lung hamartomas managed at Alexandria University Hospital between 2001 and 2007. Information on presentation; treatment and outcome were obtained. Results: Five patients aged 35.6+14.4 years had lung hamartoma. Two patients were asymptomatic; 2 had cough and 1 presented with haemoptysis. Pre-operative diagnosis was lung carcinoma in 4 patients. Four patients had lobectomy while 1 had wedge resection. Histology confirmed fibrochondromatous hamartomas in all patients. Conclusion: Lung hamartomas should be a consideration in solitary coin lesions

Particularites du cancer du sein dans le centre tunisien

Il s'agit d'une etude retrospective a propos 1135 cas de cancer du sein colliges dans le centre tunisien sur une periode de 12 ans (janvier 1990 a decembre 2001). L'age moyen des patientes etait de 49;6 ans. La taille tumorale clinique moyenne etait de 49;9 mm; 43des tumeurs etaient classees T2; 50des patientes avaient une adenopathie axillaire homolaterale et 17presentaient une metastase d'emblee. Le taux de survie a 5 ans etait de 66et la survie moyenne de 43;7 mois. Les facteurs pronostiques significatifs etaient : le delai de consultation; la taille tumorale; l'atteinte ganglionnaire; les metastases; le stade T4d; le type histologique de la tumeur primitive; le grade SBR; les embolies vasculaires et lymphatiques; la rupture capsulaire et le traitement conservateur

The Prevalence and Clinical Significance of Du Phenotype in Rhesus D Negative Pregnant Women in Maiduguri; Nigeria

To determine the prevalence and clinical significance of Du phenotype in Rhesus D negative pregnant women in Maiduguri; Nigeria; samples from 800 pregnant women who attended routine antenatal clinic from January 2004 to March 2005 were analyzed prospectively with respect to their ABO and Rhesus Blood group system. All Rhesus D negative women had elaborate indirect antiglobulin test to detect the presence of Du phenotype. The commonest ABO blood group system was group O. The prevalence's of Rhesus D positive and Rhesus D negative was 90.3