Impact of Smokeless Tobacco on Cardiovascular Disease Risk in a Nigerian Metropolitan City.

The use of smokeless tobacco products (STP) as a substitute for tobacco smoking is driving increasing consumption of these products especially in developing countries. The study sought to make comparison of cardiovascular risk profile between chronic STP users and suitably matched tobacco-naïve controls. This is a preliminary report from the cross sectional part of a two-arm prospective study of Smokeless Tobacco Products Composition and Exposure Outcome in Enugu metropolis, Nigeria. Consecutively recruited current Smokeless tobacco users, who had no history of cigarette smoking, aged 18 years and above, residing in selected communities in Enugu metropolis, Nigeria were recruited for the study from October 2022 to July 2023. Age and sex matched non-tobacco users from same localities as the study subjects served as controls. Written informed consent to participate in the study was obtained from all study participants. All participants were screened by the investigators, using the study case report forms, to obtain data on medical history, demographic, clinical, laboratory, and electrocardiographic evaluation. Data from 54 STP-users and 54 non-STP-users (mean age 56.58 ± 8.15 years) were analyzed. Anthropometric parameters were similar in both groups. Smokeless tobacco users had higher erect and supine blood pressure indices as well as greater postural drop in systolic blood pressure. The occurrence of diabetes mellitus (20.37% versus 5.56%) and hypertension (25.93%; 11.11%) was significantly higher in the STP-users than in the non-user population, (p = 0.02192 and 0.04751 respectively). Electrocardiographic evaluation showed significantly increased QTc and dispersions of P-wave, QRS and QT intervals as well as reduced PR interval in STP users. Electrocardiographic abnormalities observed in STP users include left ventricular hypertrophy, left atrial enlargement, ST-segment elevation, short PR interval and long QTc. Use of smokeless tobacco products is associated with increased risk burden of diabetes mellitus and hypertensive heart disease. Electrocardiographic findings linked to STP-use in this study are features consistent with arrhythmia, ventricular repolarization abnormality, myocardial hypertrophy and ischaemia, suggesting that smokeless tobacco products are not safe substitutes for tobacco smoking.

Need for age-specific prostate-specific antigen reference intervals in a Nigerian population.

Background: In Nigeria, the diagnostic value of prostate-specific antigen (PSA) is a matter of debate. PSA levels are known to vary with population, environmental factors, and advancing age. Studies suggest age-specific reference intervals (ASRIs) of PSA value are more accurate than single cut-off PSA value. For ASRIs to be used effectively, reference intervals (RIs) must be fully evaluated. Aim: We determine ASRIs in a Nigerian population. Materials and Methods: The study was carried out from January 2016 to January 2019 among 660 adult Nigerian men aged 30-86 years old in Enugu State. Participants completed questionnaire demographics and previous screening. Age group was the indicator. Among them, a total 24 (3.6%) were excluded. Data from 636 (96.4%) men were analyzed for ASRIs. Estimation of PSA was done as per the International Federation of Clinical Chemistry Guideline. Spearman correlation was used to identify correlates P values < 0.05 which was considered significant. Results: The mean age group was 49.6 ± 10.2 years. ASRIs using 95th percentile, and PSA values in each 10 years groups were 0-1.94 ng/ml (median 0.22), 0-2.52 ng/ml (median 0.42), 0-3.52 ng/ml (median 1.06), 0-4.8 ng/ml (median 2.1), 0-6.95 ng/ml (median 4.1), and 0-5.6 ng/ml (median 2.4), for age groups 30-39, 40-49, 50-59, 60-69, 70-79, and ≥80 years, respectively. There was positive correlation between PSA and age (r = 0.9915, P < 0.0001). Low income and educational background were more prevalent among the study group. Conclusion: Our study provided the ASRIs in our environment but higher than single cut-off value. The data recommended PSA values should be characterized by age and ethnicity.

Predisposing factors associated with uncomplicated type 2 diabetes among adults in a diabetic clinic, Enugu State, Nigeria.

BACKGROUND: The role of micronutrients and other predisposing factors associated with the aetiology of type 2 diabetes in Nigeria is not well established. The objectives of this study were to investigate predisposing factors associated with uncomplicated type 2 diabetes among a Nigerian adult population. METHODS: Predisposing factors associated with uncomplicated type 2 diabetes were investigated in 60 Igbo (a major tribe in Eastern Nigeria) adults aged 30-90 years. This study was carried out at the Diabetic Clinic, University of Nigeria Teaching Hospital (UNTH) Ituku-Ozalla, Enugu. Packed cell volume (PCV), serum ferrtin and some anthropometric parameters were measured alongside fasting blood sugar (FBS). RESULTS: PCV recorded a statistically significant lower (p<0.001) mean value at 32.94±0.61% in the patients when compared with the control group with a mean value of 39.06±1.02%. Serum ferritin revealed a statistically significant higher (p<0.01; 110.20±15.17 ng/ml) mean value in the patients when compared with the control group (20.4±5.64 ng/ml). However, PCV (32.00±0.88%) and body mass index (BMI) (31.99±1.12 Kg/m(2)) recorded a statistically significant lower (p<0.05) mean value in female patients when compared with their corresponding males. There was no significant correlation (p>0.05) between serum iron ferritin, FBS and all other anthropometric predictors of incidence of type 2 diabetes. CONCLUSION: Type 2 diabetes is not associated with elevated levels of serum iron ferritin. Hence, serum ferritin may not be a better predictor of type 2 diabetes, especially in uncomplicated cases.

Examination of haematotoxicity of fixed-dose highly active antiretroviral drug in albino wistar rats.

Highly active antiretroviral therapy (HAART) is considered toxic and has other life-threatening side effects. Our aim was to evaluate the haematotoxic effects of lamivudine, zidovudine, and nevirapine fixed-dose combinations in Albino Wistar rats. Fifty (50) three (3) months old male Albino Wistar rats weighing between 200 and 250 g were randomly assigned to five (5) groups (A, B, C, D, and E). Group A served as control. Two (2 mLs) of venous blood was aseptically collected on Days 5, 10, 15, 20, and 25 of treatment. Red blood cell (RBC) mean value recorded statistically significant increase (P < 0.05) in groups B and C when compared with the control group on Day 5. However, there was a statistically significant decrease (P < 0.05) in RBC, haemoglobin concentration (Hb), packed cell volume (PCV), and some red cell indices on Day 10. In addition there was no statistically significant difference (P > 0.05) in all the parameters evaluated when the test group was compared with the control on Day 25. Furthermore, there was a time-related statistically significant increase (P < 0.05) in the two major blood cells-RBC and platelet counts. From the result of this present study, it can be concluded that HAART when administered in fixed-dose combinations have no subacute haematotoxic effects.