Relationship between parental socio-economic status and casual blood pressure in coastal nigerian adolescents

BACKGROUND: Emerging data suggest that essential or primary hypertension occurs in the young. Parental socioeconomic status may play a role but the exact mechanisms still remain unclear. OBJECTIVE: This study was aimed at determining the relationship between parental socioeconomic status and casual blood pressure in adolescents. METHODS: One thousand and eight adolescents attending two secondary schools in Calabar; Nigeria were selected by stratified random sampling. Their blood pressure; weights and heights were taken using standard methods and sociodemographic data were obtained using a pretested semistructured questionnaire. RESULTS: Blood pressure was increased with age with males having higher values. The other major determinants of blood pressure were weight; height; body mass index; level of physical activity and parental socioeconomic status (p 0.05). Female adolescents with parents in the lower socioeconomic classes had significantly higher systolic and diastolic blood pressure (p 0.05). In contrast; parental socioeconomic status showed no significant relationship with systolic blood pressure and diastolic blood pressure in males (p 0.05).The prevalence of elevated blood pressure was higher in females than in males. CONCLUSION: Low parental socioeconomic status appear to be associated with higher casual blood pressure especially in female coastal Nigerian adolescents. Traditional determinants did not appear to play a significant role. Psychological stress arising from environmental and economic stressors may be responsible

Chronic Kidney Disease Screening and Renoprotection in Type 2 Diabetes

Background: Type 2 diabetes (T2D) is a major cause of chronic kidney disease. Control of hypertension and the use of angiotensin converting enzyme inhibitors (ACEI) and/or angiotensin II receptor blockers especially in those with proteinuria have been shown to protect against chronic kidney disease and delay its progression to kidney failure. Methods: We reviewed the medical records of 169 patients at 12 months with a view of auditing the screening for chronic kidney disease and the use of renoprotective measures. Results: Urinalysis was done in 49.1and serum creatinine in 50.3. No patient had glomerular filtration rate estimated. Seventy nine (67.6) of the hypertensive patients were on anti-hypertensives. ACEI was used in 49 (45.8) of these patients BP control was optimal in 29.1. Conclusion: There is poor adherence to guidelines on chronic kidney disease screening and renoprotection in T2D

Pharmacological and Nonpharmacological Prevention of End-Stage Renal Disease

Slowing of the rate of deterioration in renal function in patients with chronic kidney disease (CKD) is feasible; but requires a combination of pharmacological and non pharmaco- logical interventions. Pharmacological interventions of proven efficacy are the following: a. Blood pressure control using angiotensin converting enzyme inhibitors and angioten- sin receptor blockers as the first line agents because these drugs have beneficial effects on glomerular haemodynamics and proteinuria in addition to their antihypertensive actions b. Strict blood glucose control in patients with diabetes mellitus c. Use of lipid-lowering agents (statins) d. Pharmacological control of hyperphosphataemia e. Prevention of anaemia with the use of erythropoietin and f. Pharmacological management of the underlying renal disease Non-pharmacological interventions are of equal importance and include maintenance of euvolaemia; prevention or prompt treatment of urinary tract obstruction and infection; hypercalcaemia and hypocalcaemia; and avoidance of nephroto- xins and smoking. The management of CKD is multifaceted and requires diligence and a team approach. Patients and their families should be active members of the team

Hepatitis B Vaccination Status and Needle Stick Injuries among Medical Students in a Nigerian University

Background: Hepatits B virus (HBV) is the most common blood borne pathogen that poses an occupational risk to Health-care workers. The incidence of infection following needle stick injury has been reported to be high among medical students. Effective vaccines against HBV are available. The aim of this study was to determine the vaccination status and prevalence of needlestick injury among medical students in a tertiary institution in a developing country (Nigeria). Method: Information regarding hepatitis B status; history of needlestick injury and awareness of risk factors for HBV were obtained from clinical medical students using a self administered questionnaire. Three hundred and forty six students responded. Results: Three hundred and five (88.7) agreed that medical education exposes one to HBV infection and 315 (91.6) were aware of the availability of vaccine against HBV. Only 42 (47.7) were vaccinated against HBV. Majority (57.4) gave lack of opportunity as reason for non immunization while 34.7had never given it a thought. One hundred and sixty-six (48) of the respondents admitted to a previous needlestick injury and only 17 (10.2) of those who reported history of needlestick injury had post-exposure prophylaxis against HBV infection. Conclusion: HBV vaccination status is very low among medical students in Nigeria and the prevalence of needle stick injuries is high. Universities must not only provide HBV vaccination free of charge but also enforce its use by these students

Hepatitis B Vaccination Status and Needle Stick Injuries among Medical Students in a Nigerian University

Background: Hepatits B virus (HBV) is the most common blood borne pathogen that poses an occupational risk to Health-care workers. The incidence of infection following needle stick injury has been reported to be high among medical students. Effective vaccines against HBV are available. The aim of this study was to determine the vaccination status and prevalence of needlestick injury among medical students in a tertiary institution in a developing country (Nigeria). Method: Information regarding hepatitis B status; history of needlestick injury and awareness of risk factors for HBV were obtained from clinical medical students using a self administered questionnaire. Three hundred and forty six students responded. Results: Three hundred and five (88.7) agreed that medical education exposes one to HBV infection and 315 (91.6) were aware of the availability of vaccine against HBV. Only 42 (47.7) were vaccinated against HBV. Majority (57.4) gave lack of opportunity as reason for non immunization while 34.7had never given it a thought. One hundred and sixty-six (48) of the respondents admitted to a previous needlestick injury and only 17 (10.2) of those who reported history of needlestick injury had post-exposure prophylaxis against HBV infection. Conclusion: HBV vaccination status is very low among medical students in Nigeria and the prevalence of needle stick injuries is high. Universities must not only provide HBV vaccination free of charge but also enforce its use by these students