Leucocyte Profile of Adult Nigerians as Indicator of Severity Level of Acute Musculoskeletal Trauma

Leucocytosis, marked increase in the number of white blood cells (WBC) is a known physiological response to trauma. In recent times, several studies have asserted the absence of this response in Africans. In view of this, current study investigated the existence of, and prognostic implications of post-traumatic leucocytosis amongst adult Nigerians with acute musculoskeletal (MSK) trauma. Two hundred and twenty three (223) adult male and females (MSK traumatized) and fifty apparently healthy volunteers (adults) were ethically recruited from the National Orthopaedic Hospital, Enugu, regional centre for trauma, orthopaedic, burns and plastic surgery in south-east Nigeria. Using the Leishman’s stained blood smear technique, leucocyte profiles [Neutrophil, Lymphocytes, Basophils, Eosinophils and Monocyte counts] were obtained for each participant. In all case, Age, Gender and duration of hospitalization were also obtained. Following careful analysis, study found, using one way analysis of variance (ANOVA), a statistically significant increase (p < .05) in acutely traumatized subjects; with adults of ages 20 to 49 years constituting the majority (70%). A statistically significant lymphopenia was also observed in test population, with Pearson Product Moment Correlation proving positive for higher levels of WBC counts. A negative correlation was also seen for Neutrophils and lymphocyte counts, implicating the Neutrophil-Lymphocyte Stress Factor (NLSF). We recommend the exploration of the NLSF for prognosis of Leucocytosis in Africans.

Anthropometric Relation of Neck and Waist Circumference in Overweight and Obese Nigerian Subjects: Implication for the Fashion Industry

Introduction: In the local tailoring industries in Nigeria, it is generally assumed that the waist circumference is twice the neck circumference. Whether this is true for obese and overweight people is unknown. Objective: This study investigated the anthropometric relationship of the neck circumference to the waist circumference in overweight and obese people and its use in the clothing industry. Subjects and Methods: A sample size of 557 volunteers between 18 to 50 years was recruited for the study from the three campuses of the University of Port Harcourt. 391 were overweight (males=218, females=173) and 166 were obese (males=63, females=103). The neck and waist circumferences of volunteers were taken at the upper neck circumference (UNC), middle neck circumference (MNC), lower neck circumference (LNC) and upper waist circumference (UWC), middle waist circumference (MWC) and lower waist circumference (LWC) respectively. The Body Mass Index of the participants were determined after their weights and heights were measured to enable us categorize them into overweight and obese. The data obtained were analyzed with the aid of Microsoft Excel statistical tools. Results: Overweight males had UNC =37.83cm, UWC =83.69cm, MNC =37.72cm; MWC=85.79cm, LNC =38.43cm, LWC =86.37cm. Overweight females had UNC =33.64cm, UWC=78.02cm, MNC =33.64cm, MWC= 83.09cm, LNC =34.71cm, LWC=83.09cm. Obese males had UNC =40.15cm, UWC=93.87cm, MNC =40.12cm, MWC= 97.95cm, LNC =40.85cm, LWC =97.82cm. Obese females had UNC =35.07cm, UWC =90.86cm, MNC= 35.29cm, MWC =97.29cm, LNC =36.01cm, LWC =100.72cm. Pearson’s correlations(r) of the different regions of the neck and waist for overweight and obese subjects were determined. Conclusion: The correlation between the neck and waist circumference is weak in both overweight and obese. No subject has a waist circumference that is exactly twice the neck circumference. Estimation of waist circumference from the neck circumference will result in clothes that are not fitted.

Dermatoglyphic Patterns Of Schizophrenic Patients In A Nigerian Population

Introduction: Dermatoglyphic studies have been associated with many physical, behavioural and pathologicaltraits. Ridge patterns are established early in intrauterine life and serve as effective tools in determining thedevelopment of a particular trait. This study was aimed at finding out whether there exists any dermatoglyphicpatterns that could serve as predictive tools in the early detection of schizophrenia in a Nigerian population.Materials and Methods: The study was carried out on 100 Nigerians whose parents and grandparents areNigerians. They were made up of 50 diagnosed schizophrenic patients (25 males and 25 females) recruited fromthe Federal Neuro-Psychiatric Hospital, Uselu, Benin City and 50 healthy controls matched for age and gender.The palms and digits of the subjects were scanned with an HP scanner and images in jpeg format recorded usingan AutoCAD software version 2010 and the images were analyzed for arches, whorls, loops and ridges countedwith atd angles measured using standard methods.Results: There was significant increase in loops and decreased in arches in the schizophrenic when comparedwith the control groups. Also, observed were significant increase in fingerprint patterns on the right 1st digit offemale schizophrenic patients, 3rd, 4th and 5th digits on the left side also in female schizophrenics but only on the4th left digit in male schizophrenics. There was also increase in the mean total finger ridge count (TFRC) in maleschizophrenic patients.Conclusion: These findings are indicative of dermatoglyphic variability between patients with schizophrenia andhealthy controls and could serve as markers in the prediction of schizophrenia in our studied population.

Estimation of Sex Using Antero-posterior Dimension of Talus in North Eastern Nigerians.

Aim: To evaluate sexual differences using demarking point and index of sexual dimorphism from the length of talus in relation to age among male and female north-eastern Nigerians. Study Design: Retrospective Study. Place and Duration of Study: Departments of Human Anatomy and Radiology, University of Maiduguri and University of Maiduguri Teaching Hospital (UMTH) respectively, Borno State, Nigeria between October 2010 to March 2012. Methodology: Three hundred and twelve (312) radiographs of adult north-eastern Nigerians (156 males and 156 females) with ages ranged from 20 to 69 years were measured. Radiographs used for this study were obtained from the collection of records unit of Radiology Department of UMTH in Borno State, Nigeria. Radiographic viewing box, erasable maker, meter rule were used for the measurements. Both female and male samples were grouped into two separate subsamples (right and left talus). Samples were classified into five (5) age groups which spanned ten years interval. The lateral views of the plain radiographs of the ankle were mounted on viewing box connected to a light source which gave good illumination. Antero-posterior length (APL) of the talus was measured as a linear distance between the most anterior point on the head of talus and the most posterior point on the body of the talus) using a calibrated meter rule. Results: The means of APL for males are all significantly greater than their female counterparts of the same age group. The results also show statistically significant (p<0.001) differences between the lengths of talus in males and females. The values of demarking points (DP) in males were higher than in females. The Index of sexual dimorphisms (ISDs) are greater than 100 which suggest that males have higher value over female counterparts. The result also show age related variation with male APL range from 5.82 cm at 60-69 years age group to 6.21 cm at 30-39 years age group; while female APL range from 5.27 cm at 60-69 years age group to 5.56 cm at 30-39 years age group. Conclusion: It was observed that the APLs of talus are sexually dimorphic; the DPs of male are all higher than those of female Counterparts. ISD also shows that, male APLs are greater than those of the female counterparts: because the ISDs were all greater than 100 at all age groups. However more studies are required in other part of Nigeria, so as to capture the racial variation of Nigeria.

Neuro-epidemiology of Acute Stroke Syndrome in the Adult Emergency Department of a Tertiary Hospital in a Resource-limited Environment of South-eastern Nigeria.

Background: Globally, acute stroke is one of the leading causes of preventable emergency hospital admissions. It is emerging as an important cause of disability and mortality among adult Nigerian Africans in the emergency department(ED) of Nigerian hospitals. Aim: The study was designed at reviewing epidemiology of acute stroke syndrome in the adult ED of a tertiary hospital in South-east Nigeria. Study Design: This was a retrospective descriptive study. Place and Duration of Study: The study was carried out on patients with acute stroke syndrome at the ED of Federal Medical Centre, Umuahia, Nigeria over a five year period from January 2008 to December 2012. Methods: The sources of data were from medical records, patients’ case notes; ED admission registers and nurses report books. Information collected were age, sex, place of the incidence, time of presentation to the ED, duration of symptoms at presentation, month (season) of occurrence, type of stroke, number of episodes and associated clinical conditions. Operationally, time of presentation to the ED was categorized into two: day time was defined inclusively as time period from 6.00 am to 6.00 pm while night time referred exclusively to the time period from 6.00 pm to 6.00 am Nigerian time. Early presentation to the ED meant that the victim arrived the ED of the hospital inclusively within 1 hour of the occurrence of the acute stroke while those that arrived after 1 hour were defined as late presentation to the hospital. Results: The age ranged from 36 years to 95 years with mean age of 68.2±7.4 years. There were 155 (58.3%) males and 111 (41.7%) females with male to female ratio of 1.4: 1. The incident predominantly occurred at home (77.8%), 239 (89.8%) had duration of symptoms more than 1 hour at presentation, 162 (60.9%) presented during the night time, 158 (59.4%) occurred during dry season, 157 (59.1%) had repeat episode, 199 (74.8%) were ischemic stroke and the most commonly associated clinic-medical condition was hypertension (80.1%). Conclusion: There was variability in the epidemiology of stroke with ischemic stroke being the pre-eminent type and hypertension the most associated clinical condition. The incident occurred predominantly among male gender, elderly patients, at home, during dry season and most of the patients presented late to the ED and at night time. Interventional strategies aimed at risk reduction, early presentation to dedicated and responsible stroke units and centres are advocated.

Type 2 Diabetes Mellitus in Ambulatory Adult Nigerians: Prevalence and Associated Family Biosocial Factors in a Primary Care Clinic in Eastern Nigeria: A Cross-sectional Study.

Background: Type 2 diabetes mellitus is a multi-factoral medical condition that aggregates in the family and has implications for family health. Research analyses of determinants of type 2 diabetes mellitus have demonstrated the interactions and clustering of family biosocial factors in its epidemiology. Aim: To determine the prevalence of type 2 diabetes mellitus and describe the associated family biosocial factors in ambulatory adult type 2 diabetic Nigerians in a primary care clinic in Southeastern Nigeria. Study Design: This was a cross-sectional study. Seven hundred and fifty patients were screened for diabetes mellitus and thirty five of them who had diabetes mellitus were age and sex matched with thirty five non-diabetic, non-hypertensive patients for the determination of the association with family biosocial factors. Place and Duration of Study: The study was carried out at a primary care clinic in Umuahia, South-eastern Nigeria in May 2011. Methodology: Data on family biosocial factors were obtained using pretested, structured and interviewer-administered questionnaire. Diabetes mellitus was defined using American Diabetes Association criterion. Results: The prevalence of type 2 diabetes mellitus was 4.7%. Eleven (1.5%) of the diabetic patients were newly diagnosed in the hospital. There were fourteen (40.0%) males and twenty one (60.0%) females with sex ratio of 1:1.5. The age ranged from 28-82 years with mean age of 47±11.2 years. The middle aged adults were predominantly affected. Family biosocial factors significantly associated with type 2 diabetes were family history of hypertension (P=.006) and diabetes mellitus (P=.048). A significantly higher proportion of the diabetic patients had family history of hypertension compared to the non-diabetic and non-hypertensive subjects. The diabetic patients were one and half times more likely to have family history of hypertension compared to their non-diabetic and non-hypertensive counterparts. Conclusion: The study has shown the prevalence of type 2 diabetes mellitus with predilection for middle aged adult Nigerians. The associated family biosocial factors were family history of hypertension and diabetes mellitus. Screening adult Nigerians with family history of hypertension and diabetes mellitus for diabetes mellitus is recommended in primary care setting for familycentred preventive care.

Hyperuricaemia and its Relations with Serum Lipid Abnormalities in Untreated, Newly Diagnosed Adult Nigerian Hypertensive Patients.

Aims: To determine the prevalence of hyperuricaemia in adult Nigerians with untreated newly diagnosed hypertension and to evaluate its relations with serum lipid abnormalities. Study Design: Cross-sectional study. Place and Duration of Study: General Out-patient Department, Medical Out-patient Department and Emergency Room of the University of Ilorin Teaching Hospital, Ilorin, Nigeria between May 2007 and October 2007. Methodology: One hundred and fifty (150) untreated newly diagnosed hypertensive patients 18 years and above and one hundred and fifteen (115) age and sex-matched normotensive individuals were recruited into the study. Thorough clinical evaluation and laboratory investigations were done for both patients and controls including serum uric acid and serum lipid profile. Atherogenic ratio (Total cholesterol/Low density lipoprotein-cholesterol) was calculated for both patients and controls. Results: Of the one hundred and fifty newly diagnosed hypertensive patients, 52 (34.7%) were males and 98 (65.3%) females, with a range of 19-85 years and a mean age (±SD) of 50.412.3 years. Among the normotensive controls, 49 (42.6%) were males and 66 (57.4%) females with range of 23-80 years and a mean (±SD) of 50.712.7 yrs. Mean serum UA in hypertensive patients and normotensive controls was 0.40.1 mmol/l and 0.30.1 mmol/l respectively. Hyperuricaemia was found in 36.7% of hypertensive patients and 17.4% of normotensive controls (P<0.001). Serum UA was significantly higher in hypertensive patients than in normotensive controls (P<0.0001). Among hypertensive patients high TC and high LDL-c were the most prevalent types of serum lipid abnormalities. There was a significant positive correlation between serum UA and TG (r=0.21, P = 0.01). Conclusion: The study shows that hyperuricaemia and serum lipid abnormalities are prevalent among adult Nigerians with hypertension. There was a significant correlation between serum uric acid and serum triglyceride. This study recommends routine measurement of serum uric acid in both newly diagnosed hypertensive patients as well as those on antihypertensive drugs.

Dyslipidaemia in Hypertensives in South-South Nigeria.

Background: There is a strong relationship between hypertension and dyslipidaemia, and both can increase the risk of developing coronary heart disease. Methods: A total of One hundred and eighty (180) participants were recruited for this study; out of which, there was one hundred and fifty (150) hypertensive patients and thirty (30) control subjects that were age- and socio-economically matched with the hypertensive patients. Lipid profile test was carried out for them using standard laboratory techniques. Results: Fifty-four percent (n=69) of the hypertensive patients were females; majority of the female hypertensive patients were within the age bracket of 50-59years (45.7%) while majority of the male hypertensive patients were within the age bracket of 40-49 years (53.6%). With the exception of HDL-cholesterol values which were comparable with the Normotensive controls, the hypertensive patients had significantly higher lipid profiles (triglyceride, total cholesterol and LDL-cholesterol). There was positive correlation between total cholesterol, triglycerides (0.399, p<0.05), LDL-cholesterol (r=0.609, p<0.05) and HDL-cholesterol (r=0.866, p<0.05) among the hypertensive patients, also, HDL-cholesterol positively correlated with LDL-cholesterol (r=0.218, p<0.05) but in the normotensive patients, LDL-cholesterol negatively correlated with triglyceride (r=-0.409, p<0.05) and positively correlated with total cholesterol (r=0.876, p<0.05). Conclusion: Hypertensive Nigerians have significantly higher lipid profile except the HDL-cholesterol which is comparable in both hypertensive and Normotensive Nigerians. This shows that the dyslipidaemia in hypertensive Nigerians majorly involve plasma total cholesterol, triglyceride and LDL-cholesterol.

An Update on Cephalometrics among Nigerians: Ascertaining Prevalent Jaw Patterns.

Aims: Cephalometric norms vary between populations as well as among ethnicities within a known population. This study presents an update on cephalometric findings among Nigerians as well as the prevalent jaw patterns among subjects with malocclusion. Study Design: A cross sectional study design was employed. Place and Duration of Study: Orthodontic unit, University College Hospital, Ibadan, Nigeria between April 2008 and September 2011. Methodology: One hundred and seven subjects were recruited (43 males, 64 females; overall mean age was 20.74±5.78 years). Thirty-six subjects had normal occlusion, 35 had skeletal pattern II and 36 had skeletal pattern III. Socio-demographic data, dental, occlusal and other orthodontic features were recorded on a data extraction form. Lateral cephalometric radiographs were taken for soft and hard tissue tracings. The ANB angle and Wits appraisal were used to assess skeletal pattern. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 19. Frequency tables and measures of central tendency were generated. Variations in angular and linear variables were assessed using ANOVA and LSD post-hoc test. Significance was set at P<.05. Results: A hundred and seven subjects were assessed. Mean age was 20.74±5.78 years. There was significant difference in mean values for SNB, ANB, SNMP, PP-MP, FMA, LI-MP and UI-LI angles between the three groups (P<.05). LSD post-hoc test showed significant reduction in SNB for class II (P <.05) but increase in SNB for class III subjects relative to the standards was not statistically significant (P >.05). Conclusions: Mandibular deficiency appears to be the primary defect in class II malocclusion in this environment. On the other hand many factors are accountable for class III malocclusion.

Calcaneal pitch and lateral talocalcaneal angle among nigerians / Inclinación calcáneo y ángulo talocalcáneo lateral en nigerianos

Various papers in the fields of Radiology, orthopaedics and radiographic anatomy have employed the use of angles measured on X-rays to make diagnoses, select treatment modalities in the management of foot disorders as well as predicting the outcome of interventions to these disorders. Calcaneal pitch (CP) and lateral talocalcaneal angle (L TCA) are angles that can be drawn on lateral standing radiographs of the foot and are used widely in the diagnosis, prognosis and choice of treatment modalities for various disorders of the foot. Data on these important radiological tools are lacking in Nigeria. Hence, the study is an attempt to bridge this gap. Using a hinge goniometer, the angles were measured from normal lateral standing radiographs of the foot. Mean CP was found to be 15.08 +/- 2.87 (n=63) and the mean L TCA was found to be 38.85°+/-8.20° (n=130). Differences in the means of the angles seen between the sexes were not statistically significant (CP, p=0.70; L TCA, p=0.60). No such significant difference was also observed in mean of the angles with respect to the sides of the body (CP, p=0.58; L TCA, p=0.13) or between ethnic groups (CP, p=0.30; L TCA, p=0.40).

Diversos trabajos en las áreas de la radiología, ortopedia y anatomía radiográfica han empleado los ángulos medidos en las radiografías para hacer diagnósticos, seleccionar las modalidades de tratamiento en el manejo de los trastornos del pie, así como para predecir el resultado de las intervenciones para estos trastornos. La inclinación calcánea (PC) y el ángulo talocalcáneo lateral (L TCA) son los ángulos que se pueden extraer desde las radiografías laterales de los pies y ser utilizados ampliamente en el diagnóstico, pronóstico y elección de modalidades de tratamiento para diversos trastornos del pie. Los datos sobre estos importantes instrumentos radiológicos no existen en Nigeria, y su estudio es un intento de obtener esta información. Usando un goniómetro bisagra, los ángulos se midieron a partir de radiografías normales permanentes lateral del pie. La media de CP se fue 15,08+/-2,87 (n = 63) y la media de TCA L fue 38,85°+/-8,20° (n = 130). Las diferencias en las medias de los ángulos observados entre los sexos no fueron estadísticamente significativas (CP, p = 0,70; L TCA, p = 0,60). No hubo diferencias significativas en la media de los ángulos con respecto al lado (CP, p = 0,58; L TCA, p = 0,13) o entre grupos étnicos (CP, p = 0,30; L TCA, p = 0,40).

Serum and Urine Electrolyte Profiles during Amlodipine and Hydrochlorothiazide Combination Therapy in Nigerian Patients with Essential Hypertension.

Aims: To evaluate changes in electrolyte profiles during combination treatment with amlodipine (AML) and hydrochlorothiazide (HCZ) in hypertensive Nigerians. Study Design: Randomized, open-label, prospective, two-centre, outpatient, 48-week study. Methodology: We enrolled 90 male and female Nigerians aged 31-86 years with uncomplicated essential hypertension (blood pressure [BP] > 160/90 ≤ 180/120mmHg). Patients, who were 30 each (15males [M] and 15females [F]) in AML, HCZ and AMLHCZ groups, were treated, respectively, with 5mg AML for 6 weeks (wks) and the dose increased to 10mg till wk 12 (monotherapy) after which HCZ 25mg was added; HCZ 25mg till wk 6 (monotherapy) after which AML 5-10mg was added; and AML 5-10mg + HCZ 25mg. Body mass index (BMI), BP, 24h urine volume, serum and urine electrolytes (Na+, K+, Cl-) were assessed at baseline and at the end of wks 1, 3, 6, 12, 24, 36 and 48 during treatment. Results: The 3 regimens comparably significantly (P= .05) reduced BP. Diuresis was greatest and significant (P= .05) in HCZ group. A time dependent significant (P< .0001) hyponatraemic changes were observed in all subgroups except AML M subgroup such that the mean maximum M/F decrease in AML, HCZ and AML-HCZ groups, respectively, were 5.07/14.74, 17.40/16.40 and 10.93/16.86 mmol/L. A parallel significant (P< .01) increase in urine Na+ was observed in all groups with maximum mean M/F increase in AML, HCZ and AML-HCZ groups being, respectively, 26.00/24.40, 28.07/40.94 and 30.47/27.67 mmol/L. A baseline hypokalaemia was observed in all groups except in the AML M subgroup. Significant (P< .0001) M/F hypokalaemic changes were 0.23/0.35, 0.76/0.53 and 0.18/0.19 mmol/L for AML, HCZ and AML-HCZ groups, respectively. Corresponding significant (P< .0001) M/F increase in urine K+ were 4.60/5.71, 10.67/18.60 and 8.2/9.3 mmol/L for AML, HCZ and AML-HCZ groups, respectively. Significant (P= .05) disproportionate chloraemia was observed at baseline in all groups. The observed significant (P< .0001) M/F hypochloraemic changes in AML, HCZ and AML-HCZ groups were, respectively, 10.60/11.46, 25.60/26.94 and 22.93/17.67. A significant (P < .0001) parallel hyperchloriuria was evident in all groups and M/F values in AML, HCZ and AML-HCZ groups were, respectively, 8.09/6.46, 26.00/39.86 and 24.53/18.00 mmol/L. Conclusion: Long-term AML and HCZ combination therapy, though effective, is associated with biochemical changes – Na+, K+ and Cl- depletion, thus making serum electrolytes monitoring and K+ supplementation or concomitant use of a K+-sparing diuretic clinically imperative.

Effects of Initiating Antihypertensive Therapy with Amlodipine or Hydrochlorothiazide on Creatinine Clearance in Hypertensive Nigerians with Type 2 Diabetes Mellitus.

Aims: To assess the effects of initiating antihypertensive therapy with amlodipine (AML) or hydrochlorothiazide (HCZ) for 48 weeks on creatinine clearance (Clcr) in hypertensive Nigerians with type 2 diabetes mellitus (DM). Study Design: Randomized, open-label, prospective, outpatient study. Place and Duration of Study: Department of Pharmacology and Therapeutics, College of Medicine, Ambrose Alli University, Ekpoma, Edo State, Nigeria between March 2008 and March 2009. Methodology: We randomized 40 newly diagnosed hypertensive subjects with controlled type 2 diabetes mellitus (DM) aged 43-68 years to AML and HCZ treatment groups of 20 patients each (20 males (M) and 20 females (F)) and they were treated monotherapeutically, respectively, with AML 10mg and HCZ 25mg, all given once daily for 48 weeks. Body mass index (BMI), blood pressure (BP), 24h urine volume, urine creatinine, serum creatinine and the corresponding Clcr for each day were evaluated at baseline before treatment and at the end of weeks 1, 3, 6, 12, 24, 36 and 48 during treatment. Results: The 2 drugs significantly reduced BP and at week 48, the mean M vs F systolic BP (SBP)/Diastolic BP (DBP) decrease from baseline for AML group (27.0/17.5 vs 29.5/20.0 mmHg) was more significant than that of HCZ group (23.5/17.5 vs 22.0/16.5 mmHg, P < .01). HCZ caused maximum M vs F diuresis (1593.00 +/- 27.21 vs 1587.00 +/- 30.60 ml) at week 3 and this was significantly higher than that (1526.00 +/- 27.10 vs 1516.00 +/- 22.76 ml, P < .01) produced by AML. Although the treatment effect exerted by the 2 drugs on Clcr was significant (P =.05), time-dependent changes in the mean values, which were higher in AML group, were not significantly different. Conclusion: It is demonstrated that in hypertensive Nigerians with type 2 DM, single daily doses of these medications do not have a clinically significant effect on Clcr over a longterm monotherapy. Accordingly, with regard to HCZ greater diuresis which may cause problems particularly in the elderly, AML appears to be a preferred logical alternative to substitute for low dose HCZ therapy.

Evaluation of cardiac sizes of normal nigerians using posteroanterior chest radiographs.

Background: There is paucity of data on cardiac sizes and other related parameters among Africans. This study aims to establish normal values of aortic, cardiac and thoracic diameters and the cardiothoracic ratio in a normal Nigerian population. Methods: The cardiothoracic ratio of 200 males and 200 females aged between 5 and 95 years were calculated from the cardiac and thoracic diameters in posteroanterior chest radiographs in a cross-sectional study at two imaging and radiodiagnostic centres. The mean and standard deviation of aortic, cardiac, thoracic diameters and cardiothoracic ratio were established. Results: The mean values for cardiac diameter for males and females were 13.8±1.89 and 13.2±1.28cm respectively. The mean values of cardiothoracic ratio for both male and female were 46% and 48% respectively. Conclusion: The cardiothoracic ratio increased with age in both sexes. These values were larger than those reported for the Caucasians.

Psychotropic Medications and QTc Parameters in a Nigerian Cohort.

Aims: Evidence is increasing to indicate that individuals with mental illness may be at risk of premature death. We studied the prevalence of QTc prolongation, QT dispersion (QTd) and cardiac arrhythmias in patients on psychotropic drugs. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine and Department of Behavioral Sciences, University of Ilorin Teaching Hospital, Nigeria Between Januaryand June 2010. Methodology: One hundred and ninety-one consecutive patients on psychotropic medications with 121 controls were studied. All the subjects had detailed clinical examination and resting electrocardiogram (ECG) at 25mm/sec. QTc was determined using Bazett formula and QTd by subtracting shortest from longest QTc in 12-lead ECG. Results: Mean QTc of the patients (450±46msc) was longer (p=0.0001) than that of the controls (390±27msc) but mean QTd was similar (p=0.13) in both groups. QTc was prolonged in 68(35.6%) patients compared to 11(9.1%) controls, p=0.0001. LVH, arrhythmias and abnormal T-wave morphology occurred more (p=0.01, 0.01 and 0.001 respectively) in the patients than controls. Age, duration of treatment and total daily doses of antipsychotics were independent predictors of QTc. Cardiac arrhythmias were seen in 24.1% of the patients but none had ventricular arrhythmias. Conclusion: Psychotropic drug use is a risk factor for QTc prolongation and cardiac arrhythmias. We suggest periodic electrocardiography, discourage polypharmacy and recommend drug holiday in stable patients.

AIDS-related lymphomas in Nigeria

Aggressive non-Hodgkin's lymphoma (NHL), including primary central nervous system (CNS) lymphoma, lymphoblastic lymphoma and non-endemic Burkitt's lymphoma have been recognized as AIDS-defining cancers in most developed countries. However, HIV/AIDS epidemics appear not to have been associated with higher incidence of lymphomas in Africa. We therefore carried out this study to highlight the significance or otherwise of HIV/AIDS epidemics in the pathogenesis of lymphomas in a population of Nigerians with the disease. Since January 1993 to the present, all patients with haematologic cancers are routinely screened (following appropriate counseling) for HIV infection. Patients with a histological diagnosis of malignant chronic lymphoproliferative diseases {non-Hodgkin lymphoma (NHL), chronic lymphocytic leukaemia (CLL), Burkitt's lymphoma (BL) and Hodgkin lymphoma (HL)} at the Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife from January 1993 to August 2008 were noted. Those patients confirmed to be HIV/AIDS positive among the cohort with lymphomas were retrospectively studied using their clinical case notes. Data obtained were analyzed using appropriate descriptive and inferential statistics. A total of 391 patients were histologically confirmed to have lymphoma {NHL-109, (27.9 percent); CLL-76, (19.4 percent); BL-178, (45.5 percent) and HL-28, (7.2 percent)} during the study period. Nine patients (2.3 percent) were confirmed to be HIV- positive, all within the age bracket 24-60 (median = 50) years. Six of these, five males and one female, ages 24-60 (median = 37.5) years, had NHL while another three, all females (age 50 - 68years; median = 56 years) had CLL. None of the patients with HL and BL were HIV positive. Patients with NHL presented at advanced stage of the disease (at least clinical stage IIIb), and all those with CLL presented at stage C of the International Working Party Classification. All the HIV-positive patients ...