10-Year Risk of Developing Type 2 Diabetes Mellitus: A Survey of Rural Communities in Southern Nigeria.

BACKGROUND: The exponential rise in the prevalence of Type 2 Diabetes (T2DM) necessitates the introduction of strategies for early diagnosis to reduce the burden of the disease. This study assessed the prevalence of prediabetes and also determined the 10-year risk of developing T2DM in Southern Nigerian rural communities by adopting the validated Finnish Diabetes Risk Score (FINDRISC) tool. METHODS: 273 participants from 3 Southern rural communities aged 18 years and older were recruited in this cross-sectional study. Data in the FINDRISC stratification tool and Random Blood Glucose (RBG) variables were obtained for the participants. IBM SPSS version 21 was used to analyze the data with a level of significance put at p < 0.05. RESULTS: The participants' mean age was 54.20±16.61 years. The prevalence of prediabetes among the study participants based on RBG was 4.8% (3.8% of males and 6.6% of females, respectively). Most of the study participants (41%) had a low risk of developing T2DM which meant that 1 in 100 participants would become diabetic in a 10-year period, based on the FINDRISC scale. Amongst the male participants, the Total Diabetes Risk Score (TDRS) showed significant positive correlation with the RBG (r=0.315, p=0.001); similarly, a weak positive correlation between TDRS and RBG was noted among female participants. CONCLUSION: The propensity of developing T2DM in 10 years was indisputably low amongst rural dwellers in the Southern Nigerian rural communities studied. Further studies to compare the risk of developing T2DM between rural and urban communities would be required.

CONTEXTE: L'augmentation exponentielle de la prévalence du diabète de type 2 (DT2) nécessite l'introduction de stratégies de diagnostic précoce pour réduire le fardeau de la maladie. Cette étude évalue la prévalence du prédiabète et détermine également le risque sur 10 ans de développer un DT2 dans les communautés rurales du sud du Nigeria en adoptant l'outil validé FINDRISC (Finnish Diabetes Risk Score). MÉTHODES: 273 participants de 3 communautés rurales du sud du pays âgés de 18 ans et plus ont été recrutés dans cette étude transversale. Les données de l'outil de stratification FINDRISC et les variables de la glycémie aléatoire (RBG) ont été obtenues pour les participants. IBM SPSS version 21 a été utilisé pour analyser les données avec un niveau de signification mis à p < 0,05. RÉSULTATS: L'âge moyen des participants était de 54,20±16,61 ans. La prévalence du prédiabète parmi les participants à l'étude, basée sur le RBG, était de 4,8% (3,8% des hommes et 6,6% des femmes respectivement). La plupart des participants à l'étude (41%) présentaient un faible risque de développer un DT2, ce qui signifie que 1 participant sur 100 deviendrait diabétique sur une période de 10 ans, selon l'échelle FINDRISC. Chez les hommes, le score total de risque de diabète (TDRS) a montré une corrélation positive significative avec le RBG (r=0,315, p=0,001) ; de même, une faible corrélation positive entre le TDRS et le RBG a été notée chez les femmes. CONCLUSION: La propension à développer un DT2 en 10 ans est indiscutablement faible chez les habitants des communautés rurales du sud du Nigeria étudiées. D'autres études visant à comparer le risque de développer un DT2 entre les communautés rurales et urbaines seraient nécessaires. Mots clés: FINDRISC, Nigeria, TDRS, Diabète de type 2, Prédiabète, Habitants ruraux.

APOE E4 is associated with impaired self-declared cognition but not disease risk or age of onset in Nigerians with Parkinson's disease.

The relationship between APOE polymorphisms and Parkinson's disease (PD) in black Africans has not been previously investigated. We evaluated the association between APOE polymorphic variability and self-declared cognition in 1100 Nigerians with PD and 1097 age-matched healthy controls. Cognition in PD was assessed using the single item cognition question (item 1.1) of the MDS-UPDRS. APOE genotype and allele frequencies did not differ between PD and controls (p > 0.05). No allelic or genotypic association was observed between APOE and age at onset of PD. In PD, APOE ε4/ε4 conferred a two-fold risk of cognitive impairment compared to one or no ε4 (HR: 2.09 (95% CI: 1.13-3.89; p = 0.02)), while APOE ε2 was associated with modest protection against cognitive impairment (HR: 0.41 (95% CI 0.19-0.99, p = 0.02)). Of 773 PD with motor phenotype and APOE characterized, tremor-dominant (TD) phenotype predominated significantly in ε2 carriers (87/135, 64.4%) compared to 22.2% in persons with postural instability/gait difficulty (PIGD) (30/135) and 13.3% in indeterminate (ID) (18/135, 13.3%) (p = 0.037). Although the frequency of the TD phenotype was highest in homozygous ε2 carriers (85.7%), the distribution of motor phenotypes across the six genotypes did not differ significantly (p = 0.18). Altogether, our findings support previous studies in other ethnicities, implying a role for APOE ε4 and ε2 as risk and protective factors, respectively, for cognitive impairment in PD.

Outcome of Delayed Administration of Alteplase in a Resource-Poor Area: A Case Report.

An acute ischemic stroke, though carrying the risk of debilitating complications, is a preventable and treatable disease. Thrombolysis and endovascular thrombectomy are important components of its management. However, various challenges in resource-poor countries like Nigeria and other developing nations pose a great limitation in the timely intervention of ischemic stroke treatment. The challenges include late presentation, poor awareness of stroke symptoms even among health care workers, poor ambulance service/transportation network, intra-hospital delay, particularly in neuroimaging, and the unavailability of tissue plasminogen activator (alteplase/tenecteplase). We report a 32-year-old African man with an antecedent history of suspected migraine headaches with aura and a family history of hypertension and stroke, admitted 7½ hours after onset of stroke symptoms, scoring 13 on the National Institutes of Health Stroke Scale (NIHSS) with Medical Research Council (MRC) muscle power grades 1 and 3 on the right upper and lower extremities, respectively. Urgent non-contrast brain CT revealed only a hyperdense sign in the left middle cerebral artery (MCA). Intravenous tissue plasminogen activator (tPA) was administered at a lower dose of 0.6 mg/kg, 15½ hours after symptom onset, and a CT angiogram done 24 hours post-thrombolysis showed partial recanalization of the M1 segment of the MCA and intermediate collateral supply (Alberta stroke program early CT {ASPECT} score: 6). By the third day of admission, he had made a significant clinical improvement and was discharged home able to walk unsupported on the fourth day.

Management of an incompetent mid-second (mid-2nd) trimester absent ecto-cervix: a case series. Cervical amplification pre-cerclage insertion.

BACKGROUND: Cervical cerclage is a treatment for an incompetent cervix, the latter being a contributor to spontaneous preterm birth. There is significant difficulty with a transvaginal cerclage insertion for the absent vaginal or ecto-cervix in the mid-2nd trimester period resulting in a higher risk of late miscarriages, extremely preterm labour with increased neonatal morbidity and mortality. METHODS: A retrospective review of 5 consecutive cases managed by a surgical technique-modified high vaginal cerclage insertion at 18-20 weeks-and adjunct protocols which included vaginal progesterone use, serial infection screening and lifestyle advice, over a 12-month period ending in August 2021, is presented. Inclusion criteria included minimal or absent ecto-cervix, singleton pregnancies with an incompetent cervix attending for a vaginal cerclage whilst exclusion criteria were the usual contraindications to a cerclage insertion. Primary outcome was delivery after 34 weeks whilst seconday outcomes included maternal hemorrhage, bowel/bladder injury, chorioamnionitis and neonatal admission. RESULTS: A increased gestational latency of 13 gestational weeks (range 12-18). Mean gestational age at delivery was 36 weeks +1 (253 days) with a range of 241-264 days. Delivery after 34 weeks gestational age was 100% with no maternal surgical complications and corresponding neonatal outcomes. CONCLUSION: There is a potential therapeutic benefit of this technique and adjunct management, in managing an incompetent mid-2nd trimester absent ecto-cervix.

Year Risk of Developing Type 2 Diabetes Mellitus ­ A Survey of Rural Communities in Southern Nigeria

BACKGROUND: The exponential rise in the prevalence of Type 2 Diabetes (T2DM) necessitates the introduction of strategies for early diagnosis to reduce the burden of the disease. This study assessed the prevalence of prediabetes and also determined the 10-year risk of developing T2DM in Southern Nigerian rural communities by adopting the validated Finnish Diabetes Risk Score (FINDRISC) tool. METHODS: 273 participants from 3 Southern rural communities aged 18 years and older were recruited in this cross-sectional study.Data in the FINDRISC stratification tool and Random Blood Glucose (RBG) variables were obtained for the participants. IBM SPSS version 21 was used to analyze the data with a level of significance put at p< 0.05. RESULTS: The participants' mean age was 54.20±16.61 years. The prevalence of prediabetes among the study participants based on RBG was 4.8% (3.8% of males and 6.6% of females, respectively).Most of the study participants (41%) had a low risk of developing T2DM which meant that 1 in 100 participants would become diabetic in a 10-year period, based on the FINDRISC scale. Amongst the male participants, the Total Diabetes Risk Score (TDRS) showed significant positive correlation with the RBG (r=0.315, p=0.001); similarly, a weak positive correlation between TDRS and RBG was noted among female participants. CONCLUSION: The propensity of developing T2DM in 10 years was indisputably low amongst rural dwellers in the Southern Nigerian rural communities studied. Further studies to compare the risk of developing T2DM between rural and urban communities would be required

A Cross-Sectional Comprehensive Assessment of the Profile and Burden of Non-motor Symptoms in Relation to Motor Phenotype in the Nigeria Parkinson Disease Registry Cohort.

BACKGROUND: Data on non-motor symptoms (NMS) in black Africans with Parkinson's disease (PD) are sparse. OBJECTIVE: To describe the profile of NMS in the Nigeria PD Registry (NPDR) cohort and explore the relationship between NMS and PD motor phenotype. METHODS: We conducted a cross-sectional study of the frequency and burden of NMS, based on the non-motor symptoms scale (NMSS) and the Chaudhuri method respectively in our cohort. Baseline demographics, disease characteristics (Hoehn and Yahr stage, MDS-UPDRS total score and Part III motor score), motor phenotype (based on Stebbin et al's algorithm), and levodopa equivalent daily dose (LEDD) were documented. RESULTS: Data are presented for 825 PD whose mean age at study was 63.7 ± 10.1 years, female sex-221 [26.8%] while median PD duration was 36 months. PD phenotypes included tremor-dominant 466 (56.5%), postural instability and gait disorder (PIGD) 259 (31.4%), and indeterminate 100 (12.1%). 82.6% were on treatment (median LEDD of 500 mg/24 hours). 804 (97.5%) endorsed at least 1 NMS. The median NMSS score was 26.0 while subscores for urinary and sexual function domains were significantly higher in males (P < 0.05). PIGD-PD had more frequent NMS and higher frequency of severe/very severe NMSS burden (P = 0.000 for both). Nocturia and fatigue were the most prevalent NMS overall and across motor subtypes. PIGD phenotype and total UPDRS scores were the independent determinants of NMSS scores (P = 0.000). CONCLUSION: The profile and burden of NMS, and association with motor subtype in our black African cohort is largely similar to descriptions from other populations.

Sleep medicine in Africa: past, present, and future.

NONE: Interest in sleep and sleep disorders in Africa dates back thousands of years, influenced by various cultural and religious beliefs. However, the practice of sleep medicine as a specialty has been inadequate compared to other regions of the world. The objective of this study was to explore the current status of sleep medicine in Africa vis-à-vis education, professional societies, and facilities, and to identify challenges of the specialty in the region. A literature search of major electronic databases (PubMed, Google Scholar) was done. This revealed that there is a high prevalence of sleep disorders in Africa and a significant association with epilepsy, human African trypanosomiasis, human immunodeficiency virus, and other diseases. There are 6 sleep societies in Africa located in 4 countries. Forty-one sleep laboratories were identified located in 4 countries. The challenges hindering development of sleep medicine in Africa include lack of awareness, poor funding, lack of facilities, and inadequate training.

Iron Deficiency Anemia in Nigerians with Heart Failure (IDAN-HF): Therapeutic efficacy of iron replacement: An interventional study.

BACKGROUND: Recent evidence has reported significant improvement in clinical profile, quality of life, and prognosis of heart failure subjects with iron replacement. AIMS: This study aimed to determine the safety and outcome of parenteral iron replacement among heart failure subjects in Nigeria. METHOD: A randomized interventional study was done at the Cardiology Clinic of LAUTECH Teaching Hospital, Ogbomoso, Nigeria. One hundred and forty subjects with heart failure were recruited. Iron deficiency and anemia were determined according to standardized criteria. Parenteral iron dextran was administered to a block randomized group of 30 of those identified with iron deficiency and compared with controls. The primary outcome was the six minutes' walk test (6 MWT) after 8 weeks while the Kansas City Cardiomyopathy Questionnaire (KCCQ) score was used to assess the quality of life as a secondary outcome. Statistical analysis was done with the SPSS 20.0. P value <0.05 was taken as statistically significant. RESULTS: Iron deficiency was present in 84 (60.0%) of all study participants. Iron dextran was fairly tolerated with mild to moderate adverse reactions reported in 7 (23.3%) subjects who had an iron infusion. Improvement in the 6 MWT distance (390.1 ± 92.6 vs. 156.9 ± 72.5 meters, P < 0.05) and the KCCQ score (84.5 ± 3.7 vs. 64.2 ± 12.5%, P < 0.05) among iron-deficient heart failure subjects who received iron dextran was significantly higher than those who did not receive the iron replacement. Functional classification according to the New York Heart Association (NYHA) profile and heart rate were also much improved after the iron replacement than those who did not receive it. CONCLUSION: Parenteral iron dextran therapy was fairly tolerated among heart failure subjects. Iron replacement is associated with improved quality of life, better temporal clinical profile, and functional classification among Nigerians with heart failure. Iron replacement therapy can be an additional therapeutic option in heart failure management among Africans to improve prognosis.

The Nigeria Parkinson Disease Registry: Process, Profile, and Prospects of a Collaborative Project.

BACKGROUND: Clinical disease registries are useful for quality improvement in care, benchmarking standards, and facilitating research. Collaborative networks established thence can enhance national and international studies by generating more robust samples and credible data and promote knowledge sharing and capacity building. This report describes the methodology, baseline data, and prospects of the Nigeria Parkinson Disease Registry. METHODS: This national registry was established in November 2016. Ethics approval was obtained for all sites. Basic anonymized data for consecutive cases fulfilling the United Kingdom Parkinson's Disease Brain Bank criteria (except the exclusion criterion of affected family members) are registered by participating neurologists via a secure registry website (www.parkinsonnigeria.com) using a minimal common data capture format. RESULTS: The registry had captured 578 participants from 5 of 6 geopolitical zones in Nigeria by July 2019 (72.5% men). Mean age at onset was 60.3 ± 10.7 years; median disease duration (interquartile range) was 36 months (18-60.5 months). Young-onset disease (<50 years) represented 15.2%. A family history was documented in 4.5% and 7.8% with age at onset <50 and ≥ 50, respectively. The most frequent initial symptom was tremor (45.3%). At inclusion, 93.4% were on treatment (54.5% on levodopa monotherapy). Per-capita direct cost for the registry was $3.37. CONCLUSIONS: This is the first published national Parkinson's disease registry in sub-Saharan Africa. The registry will serve as a platform for development of multipronged evidence-based policies and initiatives to improve quality of care of Parkinson's disease and research engagement in Nigeria. © 2020 International Parkinson and Movement Disorder Society.

Air Quality Index and Respiratory Symptoms among Garri Processing Workers in Ogbomoso, Nigeria.

BACKGROUND: Epidemiological studies have linked morbidity and mortality of individuals to exposure to atmospheric gaseous and particulate matter especially fine particles (PM2.5) and coarse particles (PM10).The process of garri (cassava crisps) production (frying with firewood) is associated with production of gaseous and particulate matter which contribute to ambient particulate matter air pollution. The objective of this study was to determine the impact of air quality indices on the prevalence of respiratory symptoms among the garri processing workers in Ogbomoso. METHODOLOGY: A comparative cross-sectional study was carried out among 351 garri processing workers in Ogbomoso as subjects and 351 residents of Ogbomoso metropolis as controls that were age, sex and height-matched. A semi-structured questionnaire was used to obtain sociodemographic profiles and respiratory symptoms of participants and document physical examination findings. Particulate matter counter was used for air quality sampling. RESULTS: The mean age of subjects was 41.7 ± 14.9 years and that of controls was 41.6 ± 14.7 years (p =0.960). The two groups were also matched for socioeconomic status, sex and height. Prevalence of respiratory symptoms was higher at 48.4% among the garri workers than the control group which was 29.1% (p<0.001). Cough was the predominant symptom with a prevalence of 29.3% and 10.5% among the subjects and controls respectively. The mean count of PM1.0 in garri processing locations was significantly higher than that recorded in Ogbomoso metropolis; 73.77±42.08 vs 15.04±6.66mg/m3 (p<0.0001). CONCLUSION: Garri processing work is associated with significant increase in ambient air pollution and increased prevalence of respiratory symptoms among the workforce compared to the control population. Effective preventive strategies including education and provision of safety masks may reduce the occupational hazards associated with garri processing factory workers in Nigeria.

PATTERN OF ANAEMIA AND ITS CORRELATES IN NIGERIANS WITH HEART FAILURE.

BACKGROUND: Heart failure often coexists with many comorbidities, including anaemia. However, the pattern of anaemia in heart failure and its clinical and echocardiographic associations have not been adequately studied among Nigerians. OBJECTIVE: To describe the pattern of anaemia, its clinical characteristics, and its echocardiographic associations among heart failure subjects in Nigeria. METHODOS: One hundred and forty subjects with heart failure were recruited from the cardiology clinics of two teaching hospitals in southwest Nigeria: Ladoke Akintola University of Technology and Bowen University Teaching Hospitals, Ogbomoso. Complete blood analyses, among other tests, were done. Statistical analysis was done with Statistical Package for the Social Sciences (SPSS) 20.0. P <0.05 was taken as statistically significant. RESULTS: Anaemia, as defined by the World Health Organisation, occurred in 106 (75.7%) of the heart failure patients. The patterns of anaemia among participants include combined anaemia of chronic diseases (ACD) with iron deficiency in 64 (45.7%) patients, and ACD alone in 40 (28.6%). Anaemia was more significantly associated with previous diagnosis of diabetes mellitus, presence of pulmonary hypertension, and heart failure with reduced ejection fraction. Mean systolic and diastolic blood pressures, ejection fraction, and fractional shortening were significantly lower among heart failure subjects with anaemia, while serum creatinine, left atrial dimension, left ventricular end diastolic dimension, and left ventricular mass index were significantly higher among heart failure subjects with anaemia compared to those without anaemia. CONCLUSION: Anaemia occurs very frequently among heart failure patients in southwest Nigeria. It is associated with many poor prognostic factors, including diabetes mellitus, pulmonary hypertension, and kidney failure.

Angiotensin-1-converting enzyme inhibition, antioxidant activity, and modulation of cerebral Na+/K+ ATPase by free phenolics of African locust bean (Parkia biglobosa).

AIMS: To investigate the antioxidant activities and effects of free phenols (FPPB) and bound phenols (BPPB) of Parkia biglobosa leaves on some enzymes of neuro-cardiovascular relevance. METHODS AND RESULTS: HPLC-DAD fingerprinting of FPPB and BPPB, and the antihemolytic, radical (1,1-diphenyl-2 picrylhydrazyl, DPPH; 2,2-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid), ABTS) scavenging and ferric reducing antioxidant properties of extracts, were assessed. In addition, the effects of the phenolics on angiotensin-1-converting enzyme (ACE), cerebral acetylcholinesterase/butyrylcholinesterase (AChE/BuChE), and Na+/K+ATPase were determined in vitro. FPPB was more potent than BPPB in terms of ABTS (EC50:4.06 ± 0.3 vs 24.07 ± 2.1 µg/mL) and DPPH (EC50:3.82 ± 0.2 vs 10.22 ± 0.1 µg/mL) radicals scavenged, respectively. The free phenolic extract was a better DPPH. scavenger than ascorbic acid (EC50 = 12.58 ± 0.4 µg/mL; DPPH reference) and compared well with Trolox (EC50:4.44 ± 0.08 µg/mL; ABTS reference). The anti-hemolytic effect of FPPB (36%) and BPPB (53%) was highest at 15 µg/mL but lower than that recorded for ascorbic acid (67% at 10 µg/mL). Even though FPPB (IC50 = 15.35 ± 4.0 µg/mL) and BPPB (IC50 = 46.85 ± 3.3 µg/mL) showed considerably lower ACE-inhibitory effect than ramipril (IC50:0.173 ± 0.04 µg/mL), both extracts demonstrated dose-dependent, significant (p < 0.01/p < 0.05) inhibition of the enzyme. FPPB increased cerebral Na+/K+ATPase activity but neither phenolic extract affects cerebral AChE/BuChE activities. HPLC-DAD revealed catechin, caffeic acid, and quercetin, respectively, as the major phenolics (mg/g) in FPPB (29.85, 30.29, and 17.10) and BPPB (32.70, 30.51, and 19.25). CONCLUSION: The effects of P biglobosa on ACE and cerebral ATPase are related to its constituent phenolics. ACE inhibition could be an important mechanism underlying the documented hypotensive effect of the plant.

Antihypertensive Medications Adherence Among Nigerian Hypertensive Subjects in a Specialist Clinic Compared to a General Outpatient Clinic.

BACKGROUND: Poor adherence to antihypertensive medications has been linked with increased cardiovascular risk and mortality in many population. Africans have been shown to have a worse prognosis from hypertension, poorer blood pressure control, and increased risk of complications arising from hypertension compared to Caucasians. AIM: The aim was to describe the level of adherence to antihypertensive medications, its determinants and whether any difference exist between those attending specialty clinic or general outpatient department (GOPD) Clinic in a Nigerian University Teaching Hospital. SUBJECTS AND METHODS: An analytical cross-sectional study. The Morisky scale was used to assess for adherence to antihypertensive medications. Clinical and demographic data were taken. Statistical analysis was performed using SPSS 17.0. (Chicago, IL, USA). P < 0.05 was taken as statistically significant. RESULTS: A total of 114 hypertensive subjects were recruited for this study. Seventy-nine were from the cardiology clinic whereas 35 were from the GOPD. They consisted of 60 males (52.6%, 60/114) and 54 females (47.4%, 54/110). The mean age was 63.6 (14.1) years. High adherence, low adherence and medium adherence as defined by Morisky scale was found in 36.8% (42/114), 23.9% (27/114) and 39.5% (45/114), respectively. Adherence level was higher among those attending specialty clinic despite shorter duration of hypertension and use of more medications. More than four-fifth of those attending cardiology clinic had at least medium level of adherence compared to a little bit over half of those attending GOPD clinic. Those with good adherence were likely to be older, had a higher level of education and higher average monthly income than those with poor adherence. CONCLUSION: Poor adherence to medications is very common in the hypertensive Nigerians. Hypertensive subjects attending specialty clinic seems to have a better adherence to antihypertensive medications possibly due to the level of health education and information provided to patients. Effective health education and regular screening for compliance and adherence is a potential way to reduce cardiovascular risk associated with uncontrolled hypertension.

Prevalence of traditional cardiovascular risk factors among staff of Ladoke Akintola University of Technology, Ogbomoso, Nigeria

Aim: The aim was to describe the frequency of occurrence of traditional cardiovascular (CV) risk factors among selected university workers in Ladoke Akintola University of Technology (LAUTECH) Nigeria.Materials and Methods: A cross­sectional study of 206 staff of LAUTECH, Ogbomoso, Nigeria had an assessment for nine traditional CV risk factors. Demographic and clinical parameters were taken. Blood sample was taken to determine the random blood sugar and lipid profile. 12­lead resting electrocardiography (ECG) was done for all participants. Statistical analysis was performed with the aid of Statistical Package for Social Sciences (SPSS)version 17.0 (Chicago Ill., USA)Results: The study population included 96 males (46.6%) and 110 females. The mean age was 45.3 ± 7.9 years (range 27-73 years). The prevalence of CV risk factors were as follows: Hypertension 84 (40.8%), visceral obesity 92 (44.7%), generalized obesity 79 (38.3%), low high density lipoprotein 113 (54.9%), impaired blood glucose 16 (7.8%), diabetes mellitus 3(1.5%),hypercholesterolemia 102 (49.5%), left ventricular hypertrophy­ECG 24 (11.7%), elevated low density lipoprotein­cholesterol 99 (48.1%). About ­ (72.3%) had two or more CV risk factors clustered together. Females had a higher prevalence of CV risk factors and its clusters than their male counterparts. Of those diagnosed with hypertension in this study, more than half had never been told they werehypertensive 48 (57.1%). Conclusion: This study suggests a very high prevalence of CV risk factors among University Staff in LAUTECH,Ogbomoso, Nigeria. Clustering of CV risk factors is more prevalent among women. Appropriate preventive strategy in terms of education and modification of risk factors are important to reduce the burden of CV diseases among this population

Prevalence of traditional cardiovascular risk factors among staff of Ladoke Akintola University of Technology, Ogbomoso, Nigeria.

AIM: The aim was to describe the frequency of occurrence of traditional cardiovascular (CV) risk factors among selected university workers in Ladoke Akintola University of Technology (LAUTECH) Nigeria. MATERIALS AND METHODS: A cross-sectional study of 206 staff of LAUTECH, Ogbomoso, Nigeria had an assessment for nine traditional CV risk factors. Demographic and clinical parameters were taken. Blood sample was taken to determine the random blood sugar and lipid profile. 12-lead resting electrocardiography (ECG) was done for all participants. Statistical analysis was performed with the aid of Statistical Package for Social Sciences (SPSS) version 17.0 (Chicago Ill., USA) Results: The study population included 96 males (46.6%) and 110 females. The mean age was 45.3 ± 7.9 years (range 27-73 years). The prevalence of CV risk factors were as follows: Hypertension 84 (40.8%), visceral obesity 92 (44.7%), generalized obesity 79 (38.3%), low high density lipoprotein 113 (54.9%), impaired blood glucose 16 (7.8%), diabetes mellitus 3 (1.5%), hypercholesterolemia 102 (49.5%), left ventricular hypertrophy-ECG 24 (11.7%), elevated low density lipoprotein-cholesterol 99 (48.1%). About - (72.3%) had two or more CV risk factors clustered together. Females had a higher prevalence of CV risk factors and its clusters than their male counterparts. Of those diagnosed with hypertension in this study, more than half had never been told they were hypertensive 48 (57.1%). CONCLUSION: This study suggests a very high prevalence of CV risk factors among University Staff in LAUTECH, Ogbomoso, Nigeria. Clustering of CV risk factors is more prevalent among women. Appropriate preventive strategy in terms of education and modification of risk factors are important to reduce the burden of CV diseases among this population.

Parkia biglobosa improves mitochondrial functioning and protects against neurotoxic agents in rat brain hippocampal slices.

OBJECTIVE: Methanolic leaf extracts of Parkia biglobosa, PBE, and one of its major polyphenolic constituents, catechin, were investigated for their protective effects against neurotoxicity induced by different agents on rat brain hippocampal slices and isolated mitochondria. METHODS: Hippocampal slices were preincubated with PBE (25, 50, 100, or 200 µg/mL) or catechin (1, 5, or 10 µg/mL) for 30 min followed by further incubation with 300 µM H2O2, 300 µM SNP, or 200 µM PbCl2 for 1 h. Effects of PBE and catechin on SNP- or CaCl2-induced brain mitochondrial ROS formation and mitochondrial membrane potential (ΔΨm) were also determined. RESULTS: PBE and catechin decreased basal ROS generation in slices and blunted the prooxidant effects of neurotoxicants on membrane lipid peroxidation and nonprotein thiol contents. PBE rescued hippocampal cellular viability from SNP damage and caused a significant boost in hippocampus Na(+), K(+)-ATPase activity but with no effect on the acetylcholinesterase activity. Both PBE and catechin also mitigated SNP- or CaCl2-dependent mitochondrial ROS generation. Measurement by safranine fluorescence however showed that the mild depolarization of the ΔΨm by PBE was independent of catechin. CONCLUSION: The results suggest that the neuroprotective effect of PBE is dependent on its constituent antioxidants and mild mitochondrial depolarization propensity.

Gender specific pattern of left ventricular cardiac adaptation to hypertension and obesity in a tertiary health facility in Nigeria.

BACKGROUND: Cardiac adaptation to hypertension and obesity may be related to many factors such as race, gender and haemodynamic status. Some gender specific associations with left ventricular structure and function have been described among Caucasians. OBJECTIVES: To describe the sex specific pattern of left ventricular adaptations to obesity and hypertension among Nigerians. METHODOLOGY: It was a cross sectional study carried out at LAUTECH Teaching Hospital, Osogbo, Nigeria. 313 subjects had full echocardiography performed. Participants were divided into four groups: normal, obese, hypertensives and obese-hypertensives. Indices of LV adaptation were compared between the groups. SPSS 16.0 was used for analysis. RESULTS: Relative to normal subjects, LV mass (LVM), LV mass index (LVMI) and wall thickness were significantly higher among hypertensive men and obese hypertensive men. They were similar between normal and obese men. However, LVM, LVMI and wall thickness were increased among obese women compared to normal women while they were similar among obese, hypertensive and obese-hypertensive women. Men with concurrent obesity and hypertension presented with a further increase of LVM and wall thickness above values in the merely obese or hypertensive subjects. Female obese-hypertensive seem to present more with eccentric hypertrophy than male obese-hypertensive subjects (17.2% vs. 9.1% respectively, p<0.05) while male obese-hypertensive seem to present more with concentric hypertrophy (54.5% vs. 43.1% respectively, p>0.05) than female obese-hypertensive subjects. CONCLUSION: Structural, functional and geometric LV adaptation to obesity and hypertension varies between the two genders among Nigerians. The impact of isolated obesity on LV adaptation in women appears very significant.

Testicular membrane lipid damage by complex mixture of leachate from municipal battery recycling site as indication of idiopathic male infertility in rat.

Leachate from a municipal battery recycling site is a potent source of mixed-metal released into the environment. The present study investigated the degree at which mixed-metal exposure to the municipal auto-battery leachate (MABL) and to the Elewi Odo municipal auto-battery recycling site leachate (EOMABRL) affected the lipid membrane of the testes in in vitro experiment. The results showed elevated level of mixed-metals over the permissible levels in drinking water, as recommended by regulatory authorities. In the leachate samples, the levels of malondialdehyde (MDA), a biomarker of lipid damage, was significantly (p<0.05) increased in rat testes in a dose-dependent manner. MDA induced by the municipal auto-battery leachate (MABL) was significantly (p<0.05) higher than the leachate from Elewi Odo municipal auto-battery recycling site (EOMABRL). The testicular lipid membrane capacity was compromised following treatment with leachate from the municipal battery recycling site, implicating mixed-metal exposure as the causative agent of testicular damage and male infertility.

Impact of urbanization and gender on frequency of metabolic syndrome among native Abuja settlers in Nigeria.

BACKGROUND: Metabolic syndrome (MetS) is an important cause of morbidity and mortality. Nigeria is currently undergoing rapid epidemiological transition. The objective was to study whether urbanization is associated with increased prevalence of MetS between native rural Abuja settlers and genetically related urban dwellers. MATERIALS AND METHODS: It was a cross-sectional study. Three hundred and forty-two urban native Abuja settlers and 325 rural dwellers were used for the study. Fasting blood lipid, glucose, waist circumference, blood pressure, and body mass index were determined. MetS was defined according to three standard criteria. SPSS 16.0 was used for statistical analysis. P<0.05 was used as statistically significant. RESULTS: Obesity, hypertriglyceridemia, and hypertension were commoner among urban dwellers than rural dwellers. MetS was associated more with the female gender. Urbanization significantly increases the frequency of MetS using the three standard definitions. The prevalence of MetS using International Diabetes Federation, World Health Organization, and National Cholesterol Education Program Adult Treatment Panel III among rural versus urban dwellers were 7.7% vs. 14.9%, P<0.05; 0% vs. 0.9%, P>0.05; and 3.7% vs. 13.7%, P<0.05, respectively. CONCLUSION: This study shows that MetS is a major health condition among rural and urban Nigerians and that urbanization significantly increases the prevalence of MetS. This can be explained on the basis of higher prevalence of dyslipidemia, obesity, and hypertension in urban setting, possibly as a result of stress, diet, and reduction in physical activity. Effective preventive strategy is therefore required to stem the increased risk associated with urbanization to reduce the cardiovascular risk associated with MetS among Nigerians.