Short-term outcomes among patients with subclinical hypothyroidism undergoing primary percutaneous coronary intervention

Objectives: This study aimed to examine possible associations between previously undiagnosed subclinical hypothyroidism and short-term outcomes and mortality in a sample of Iraqi patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Design: This is a prospective observational cohort study. Setting: The study was conducted in a single tertiary referral centre in Baghdad, Iraq. Participants: Thyroid-stimulating hormone and free T4 levels were measured in 257 patients hospitalised with STelevation myocardial infarction who underwent primary percutaneous coronary intervention between January 2020 and March 2022. Main outcome measures: Adverse cardiovascular and renal events during hospitalisation and 30-day mortality were observed. Results: Previously undiagnosed subclinical hypothyroidism was detected in 36/257 (14%) ST-elevation myocardial infarction patients and observed more commonly in females than males. Patients with subclinical hypothyroidism had significantly worse short-term outcomes, including higher rates of suboptimal TIMI Flow (< III) (p =0.014), left ventricular ejection fraction ≤ 40% (p=0.035), Killip class >I (p=0.042), cardiogenic shock (p =0.016), cardiac arrest in the hospital (p= 0.01), and acute kidney injury (p= 0.044). Additionally, 30-day mortality was significantly higher in patients with subclinical hypothyroidism (p= 0.029). Conclusion: Subclinical hypothyroidism previously undiagnosed and untreated had a significant association with adverse short-term outcomes and higher short-term mortality within 30 days compared to euthyroid patients undergoing primary percutaneous coronary intervention. Routine thyroid function testing during these patients' hospitalisation may be warranted.

Vitamin D status and COVID-19 severity

Background: Age, body mass index (BMI) and pre-existing comorbidities are known risk factors of severe coronavirus disease 2019 (COVID-19). In this study we explore the relationship between vitamin D status and COVID-19 severity. Methods: We conducted a prospective, cross-sectional descriptive study. We enrolled 100 COVID-19 positive patients admitted to a tertiary level hospital in Johannesburg, South Africa. Fifty had symptomatic disease (COVID-19 pneumonia) and 50 who were asymptomatic (incidental diagnosis). Following written informed consent, patients were interviewed regarding age, gender and sunlight exposure during the past week, disease severity, BMI, calcium, albumin, magnesium and alkaline phosphatase levels. Finally, blood was collected for vitamin D measurement. Results: We found an 82% prevalence rate of vitamin D deficiency or insufficiency among COVID-19 patients. Vitamin D levels were lower in the symptomatic group (18.1 ng/mL ± 8.1 ng/mL) than the asymptomatic group (25.9 ng/mL ± 7.1 ng/mL) with a p-value of 0.000. The relative risk of symptomatic COVID-19 was 2.5-fold higher among vitamin D deficient patients than vitamin D non-deficient patients (confidence interval [CI]: 1.14­3.26). Additional predictors of symptomatic disease were older age, hypocalcaemia and hypoalbuminaemia. Using multiple regression, the only independent predictors of COVID-19 severity were age and vitamin D levels. The patients exposed to less sunlight had a 2.39-fold increased risk for symptomatic disease compared to those with more sunlight exposure (CI: 1.32­4.33). Conclusion: We found a high prevalence of vitamin D deficiency and insufficiency among patients admitted to hospital with COVID-19 and an increased risk for symptomatic disease in vitamin D deficient patients.

Probable horizontal transmission of SARS-CoV-2 in an asymptomatic neonate: A case report

Introduction: Preterm delivery is of considerable concern to clinicians and researchers being a leading cause of infant morbidity and mortality in the industrialized countries and also contributes to substantial complications among survivors. Sub-Saharan Africa, including Nigeria accounts for significant proportion of preterm births, with over million deaths due to complication of prematurity. Objectives: The study aimed to determine the prevalence and associated morbidities of preterm deliveries at the University of Maiduguri Teaching Hospital, Maiduguri, North-Eastern Nigeria. Patients and methods: This is a retrospective review of neonates delivered before 37 completed weeks of gestation and admitted into the Special Care Baby Unit (SCBU) of the University of Maiduguri Teaching Hospital, from 1st January 2008 to 31st December 2015. Results: There were 3435 admissions into the Special Care baby Unit (SCBU) during the 8 year period. Out of these 1129 were preterm babies giving a prevalence of 32.9%. Of the 1129 preterm babies managed in SCBU, 714 case records were retrieved and analyzed giving a retrieval rate of 63%. There were 372 (52.1%) males and 342 (47.9%) females; with the male to female ratio of 1:1.08. There were 17(2.3%) extreme low birth weight (1000-1499 g), 406 (56.9%) low birth weight (1500- 2499 g) babies. The range of admission weights was 700-2500g with mean of 1600±900g. Conclusion: The burden, complications and mortality from preterm newborns remain significant public health challenges to care givers in Nigeria

Prevalence of chlamydia trachomatis infection in infertile women attending fertility clinics in Benin city, Nigeria: a public health concern

This study was carried out to deduce the prevalence of Chlamydia infection amongst infertile women attending fertility clinics in Benin City, Nigeria. Fifty infertile women with either primary or secondary infertility and with their ages ranging from 24 to 51 years were enrolled for this study. The serum of each patient was screened for Chlamydia antibodies with the enzyme-linked immune-sorbent assay (ELISA) and immunoglobulin G (IgG) index of 0.90 or less was reported as seronegative for IgG antibody, while IgG index of 1.00 or greater were positive for IgG antibody. Findings in the present study revealed that 24 % to 52 % of the patients that attend the fertility clinics in Benin City, Nigeria were most likely to be infected with Chlamydia; with the primary infertile patients accounting for 32 % of the cases and secondary infertile patients for 68 % of the cases. Prevalence of Chlamydia infection was also found to be quite high amongst women aged between 36 and 40 years old. Since lack of symptoms often makes the clinical diagnosis of Chlamydia infection somewhat difficult, thus increasing the prevalence of this disease; routine screening is recommended to enable early therapeutic interventions of positive cases

Seroprevalence of Ebola virus infection in Bombali District, Sierra Leone

A serosurvey of anti-Ebola Zaire virus nucleoprotein IgG prevalence was carried out among Ebola virus disease survivors and their Community Contacts in Bombali District, Sierra Leone. Our data suggest that the specie of Ebola virus (Zaire) responsible of the 2013-2016 epidemic in West Africa may cause mild or asymptomatic infection in a proportion of cases, possibly due to an efficient immune response

Pattern of Asymptomatic Bacteriuria among Pregnant Women Attending an Antenatal Clinic at a Private Health Facility in Benin; South-South Nigeria

"Background/Objective: The objective was to establish the characteristics of antenatal attendees in Faith Medical Centre; a private health facility in Benin City who have asymptomatic bacteriuria (ASB) as well as to determine the relationship between ASB and socioeconomic status.Methods: It was a descriptive; cross-sectional study involving 240 pregnant women who presented in the course of antenatal care from January to April 2009. With the aid of a questionnaire patients who were recruited for the study had their socio-demographic data and relevant gynecological and drug history recorded. A physical examination was done to document temperature; height; weight and symphysiofundal height. A clean-catch midstream urine sample was collected for microscopy and culture. White blood cell count of?5/hpf and/or bacteria count of?1/hpf of urine was considered significant for urine microscopy and a single colony count of ?105/ml from two consecutive urine samples was considered significant for urine culture.Results: The prevalence of ASB was 13.8 by urine culture and 43.8 by urine microscopy among antenatal attendees in Faith Medical Centre; Benin City. There was no relationship between ASB and socio-economic factor (P value=0.1267). There was also no significant specific trend between ASB and age (P value=0.0578). Using urine culture as gold standard; the sensitivity of urine microscopy was 90.9; the specificity was 49.3; the positive predictive value was 22.2 and the negative predictive value was 97.1.Conclusion: ASB in pregnancy is common in Faith Mediplex and has no statistically significant relationship with socioeconomic status. The current practice of diagnosing and treating ASB based on urine microscopy needs to be reviewed since the specificity of urine microscopy is very low. Also the practice of screening pregnant women only at the time of booking can lead to under-diagnosis of ASB. This is so because most women who develop this condition later in the course of antenatal care will be missed."""

Prevalence and Risks of Asymptomatic Bacteriuria among HIV Positive Pregnant Women

The objective of the study was to determine whether the prevalence of asymptomatic bacteriuria (ASB) and subsequent complications are higher in HIV-positive than in HIV-negative pregnant women. A prospective controlled study of asymptomatic pregnant women was carried out. One hundred and twenty-five consecutive HIV-positive women and 247 HIV-negative controls were screened for asymptomatic bacteriuria. Treatment of positive cultures was by means of antibiotics as per protocol. Nine percent (n=11) of HIV-positive patients and 7.9 (n=19) of HIV-negative patients had positive urine cultures (p=0.68). Microorganisms were similar in both groups. The incidence of preterm labour was 6.7 in the HIV-positive cohort; versus 11.3 in HIV-negative control patients (p=0.17). The rate of prelabour rupture of membranes was significantly increased in HIV-positive patients compared to HIV-negative controls (17 HIV-positive versus 13 HIV-negative patients; 14.17 and 5.42; respectively; RR 2.615; 95 CI; 1.314-5.204). CD4+ cell count level

Predictors of Asymptomatic Bacteriuria among Obstetric Population in Ibadan

Asymptomatic bacteriuria in pregnancy is the major risk factor for symptomatic urinary tract infection during pregnancy. Screening and identification of bacteriuria during pregnancy have been recommended.The general objective of the study was to determine the pattern as well as possible predictors of asymptomatic bacteriuria at the University College Hospital; Ibadan. The study was a descriptive; cross sectional; exploratory survey of the pattern of asymptomatic bacteriuria among all consecutive patients presenting for the first antenatal visit at the University College Hospital; Ibadan during the study period. The prevalence of asymptomatic bacteriuria was 10.7. Although no statistically significant association was found; the prevalence was higher among women aged between 26 - 35 years (11.5) and those with only secondary education (14.6). Other demographic parameters characterized by high rates of bacteriuria were Christian women (12.7compared to 4.3among Muslims) and genotypes AS andAC (16.4and 16.7respectively). Low parity (para 1-2); 2 and 3 trimesters of pregnancy were the identified possible obstetric predictors of bacteriuria in pregnancy. Staphylococcus species constitute the predominant isolates in 3 trimester and among Muslim pregnant women. Since no statistically significant predictors for bacteriuria in pregnancy were found; routine screening of all our pregnant women for this condition in 2 trimester is recommended

Presence of Lupus anticoagulant in an asymptomatic Nigerian

Background:The lupus anticoagulant (LA) is one of the antiphospholipid antibodies (aPL); which prolong phospholipid- dependent coagulation tests by interfering with coagulation reactions that depend on protein - phospholipid complexes in vitro. Method: A 25 year old 'healthy' male Nigerian was screened for the presence of any coagulation abnormality using the KCT; PT and platelet count; after volunteering for his plasma to be used in the preparation of normal pooled plasma in a study. Results: He was disco- vered to have a prolonged KCT; PT and normal platelet count. Based on the prolonged KCT his plasma was subjected to mixing studies with various concentration of normal pooled plasma; the KCT index was calculated and a curve was plotted. His KCT index was 1.6 and the curve convex in the left axis suggesting the presence of LA. His past medical history and physical examination were not remarkable.Three months after the initial study; a repeat KCT index was 1.4 and the subject asymptomatic. Conclusion: From literature review this is the first report of LA in an asymptomatic adult Nigerian; the importance of this finding is discussed