Cardiovascular risk factors and renal impairment among young adults in a tertiary institution in Southwest Nigeria

Background: Specific research is sparse on renal dysfunction among homogenous group of young adults. This study estimated the prevalence of renal dysfunction among apparently healthy young adults and determine association (if any) between renal dysfunction and some cardiovascular risk factors. Methodology:Undergraduates (18-37 years) of a tertiary institution were studied on 2017 World Kidney Day. Their biodata, blood pressure, anthropometry, total cholesterol and estimated glomerular filtration rate were determined. Data was analyzed using SPSS version 20.0. Results:A total of 640 students were studied (M:F=1:3.8). Their mean age was 23.1±2.8 years. Thirty-three(5.2%) participants had renal dysfunction (eGFR < 60ml/min/1.73m2). The mean age of subjects with renaldysfunction (eGFR < 60ml/min/1.73m2) was significantly higher with an inverse association to renal function (p = 0.005). Two hundred and fifty-seven(40.2%) and 58 (9.1%) participants were pre-hypertensive and hypertensive respectively; overweight, abdominal obesity and hypercholesterolaemia were found among 12.2%, 14.2% and 8.1% of subjects respectively. The mean body mass index (p = 0.009) and serum total cholesterol (p = 0.003) were significantly higher among females. There was a higher prevalence of renal dysfunction among females even though this was not to the significant level (5.9 v 2.2%, p = 0.12). Conclusions:The prevalence of renal dysfunction among young adults is lower than current global estimates. The prevalence of cardiovascular risk factors for CKD were lower than that of older adults with no significant association to renal dysfunction. Increasing age was found to be significantly associated with reduced renal function.

Immunovirological treatment outcomes after 2 years of antiretroviral therapy in children living with the human immune deficiency virus in Lagos Nigeria

Background/objective: The World Health Organization (WHO) recommends routine assessment of antiretroviral treatment outcomes to detect treatment failure early and prevent the development of drug resistance. The aim of this study was to describe treatment outcomes of antiretroviral therapy (ART) over 2 years in children living with the human immune deficiency virus enrolled in the paediatric HIV clinic at the Lagos UniversityTeaching Hospital (LUTH). Materials and methods: This was a retrospective study of antiretroviral treatment outcomes in 278 children receiving antiretroviral therapy at the paediatric HIV clinic of LUTH. Demographic, clinical and laboratory data were retrospectively collected from clinical records of pediatric patients who received antiretroviral therapy for 2 years ( from November 2015 to December 2017) . Virological failure was defined as viral load > 400 copies/ml and immunological failure was defined as a CD4 count <100 cells/mm3 or CD4 % <15% after receiving antiretroviral agents for 12 months. Data was analysed using graph pad prism version 5.0.Results: After 12 months on antiretroviral therapy (ART), 101 (36%) had virological failure while 14 (5%) and 36 (13%) failed immunologically [CD4 count <100 cells/mn3 and CD4 <15% respectively]. Virological blips were observed at 24 months in 6.1% of patients while immunovirological discordance occurred in 30% of patients (poor virological clearance despite good immunological recovery) . High baseline viral load (>5000 copies/ml), poor adherence (<95%) and low baseline CD4 counts (101-249 cells/mn3) were significantly associated with virological failure, while low baseline CD4 counts (<350 cells/mn3) and poor adherence (<95%) were significantly associated with immunologic failure.Conclusion: The treatment outcomes observed in this study are similar to those reported in earlier studies. At 1 and 2 years of antiretroviral therapy , there was immune restoration however 101 (36%) and 87 (31%) respectively had virological failure despite good adherence to therapy and good Immunological restoration. This calls for early initiation and switch to second and third line drugs

Impact of internal migration on fertility in Cotonou, Benin Republic

Context/Background: In developing countries, fertility is usually higher in rural than urban areas. This is partly due to lower access to and utilization of reproductive health services in rural areas. However, migration to cities may alter the fertility behaviour of migrants from rural areas. Data Source and Methods: The study used 2012 Benin Republic Demographic and Health Survey data and focused on married women aged 15-49 years and residing in Cotonou (n=722). Tobit regression was employed for the multivariate-level analysis. Findings: The results showed that migrants adapt gradually to the fertility patterns of non-migrants. This gradual adaptation is compounded by a relative selectivity of migrants whose fertility preferences are similar to those of non-migrants. Finally, recent migrants for employment or school reason had the lowest number of births over the past five years, which supports the disruption hypothesis. Conclusion: The migration-fertility relationship depends on the length of residence, migrant' socioeconomic characteristics and reason for migration

Internal migration and unmet need for family planning in Cotonou, Benin Republic

Context/Background: Evidence shows that addressing the unmet need for FP of vulnerable groups such as rural-to-urban migrants is another alternative to lowering fertility in developing countries. This study examines how migration affects unmet need in Cotonou. Data Source and Methods: We employed multinomial logistic regression using 2012 Benin Republic Demographic and Health Survey data concerning 827 married women aged 15-49 years and residing in Cotonou. Findings: Findings show that recent migrants were less likely to have an unmet need than non-migrants. Then, earlier migrants and non-migrants had similar odds of unmet need. After adjusting for socioeconomic variables, the risks of unmet need for spacing and limiting among recent migrants decreased and increased, respectively, by 7%. Earlier migrants became significantly less likely to have an unmet need for spacing births than non-migrants. Conclusion: The odds of unmet need are lower among migrants than non-migrants, but complementary research on migrants' fertility in Cotonou is necessary before any conclusion33

The relationship between zidovudine, lamivudine and nevirapine plasma drug levels and antiretroviral treatment outcomes in Nigeria children living with HIV

Plasma concentrations of antiretrovirals are significant and important determinants of treatment failure and toxicity. The relationship between antiretroviral pharmacokinetic exposures and immunovirological outcomes has not been extensively studied in our setting. The aim of this study was to investigate the relationship between antiretroviral plasma concentrations and virological and immunological treatment outcomes in children living with human immunodeficiency virus (HIV) A retrospective collection of demographic, clinical , laboratory data and a prospective determination of plasma drug concentrations in 120 children aged 2-14 years after two years of receiving fixed dose zidovudine, lamivudine and nevirapine tablets using a simple, rapid, sensitive and validated method of high performance liquid chromatography with UV detection for simultaneous quantification of zidovudine, lamivudine and nevirapine in human plasma. All analyses were performed using graph pad prism version 5.0. A perfect agreement (p<.001) was found between nevirapine drug levels and prescriptionrefill visit adherence records (Kappa 0.093). Plasma zidovudine, lamivudine and nevirapine concentrations were not statistically associated with virological success (Viral load <400copies/µl ) and immunological success (CD4 cells >100 cells/mm3). At 2 years zidovudine, lamivudine and nevirapine therapeutic levels, zidovudine supra therapeutic levels ,and nevirapine subtherapeutic levels were respectively significantly associated with immunologic success (CD4%>15 %). Low nevirapine levels can be used to identify those that require adherence counseling. Despite good virological and immunological outcomes, plasma concentrations of zidovudine, lamivudine and nevirapine were not significantly associated with virological and immunological outcomes (Absolute CD4 counts) but was significantly associated with immunological outcomes (CD4%). Plasma drug levels may be good surrogates of adherence but not of treatment outcomes. Monitoring CD4% remains important to optimize paediatric HIV treatment

Assessment of level of fear of radiotherapy in oncology patients attending a tertiary health facility

This prospective study is designed to assess the level of fear of radiotherapy in Oncology Patients attending a tertiary health facility. Two hundred and thirteen (213) Oncology patients reported to the University of Benin Teaching Hospital (UBTH) for Radiotherapy from March 1, 2013 to December 22, 2013 were recruited for this study. Descriptive statistics (Frequency and percentage) as well as inferential statistics (χ2) test was used in analyzing the data. The dataset were entered and analysed using IBM Statistical Package for Social Sciences (SPSS) version 24.0 for windows. The level of significance was set at p<0.05. The result showed that more than half (70.4%) of the Oncology patients reported high level of fear. Age of oncology patients, educational level and site of tumour were significantly (p<0.0001) associated with high level of fear of RT. This study reported very high proportion of fear of radiotherapy among Oncology patients which may be due to lack of awareness of the mechanism of operation of the procedure and the positive outcome as against the negative fears they have. Therefore, there is the need for awareness/teachings to patients prior to therapy to help ameliorate their fears; also special attention should be paid to provide adequate psychological or psychiatric support to patients with high level of fear of Radiotherapy

An audit of chemical pathology laboratory investigation request forms received at a private tertiary hospital in Nigeria

Context: Laboratory testing constitutes an integral part of patient management and has an extensive influence on medical decision-making. The completion of laboratory investigation request forms is a vital aspect of the highly variable pre-analytical phase of laboratory testing.Aim: We aimed to assess the adequacy of completion of investigation request forms received at our laboratory.Methods: An audit of systematically selected laboratory investigation request forms received over a six-month period at our laboratory was performed to assess the degree of completion of these forms by requesting clinicians. Data was analysed using Microsoft Excel®.Results: Two hundred and fifty four request forms were reviewed. None of the reviewed forms was adequately completed. The clinician's contact number was missing in all the request forms. About two-thirds of the request forms did not have the patient's hospital number (66.1%) and the referring clinician's signature (66.9%) available on them. The clinical diagnosis of the patient was not stated in 18.9% of the request forms. The patient's name, gender and age were the most frequently completed parameters in 100.0%, 98.4% and 97.2% of the request forms respectively.Conclusion: Basic information required for the accurate interpretation of laboratory results are missing in several request forms. This may have deleterious impact on laboratory turn around time, healthcare costs and patient management as most medical decisions are influenced by laboratory results

Prescribing Pattern of Non-Steroidal Anti-inflammatory Drugs at the Outpatient Pharmacy Department of Lagos University Teaching Hospital; Nigeria

Background: Non-steroidal Anti- inflammatory Drugs (NSAID); are among the most widely used and misused of all drugs. Though they provide symptomatic relief from pain and swelling in chronic joint diseases; they may cause renal impairment; especially in combination with other nephrotoxic agents.Objectives: This study aimed to investigate the prescription pattern of NSAID in the Out-patient Pharmacy Department of Lagos University Teaching Hospital (LUTH); Nigeria.Design: A total of 3800 prescriptions containing NSAIDs were analyzed for information on drug name; the number of NSAIDs per prescription; the presence of ACE inhibitors and diuretics alongside NSAIDs and NSAIDs prescribed in generic or brand names. Results: The results showed that Aspirin was the most frequently prescribed NSAID (62.2) and 68.4 of the NSAIDs prescriptions studied were written in generic names. The total number of drugs per prescription was in most cases 3 or greater (84.6). There were statistically significant (p ? 0.05) associations between the individual NSAID prescribed and whether they were prescribed in generics or brand names; individual NSAID prescribed and the frequency of co-prescription with an ACE inhibitor and a diuretic; types of NSAID prescribed and the cost in Naira. Conclusion: Though most of the prescribers complied with WHO standard in their prescriptions vis a vis generic prescription; avoidance of polypharmacy and avoidance of drug interactions and contraindications; there is obvious need for interventional measures or strategies to improve rational prescribing for some of the prescribers tailored towards rational prescription and use of drugs

Antibiotic Susceptibility Pattern and Beta-lactamase Production in Isolates of Staphylococcus aureus from Recurrent Furunculosis in Southwestern; Nigeria

Furuculosis is a skin infection caused by Staphylococcus aureus. It is characterised by honey crusted 'cropped' latent boil with potential to recur in a susceptible host. Isolates of S.aureus obtained from both hospitalised and non-hospitalised patients with furuncles in Southwest; Nigeria were characterised in relation to their resistance to commonly used antimicrobial agents. Exudates of 'cropped-boils' from one hundred and forty (140) individuals consisting of forty (40) hospitalised and one hundred (100) non-hospitalised cases of recurrent furunculosis were screened for S. aureus. One hundred and two (102) were positive for the organism by conventional biochemical tests. Detection of ?-Iactamase was determined by cell-suspension iodometric method. Of the 102 isolates; 30(29.4) strains possessed ?-lactamase and the minimum inhibitory concentration (MIC) of selected antibiotics was in the range of 3.95- 250?g/ml. The multiple drug resistance as evident in high MICs of the antibiotics tested could probably be due to abuse/misuse of antibiotics resulting in recurrence of furuncles in the patients

Effect of Aqueous Extract of Alstonia Congensis on Glucose Transport and Na+-K+-ATPase Activity in the Everted and Non-Everted Guinea Pig Intestine and Erythrocyte Fragility

The seed of Alstonia congensis has been used as purgative by traditional doctors. It is not known if glucose transport and Na+-K+ ATPase activity are affected during the purging process. The effect of the plant on erythrocytes fragility is also not known. This study was designed to provide this information. The effect of aqueous extract (1:25w/v) of Alstonia congensis on the transportation of glucose ranging from 0.10 to 0.40M from normal and everted guinea pig intestinal strips into the surrounding 0.5M TrisEDTA saline buffer pH 8.2; on Na+-K+- ATPase activity and erythrocytes fragility were measured. Results showed that the aqueous extract reduced glucose transportation; inhibited Na+-k+-ATPase activity and specific activity at higher enzyme protein concentration and activated the enzyme activity and specific activity at lower enzyme protein concentration. Glucose transport reduction was linked to the effect of the extract on the Na+-k+-ATPase system. The extract also increased erythrocytes fragility. The active ingredient(s) in the extract is not known yet and research work is in progress to ascertain it

Analgesic activity of the aqueous leaf extract of Byrsocarpus Coccineus

Byrsocarpus coccineus (Schum. and Thonn.) is used as an herbal remedy for earache; muscular and rheumatic pains in West Africa. To validate the claim of the users; the analgesic effect of the aqueous leaf extract of the plant was studied in mice and rats using acetic acid-induced writhing; formalin; tail immersion; and cold-water tail flick pain tests. The extract (50 - 400mg/kg; p.o) showed a dose dependent and significant (p0.05) inhibition of pain in the acetic acid-induced writhing; tail immersion; tail flick and the formalin (second phase) tests. The extract (400mg/kg) gave a significantly (p0.05) higher inhibition than acetylsalicylic acid; ASA; (100mg/kg; p.o) in the acetic acid-induced writhing test. Its effect on the second phase of the formalin test was comparable to that of ASA. The elevation of pain threshold at 60 minutes post-treatment produced by 400mg/kg of the extract in the tail immersion and tail flick tests were slightly lower than that of morphine (2mg/kg; s.c). The results suggest that the aqueous leaf extract of Byrsocarpus coccineus possesses effective analgesic activity mediated via peripheral and central mechanisms