Serum leptin levels and relationship with maternal weight gain at term among obese and non-obese pregnant women in Enugu, Nigeria: a comparative cross-sectional study.

OBJECTIVE: To determine and compare the mean maternal serum leptin levels, the prevalence of high serum leptin levels and mean gestational weight gain at term among obese and non-obese pregnant women in Enugu, Nigeria. METHODS: This cross-sectional comparative study enrolled obese and non-obese pregnant women. The serum leptin levels of the women were determined using an enzyme-linked immunosorbent assay kit. Anthropometric and sociodemographic data were obtained and compared. Mean weight gain during pregnancy was determined. RESULTS: A total of 170 pregnant women were included in the study. The mean ± SD serum leptin level (99.39 ± 50.2 ng/ml) and the prevalence of hyperleptinaemia (81 of 85 patients; 95.3%) among the obese pregnant women at term were significantly higher than those of the non-obese pregnant women (48.98 ± 30.35 ng/ml/65 of 85 patients; 76.5%). The mean percentage weight gain was significantly higher in the non-obese women compared with the obese women at term. The predictors of high maternal serum leptin level at term among the participants were the employment status and levels of education of the participants. CONCLUSION: Maternal serum leptin level, maternal weight gain and prevalence of hyperleptinaemia at term were significantly higher in the obese compared with the non-obese pregnant women.

Central laboratory and point-of-care cardiac marker testing capacity of tertiary hospitals in Nigeria - a multicenter study.

Background: Cardiovascular diseases are major contributors to morbidity and mortality. It is generally recognized that cardiac markers are of particular benefit in the evaluation of patients with suspected Acute Coronary Syndrome (ACS). Tertiary hospitals, mainly teaching hospitals, are expected to be optimally equipped to offer these services. The study therefore aimed at determining the central laboratory and point-of-care cardiac marker testing capacity of tertiary hospitals in Nigeria. Method: A cross-sectional survey was carried out in government-owned tertiary hospitals in Nigeria. Data were collected using semi-structured self-administered questionnaires, and analyzed using Stata version 13 (Stata Corp., USA). Results: A total of 34 hospitals participated in the study. The mean (SD) age of respondents was 43.68 (5.2) years. A total of 19 (55.88%) hospitals were found to have a functional cardiac marker testing facility, either in the form of point-of-care, central laboratory testing or both. Of those without a facility, lack of funds to procure equipment was the major reason given. In hospitals with a testing facility, most testing devices were located in the Central laboratory. Conclusion: Cardiac marker testing capacity of tertiary hospitals in Nigeria, both in the form of point-of-care and central laboratory testing, was found to be barely adequate. Improvement is needed in this area for better diagnosis and evaluation of patients who need the tests.

Assessment of thyroid function of newly diagnosed SARS-CoV-2 infected patients in Nigeria.

INTRODUCTION: the outbreak and rapid spread of the novel SARS-CoV-2, the causative agent of the coronavirus disease 2019 (COVID-19), has evolved into an unprecedented global pandemic. The infection impairs several human organs and systems, however, it is not clear how it affects thyroid function. The study therefore aimed at measuring plasma levels of thyroid hormones and Hs-CRP in COVID-19 patients and apparently healthy uninfected controls to assess the possible effect of SAR-CoV-2 infection on thyroid function. METHODS: in this cross-sectional study carried out between May-August 2020, 90 consenting participants comprising 45 COVID-19 patients and 45 apparently healthy uninfected controls were recruited. Plasma FT3, FT4, TSH and Hs-CRP were measured using Enzyme Linked Immunosorbent Assay (ELISA) method. Data was analysed using SPSS version 20 and statistical significance set at p < 0.05. RESULTS: the mean plasma FT3 and TSH concentrations were significantly higher in COVID-19 patients compared to controls (p < 0.001, p < 0.001 respectively). Euthyroidism was observed in all uninfected controls, whereas 35 (77.8%) COVID-19 patients were euthyroid. Sick euthyroid and subclinical hypothyroidism was observed in 7 (15.6%) and 3 (6.7%) COVID-19 patients, respectively. CONCLUSION: though there was a preponderance of euthyroidism among COVID-19 patients, significantly higher mean plasma levels of TSH and FT3, sick euthyroid syndrome and subclinical hypothyroidism observed among some COVID-19 patients may be indicative of disease-related thyroid function changes. Hence, there is need to pay attention to thyroid function during and after treatment of COVID-19.

Perspectives of buruli ulcer patients toward informed consent - An insight from Nigeria.

Introduction: Informed consent is a basic ethical requirement in situations involving sharing of patients' data. It supports and upholds the ethical principle of respect for persons and individual autonomy. For Buruli ulcer (BU) patients, associated stigma renders them vulnerable, hence the need for emphasis on additional protection by ensuring obtaining informed consent before third party use of their data. The authors therefore sought to determine willingness of these patients to give informed consent to the third party use of their data before and after treatment. Methodology: This cross-sectional study was carried out between February and August, 2019. The study involved BU patients from three endemic states in Nigeria. Data were collected using pretested, researcher-administered semi-structured questionnaires. Results: A total of 92 respondents participated in the study. The median age was 23.5 years (range 4-74 years) with the age group <15 years being the modal age group 36 (39.13%). About a quarter of the respondents (23.91%) had suffered some form of discrimination in the course of their disease. Majority 86 (93.48%) were favorably disposed to allowing the use of their data for donor drive, policy development, and teaching/training purposes. A significant greater proportion of respondents 90 (97.83%) were willing to give consent for the use of their oral interview as against pictures and videos both in the pre- and post-treatment periods. Conclusion: The present study provides evidence that majority of the respondents were positively inclined to give consent to use of their data by a third party. However, intrusion into privacy and anonymity were major concerns for the respondents.

RésuméIntroduction: Le consentement éclairé est une exigence éthique de base dans les situations impliquant le partage des données des patients. Il soutient et défend le principe éthique du respect des personnes et de l'autonomie individuelle. Pour les patients atteints d'ulcère de Buruli, la stigmatisation associée les rend vulnérables, d'où la nécessité de mettre l'accent sur une protection supplémentaire en garantissant l'obtention d'un consentement éclairé avant l'utilisation par des tiers de leurs données. Les auteurs ont donc cherché à déterminer la volonté de ces patients de consentir en connaissance de cause à l'utilisation de leurs données par des tiers avant et après le traitement. Les méthodes: Cette étude transversale a été réalisée entre février et août 2019. L'étude a porté sur des patients atteints d'ulcère de Buruli provenant de trois États endémiques du Nigéria. Les données ont été recueillies à l'aide de questionnaires semi-structurés prétestés et administrés par des chercheurs. Résultats: Au total, 92 répondants ont participé à l'étude. L'âge médian était de 23,5 ans (de 4 à 74 ans), le groupe d'âge <15 ans étant le groupe d'âge modal 36 (39,13%). Environ un quart des répondants (23,91%) ont subi une forme de discrimination au cours de leur maladie. La majorité 86 (93,48%) étaient favorables à autoriser l'utilisation de leurs données à des fins de mobilisation des donateurs, d'élaboration de politiques et d'enseignement / formation. Une proportion significativement plus élevée de répondants 90 (97,83%) étaient disposés à donner leur consentement pour l'utilisation de leur entretien oral par rapport aux photos et vidéos à la fois avant et après le traitement. Conclusion: La présente étude prouve que la majorité des répondants étaient positivement enclins à consentir à l'utilisation de leurs données par un tiers. Cependant, l'intrusion dans la vie privée et l'anonymat étaient des préoccupations majeures pour les répondants.

Serum antioxidant micronutrient levels in pre-eclamptic pregnant women in Enugu, south-East Nigeria: a comparative cross-sectional analytical study.

BACKGROUND: Pre-eclampsia is a common obstetric complication of pregnancy in Nigeria, and oxidative stress has been implicated in its aetiopathogenesis. Despite this fact, there is a paucity of information regarding the serum antioxidant micronutrient status of pre-eclamptic Nigerian women. The objective of the was to determine the mean serum levels of some antioxidant trace elements (copper, zinc, selenium, magnesium, manganese) in pre-eclamptic pregnant women and compare with that of healthy pregnant women in Enugu, South-Eastern, Nigeria. METHODS: A cross-sectional analytical study was carried out at the Obstetrics and Gynaecology department of the University of Nigeria, Teaching Hospital Ituku-Ozalla, Enugu. Using atomic absorption spectrophotometry, the sera of 81 pregnant pre-eclamptic and 81 matched healthy pregnant controls were analyzed for the antioxidant micronutrients. Both descriptive and inferential analysis was performed using the statistical package for social sciences (SPSS) version 21.0 and a P value of < 0.05 was considered to be statistically significant. RESULTS: The mean serum levels of copper, selenium, and magnesium were found to be significantly lower in the pre-eclamptic pregnant group when compared to the healthy pregnant controls (p < 0.05). The mean serum levels of zinc and manganese did not differ between the two groups (p > 0.05). All the mean serum levels of micro-nutrients studied did not vary by category of pre-eclampsia (with or without severity findings) except manganese which was significantly lower in pre-eclamptic women without severity findings when compared to those with severity findings (p = 0.043). CONCLUSIONS: The serum levels of copper, selenium, and magnesium were significantly lower among pre-eclamptics when compared to their normal healthy controls. Low levels of selenium, copper, and magnesium may have contributed to the incidence of pre-eclampsia in our environment.

Perception of problem based learning versus conventional teaching methods by clinical medical students in Nigeria.

INTRODUCTION: Problem-based learning (PBL) method which was introduced about 50 years ago in Canada is beginning to gain acceptance over conventional teaching method (CTM) worldwide in medical education but still remains unpopular in Nigeria. This study aims to determine the perception of clinical medical students to the use of both learning methods in pathology courses. METHODS: A cross-sectional quantitative survey was conducted in four Nigerian universities drawn from four regions of the country. Data were collected using pretested semi-structured self-administered questionnaires. RESULTS: The study included 310 respondents, 182(58.7%) males and 128(41.3%) females. Of all the participants, 257(82.9%) had heard of PBL prior to the study and 260(83.9%) thought it suitable for teaching and learning Pathology. Majority of participants, 221(71.3%) preferred a combination of both PBL and CTM while 238(76.8%) thought PBL suitable for all medical students. Some identified factors capable of enhancing adaptation of PBL into medical curriculum include conducive quiet spaces for learning and availability of computers with internet facilities for students' use. CONCLUSION: Participants demonstrated high level of awareness of PBL and thought it suitable for all medical students. Availability of computers and up-to-date libraries with internet and audio-visual facilities could enhance adaptation of PBL into medical curriculum in Nigeria.

Contraception among bankers in an urban community in Lagos State, Nigeria.

INTRODUCTION: Contraception means procedures employed to interfere at one stage or the other with the normal sequence of events in the process of reproduction leading to a failure in conception. It means voluntary techniques adopted to achieve birth control. Its use remains sensitive worldwide. Within the same society, contraception varies amongst people of different socio-cultural, educational, religious, or occupational affiliations. It also varies between urban and rural settlements. Some contraceptive techniques also prevent sexually transmitted infections (STIs). The prevalence of STIs also varies with these same factors. There is very limited literature on contraception exclusively amongst bankers. We sought to investigate the level of awareness and practice of contraception amongst bankers in an urban society in Lagos State, Nigeria. METHODS: In this descriptive cross-sectional study, 200 self-administered structured questionnaires were retrieved from bankers from 5 banks selected by simple random sampling in Surulere Local Government Area of Lagos State, Nigeria. Data was subsequently statistically analyzed using SPSS. RESULTS: The age range was 21-45 years, mean 28.8±1.4 years, 51.7% were males (72% single, 27% married, 1% separated) and 48.3% were females (52.4% single, 47.6% married). All (100%) respondents were aware of contraception, 93.3% males and 91.7% females were sexually active, 88.9% males and 84.5% females believe contraception is useful. Most (71.4%) respondents practice contraception, males (81%) being more than females (61.1%), p < 0.05. More (71.4%) females and fewer (37.8%) males believe that contraception prevents pregnancy but not STIs, 28.6% of females and 46.6% of males believe it prevents both pregnancy and STIs, whereas 14% of males and no female believe contraception prevents STIs but not pregnancy. CONCLUSION: The awareness of and practice of contraception was very high among the bankers but more male bankers practice contraception whereas more female bankers perceive contraceptives to be for the married only.