Diabetes-related-distress and its relationship with glycaemic control among type 2 diabetes mellitus patients attending a specialty clinic in Lagos, Nigeria

Diabetes Mellitus (DM) is a chronic metabolic disease with various complications throughout its course. The presence of emotional burden in diabetes disease, which is referred to as diabetes-related distress (DRD) is common among such patients and may affect their response to treatment. Objectives: To assess the relationship of diabetes-related distress and glycaemic control among patients with Type 2 Diabetes mellitus. Methods: This hospital-based cross-sectional study was conducted at the Family Medicine Department of LASUTH, Ikeja, Lagos. A total of 317 patients with Type 2 Diabetes mellitus were systematically recruited. The data were collected over a four-month period. Important clinical information including clinical characteristics and diabetes-related distress using the diabetes distress scale (DDS-17) was collected. Glycosylated haemoglobin (HbA1c) was also assessed. Results: The degrees of DRD were as follows: 54.9% (None/little), 40.1% (moderate) and 5.0% (severe). The mean HbA1c estimate for all participants was 7.83±1.8%. Among the 317 study participants, 67.2% had poor glycaemic control while 32.8% had good glycaemic control. There was a statistically significant association between DRD and glycaemic control (p< 0.001). Likewise, the various domains of DRD had statistically significant associations with glycaemic control with the exception of physician-related domain. Participants with better glycaemic control reported lower levels of DRD than participants with poorer glycaemic control. Conclusion: There is a high level of diabetes-related distress patients with diabetes mellitus. Good glycaemic control is important in improving or preventing DRD. Therefore, T2DM patients should be screened for DRD during their treatment.

C-Reactive Protein as an Inflammatory Biomarker for the Assessment of Malaria Parasitemia in a Tertiary Health Care Facility in Rivers State, Nigeria

Aim: To use C-Reactive Protein (CRP) in assessing` malaria and malaria parasitemia among out-patients in the University of Port Harcourt Teaching Hospital (UPTH).Study Design:Cross-sectional descriptive study.Place and Duration of Study:This study was carried out at the Out Patients Department (OPD) of the University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria. It was conducted between November 2017 and April 2018.Methodology: This study was done on 400 subjects between the ages of 11 and 60years which consisted of 254 falciparum malaria infected patients and 164 non-infected patients. Quantitative analysis of Serum CRP was done using the High Sensitivity C-Reactive Protein (HsCRP) enzyme immunoassay test kit (Biocheck©) while malaria diagnosis was done using microscopy Giemsa thick and thin film prepared on separate slides, slides were observedunder the ×10 and ×100 objectives of the light microscope. Slides viewed under a high power field with parasite density less 464932than three (<3), between 3 and 10 (3-10), from eleven to nineteen (11-19) and greater or equal to 20 (≥20) were classified as scanty, one plus (+), two pluses (++) and three pluses (+++) respectively. Data analysis was done using statistical packages for social science (SPSS) version 21.Results:The results showed a significant (p<0.001) overall mean high serum CRP concentration (25.63±14.40 mg/l) in the malaria infected patients compared to 3.74±1.02mg/l in the non-infected group, with a direct increment of the CRP level from the scanty to the three pluses with 9.50±0.37 mg/l, 13.51±1.6 mg/l, 44.19±2.62 mg/l and 53.84±1.75 mg/l recorded for scanty, one plus, two pluses and three pluses respectively. CRP correlated positively and significantly with malaria parasitemia (r = 0.89; p < 0.001).Conclusion:The abnormally elevated level of CRP in the infected patients showed that CRP is apositive biomarker for Plasmodium falciparum malaria and can be used as an indicator of the disease coupled with other febrile symptoms.

The Metabolic Clinic: Challenges in a Developing Country

The “Type of Article” of this paper is “Letter to the Editor”. This paper discuses about: “The Metabolic Clinic: Challenges in a Developing Country”. No formal abstract is available. Readers are requested to read the full article.

Review of the Practice of Traditional Bone Setting in Nigeria

Background: The practice of traditional bone setting (TBS) is extensive in Nigeria and it enjoys enormous patronage by the populace. However; the outcome of the intervention of TBS treatment is usually poor with profound effects on the patient. There are many publications highlighting different aspects of this subject but none has summarized the entire practice and problems as a single publication. Objective: This work aims at reviewing the entire subject of traditional bone setting in Nigeria in a single article to enable easy understanding and appreciation of the practice and problems of traditional bone setting by orthodox practitioners. Method: A total of thirty-one relevant published original scientific research papers involving all aspects of the subject were reviewed and the practices and problems were documented. Results: The results showed that the origin of the practice is shrouded in mystery but passed on by practitioners from one generation to another. There is no formal training of bonesetters. Though the methods of treatment vary; the problems caused by them are usually similar with extremity gangrene being the worst. When attempts have been made to train the bone setters; improvement have been noted in their performance. Conclusion: In other to prevent some of the most debilitating outcomes like amputation; it is suggested that the TBS practitioners undergo some training from orthopaedic practitioners

Comparison of Araoye's criteria with standard electrocardiographic criteria for diagnosis of left ventricular hypertrophy in Nigerian hypertensives

Background: Left ventricular hypertrophy (LVH) is a major risk factor for cardiovascular morbidity and mortality. Various electrocardiographic (ECG) criteria for LHV give poorer performance in black subjects when compared with white subjects. Araoye proposed a code system for improved ECG diagnosis of LVH in blacks. The Araoye's criteria are yet to be validated in black subjects.Study design: Electrocardiograms and echocardiograms were obtained from 100 hypertensive subjects and 60 controls. ECG LVH was determined by the Araoye's code criteria; Sokolow-Lyon; Cornell voltage; and Romhilt-Estes point score. Echocardiographic LVH was defined by LV mass indexed for height at 97.5 percentile of the controls (126g.m-1 and 130g.m-1 in females and males respectively). Results: The prevalence of echocardiographic LVH indexed for height was 34and 1.67in the hypertensive and controls respectively while the prevalence of electrocardiographic LVH among the hypertensives were 18by Romhilt Estes score; 48by Sokolow-Lyon's criteria; 22by Cornell's criteria and 51by Araoye's criteria. The sensitivity and specificity respectively of the various electrocardiographic criteria were 65.7and 76.8for Sokolow-Lyon; 25.7and 88.8for Cornell's criteria 25.7and 92.8for Romhilt-Estes score and 71.4and 74.4for Araoye's criteria. Araoye's criteria did not differ significantly from Sokolow-Lyon criteria in identifying LVH but differed significantly from Cornell and Romhilt-Estes criteria. The number of positive codes in Araoye's criteria was significantly associated with the blood pressures; LV dimensions; and LV mass. Conclusion: The Araoye's code system for electrocardiographic diagnosis of LVH offer no comparative advantage over Sokolow-Lyon's criteria. However; the number of positive codes in Araoye's criteria identifies those individuals with more severe LVH