Androgenetic alopecia: Traditional cardiovascular risk factors, metabolic syndrome, and component traits among Nigerian adults.

Background: Androgenetic alopecia (AGA) has been linked to cardiovascular diseases (CVDs) and metabolic syndrome (MetS). Works on AGA, cardiovascular risk factors (CVRFs) and MetS are rare among Nigerians. Aim: This study set out to determine the relationship among CVRFs, MetS, and AGA. Subjects and Methods: This is a cross-sectional study done among adults who were 18 years and above in selected communities in Ogbomoso on 260 consenting AGA participants as well as 260 age controls without AGA. They were matched for age and sex using a multistage sampling method. Anthropometric measurements, fasting blood glucose, and lipid profile samples were collected. MetS was diagnosed using International Diabetes Federation criteria. Data were analyzed using IBM SPSS version 20. Ethical approval was gotten before commencement of the study (LTH/OGB/EC/2017/162). Result: Metabolic syndrome in AGA was higher than in controls (8.08% vs. 7.69%, p = 0.742). AGA was significantly associated with elevated mean systolic blood pressure (SBP) (p = 0.008), low High Density Lipoprotein (HDL-c) (p < 0.001), alcohol intake (p < 0.001), dyslipidaemia (p = 0.002), and sedentary lifestyle (p = 0.010). The correlates of AGA severity in male and female gender are age (p < 0.001 and 0.009 respectively), SBP (p = 0.024) and abdominal obesity (p = 0.027) in male gender. Conclusion: AGA in Nigerians is associated with dyslipidaemia, alcohol intake, and sedentary lifestyle. AGA severity is related to age, higher mean SBP, abdominal obesity and low HDL-c in male and age, and Body mass index in females. Nigerians with AGA should be screened for dyslipidaemia and counseled against the use of alcohol and sedentary lifestyle.

Vitamin D Level in Patients Receiving Highly Active Antiretroviral Therapy in LAUTECH Teaching Hospital, Ogbomoso.

BACKGROUND AND OBJECTIVE: Hypovitaminosis D is a worldwide disorder, with a high prevalence in the general population. This study aims to assess the serum vitamin D level and its relationship with cluster for differentiation; CD4+T cells among HIV infected individuals on HAART. METHODS: This is a cross-sectional study conducted among 150 subjects attending the infectious disease Clinic of LAUTECH Teaching Hospital, Ogbomoso and presently on antiretroviral treatment. Serum from blood samples collected was analyzed and diagnostic cut-off of (<30ng/ml) and (> 30ng/ml) were used as Deficient and Sufficient vitamin D respectively. Variables such as duration on ART, CD4 count and viral load were extracted from case notes of subjects. RESULTS: There was disproportionately more female than malesubjects with a male to female ratio of 1:3. Subjects were aged between 16 and 73 years with a mean age of 41.57 ± 10.62. Few subjects (5.3%) were underweight, 23.3% were overweight, and 26% were obese. The median CD4 count was 241.5 cells/mm3 and 72% of subjects were immunosuppressed. The prevalence of vitamin D deficiency was 45.3% (n=68). CD4 count was associated with the level of serum vitamin D, p-value < 0.05. CONCLUSION: Vitamin D deficiency was prevalent among the studied HIV population. Our study found a significant correlation between serum vitamin D level and CD4 counts. It may be concluded that highly antiretroviral therapy HAART, improves CD4 level when there is sufficient vitamin D level, however, this merits further extensive exploration.

CONTEXTE ET OBJECTIF: L'hypovitaminose D est un trouble mondial dont la prévalence est élevée dans la population générale trouble mondial, avec une prévalence élevée dans la population générale. Cette étude vise à évaluer le taux sérique de vitamine D et sa relation avec le groupe de différenciation des cellules T CD4+ chez les personnes infectées par le VIH sous traitement antirétroviral. MÉTHODES: Il s'agit d'une étude transversale menée parmi 150 sujets qui fréquentent la clinique des maladies infectieuses du infectieuses du LAUTECH Teaching Hospital d'Ogbomoso et actuellement sous traitement antirétroviral. Le sérum des échantillons de sang prélevés a été analysé et les seuils de diagnostic de (<30ng/ml) et (> 30ng/ml) ont été utilisés comme carence et suffisance en vitamine D respectivement. Les variables telles que la durée du traitement antirétroviral, le nombre de CD4 et la charge virale ont été extraites des notes de cas des sujets ont été extraites des notes de cas des sujets. RÉSULTATS: Il y avait un nombre disproportionné de femmes parrapport aux hommes hommes, avec un rappor hommes/femmes de 1:3. Les sujets étaient âgés de entre 16 et 73 ans, avec un âge moyen de 41,57 ± 10,62 ans. Peu de sujets sujets (5,3 %) étaient en souspoids, 23,3 % étaient en surpoids et 26 % étaient obèses. 26 % étaient obèses. Le nombre médian de CD4 était de 241,5 cellules/ mm cube et 72 % des sujets étaient immunodéprimés. La prévalence de la carence en vitamine D était de 45,3 % (n=68). Le taux de CD4 était associé au niveau de vitamine D sérique, valeur p < 0,05. CONCLUSION: La carence en vitamine D était prévalente parmi la population la population VIH étudiée. Notre étude a trouvé une corrélation significative corrélation significative entre le taux de vitamine D sérique et le nombre de CD4. Il peut être conclu que le traitement hautement antirétroviral HAART améliore le taux de CD4 lorsque le taux de vitamine D est suffisant, cependant, cela mérite une étude plus approfondie. MOTS-CLÉS: Vitamine D, Hypovitaminose D, VIH/SIDA, HAART.

Thumb talc granuloma mimicking squamous cell carcinoma: A case report.

Application of topical powdery substances to the wound is an age old practice. Talc containing powdery substances are however commonplace and predominant in our environment. This insoluble mineral has been linked to chronic granulomatous reaction particularly in the lungs. We present a case report of a fifty-year-old man with prolonged application of talc containing powdery substances to the left thumb wound and excitation of exuberant granuloma mimicking squamous cell carcinoma. He had complete excision of the mass and satisfactory first dorsal metacarpal artery flap coverage of the soft tissue defect.

Impact of specialist rehabilitation services on hospital length of stay and associated costs.

BACKGROUND: Provision of specialist rehabilitation services in North Yorkshire and Humberside may be suboptimal. Local commissioning bodies need to prioritise investments in health care, but previous studies provide limited evidence to inform the decision to expand existing services on the basis of cost-effectiveness. We examine the impact of specialist rehabilitation services in the subregion on hospital length of stay (LoS) and associated costs compared to routine care. METHODS: Comparison of hospital LoS and associated costs in centres with greater access (Hull) and limited access (i.e. routine care, York and Northern Lincolnshire), to specialist rehabilitation services for patients with complex disabilities following illness or injury, using Hospital Episodes Statistics data. RESULTS: Average LoS and duration costs by Healthcare Resource Group (HRG) were lower for the majority of patients with greater access to specialist rehabilitation compared to routine care. Difference in LoS between groups widened with level of complexity within each HRG. For the more frequent HRG codes, the LoS difference was as high as 34 days longer for York compared to Hull and £7900 more costly. CONCLUSION: Rehabilitation patients within York and Northern Lincolnshire areas appear to have longer LoS and higher associated costs compared to those admitted to the Hull Trust. This analysis suggests that specialist rehabilitation may be cost saving compared to routine care and supports the case for expansion of the existing services to improve coverage in the area.

Behavioural and anthropometric risk factors for diabetes mellitus among newly admitted undergraduates in a Nigerian University.

BACKGROUND: Type 2 diabetes mellitus (DM) is fast becoming a global epidemic, and its prevalence is increasing in children and young adults. The aim of the study was to identify young adults who had type 2 DM or impaired fasting glucose as well as those at risk of these conditions using anthropometric data and behavioral pattern. METHODOLOGY: Two hundred and twenty newly admitted undergraduates who were randomly selected during the registration process were involved in the study. Anthropometric parameters were measured while information on demographic details, medical history, and family history were obtained using a standard questionnaire. Fasting blood glucose was measured using the glucose oxidase method. RESULTS: Two hundred and seven (94%) participants had serum glucose within reference range, 10 (4.6%) had impaired fasting glucose, and 3 (1.4%) had serum glucose> 7.1 mmol/L, which is indicative of DM. A large number (91.4%) of individuals engaged in physical activity equivalent to a walk of at least 30 min/day. Most of them (93.2%) had body mass index <25.0 while 6.8% were overweight. One hundred and three participants (46.8%) indicated that they eat 3 or more servings of whole grain per day. CONCLUSION: Most of the participants are involved in healthy lifestyle. This has resulted in very low prevalence of impaired fasting glucose and type 2 DM among the group. It will be useful to follow up the group and note if they are able to maintain this trend since the risk of developing DM is known to increase with age.

PATRONAGE AND COST OF MALARIA TREATMENT IN PRIVATE HOSPITALS IN IBADAN NORTH L.G.A SOUTH WESTERN, NIGERIA.

BACKGROUND: Malaria accounts for about 60% of all clinic attendance in Nigeria. About 300,000 children die of malaria annually while an estimated 4,500 pregnant women are lost annually on account of malaria in Nigeria alone. High cost of treatment is a barrier to the uptake of health services in low resource settings, therefore an exploration of the cost of malaria management will reveal possible components that may benefit from intervention and thus reveal important clues for improving access to malaria treatment. Objective of this study therefore is to describe patronage and cost of malaria treatment in private hospitals in Ibadan. METHOD: This was a descriptive cross sectional study, carried out in private hospitals in Ibadan, South Western Nigeria. A self-administered questionnaire with open and close-ended questions was used to collect data on patronage and cost of treatment in adults, children and pregnant women attending private health facilities in Ibadan, Nigeria. Data were presented using tables of frequencies and proportions while analysis was by descriptive statistics. RESULTS: A total of 40 doctors and hospitals participated in the study. Average patronage for malaria, both complicated and uncomplicated per month was 153 patients per hospital. Malaria cases accounts for 331 (46.2%) of total clinic cases seen in private hospitals in a month. About 121 (78%) of malaria cases seen were uncomplicated while 32 (21%) of cases were complicated malaria. Average amount charged patient for treating uncomplicated malaria in private hospitals was N3,941. Average amount spent on antimalarial drugs was about N2,443 (62%) while N1,064 (27.7%) was spent on laboratory investigation and N406.00 (10.3%) for medical consultation. CONCLUSION: Drugs cost constitute the bulk of expenses on malaria treatment. Policy makers may improve access to malaria treatment by subsidizing the cost of anti-malaria drugs for pregnant women and children, who might not be able to afford treatment.

Sexual behaviour and use of electronic media among undergraduates in the University of Ibadan.

BACKGROUND: Sexual behaviour among the youth contributes largely to the burden of reproductive health problems in Nigeria. This may have been worsened by the introduction of electronic media like internet and television (TV). However, little is known about the effects of electronic media on sexual behaviour of youth in Nigeria. Therefore, exploring the influence of effect of electronic media on sexual behaviour of youth may help policy maker to provide interventions to these problems. Thus, this study was aimed at assessing the effect of electronic media on sexual behaviour of Undergraduates in the University of Ibadan. METHOD: This was an analytical cross-sectional study, using a multistage sampling method and data were collected through self-administered semi-structured questionnaire. Variables measured are socio-demographic characteristics, exposure to electronic media and sexual practices of youths. Frequency tables were generated, and data analyzed by logistic regression. RESULTS: Four hundred and thirty three questionnaires were returned out of 456 distributed, giving a response rate of 95%. Mean age of respondents was 18.75 (SD = 2.5) years. About 58.4% of males use the internet and 58.6% watch TV while 41.6% of female use the Internet and 41.4% watch TV. Watching sexually explicit program on internet increases risk of having premarital sex (OR = 3.1; CI = 1.2-7.7) while watching non sexually explicit programmes on T.V protects from having premarital sex (OR = 0.4 CI = 0.2-0.8). CONCLUSION: These observed influence of exposure to sexually charged materials on the internet and electronic media indicates the need for efforts to be directed to controlling access, of youths to these sexually explicit programmes on the internet and television programmes.

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.

Antioxidant status and reproductive hormones in women during reproductive, perimenopausal and postmenopausal phase of life.

BACKGROUND: Reproductive aging resulting in menopause with permanent cessation of ovarian follicular activity. The progressive loss of estrogen and its protective effects, combined with deficient endogenous antioxidant results in oxidative stress. OBJECTIVE: To assess the level of oxidative stress and its relationship with reproductive hormones at various developmental phases of women. METHODS: A total of 186 (65 in Reproductive, 58 in Perimenopausal, and 63 in Postmenopausal phase) participants between the ages of 20-60 years were recruited for the study. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, estradiol, total antioxidant status (TAS), malondialdehyde (MDA) and reduced glutathione (GSH); activities of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and catalase (CAT) levels were all determined. RESULTS: FSH, LH and MDA levels were significantly increased during perimenopausal and postmenopausal phases compared to reproductive phase; however, estradiol, progesterone, TAS and GSH levels were significantly decreased during perimenopausal and postmenopausal phases compared to reproductive phase. The erythrocyte activities of GSH-Px, SOD and CAT were significantly decreased during perimenopausal and postmenopausal phases compared to reproductive phase. It was observed that MDA showed positive correlation with LH and FSH while a negative correlation with estradiol and progesterone was observed; whereas, antioxidants showed negative correlation with LH and FSH while a positive correlation with estradiol and progesterone. CONCLUSION: The present study revealed that normal perimenopausal and postmenopausal phase are associated with oxidative stress. Therefore it may be of benefit when both phases are being managed in term of hormonal deficit if antioxidant is an adjunct.

Analgesic, anti-inflammatory, and heme biomineralization inhibitory properties of Entada africana ethanol leaf extract with antiplasmodial activity against Plasmodium falciparum.

BACKGROUND: Entada africana (EA) is a medicinal plant used in West Africa for the treatment of malaria fever, but its efficacy against malaria is yet to be scientifically validated. Our study explores the antimalarial potential of the ethanol leaf extract of EA. METHODS: The antiplasmodial activity of EA against chloroquine-sensitive (HB3) and chloroquine-resistant (FcM29) Plasmodium falciparum was determined as well as its peripheral antinociceptive and anti-inflammatory properties. The effect of the extract on human monocytic (THP-1) cells was recorded as a measure of cytotoxicity, whereas the inhibitory effect on heme detoxification was evaluated as a possible mechanism of antiplasmodial activity. RESULTS: At a concentration of 100 µg/mL, EA was noncytotoxic and displayed moderate antiplasmodial activity against HB3 and FcM29 (IC50=26.36 and 28.86 µg/mL, respectively). It also exhibited concentration-dependent inhibition of synthetic heme (IC50=16 mg/mL). The extract (200 mg/kg body weight) showed significant (p<0.05) inhibition of paw inflammation, and significantly (p<0.01, 0.05) reduced the number of abdominal writhes induced by acetic acid (58.62%-65.51%), which was higher compared to that of diclofenac (50%, p<0.05). CONCLUSIONS: These findings suggest that peripheral antinociceptive effects and parasiticidal activity of EA contribute to its antimalarial properties and it can be further explored as effective therapy against malaria infection.

Evaluation of nutritional status using body fat, physiological and biochemical parameters in some Nigerian women.

Some nutritional parameters were investigated in 62 healthy Nigerian female subjects of low socio-economic status. The percentage body fat (% BF) and some biochemical parameters, High and Low Density Lipoprotein Cholesterol (HDL-C and LDL-C), Total Plasma Cholesterol (TC), Triglyceride (TG), Uric Acid (UA), Urinary Creatinine (U-Cr), Creatinine in plasma (P-Cr) and Creatinine clearance (Cr-CI), were evaluated. Also determined were the Body Mass Index (BMI), Packed Cell Volume, Systolic and Diastolic Blood Pressure (BP-I, BP-2), various skin-fold measurements and body circumferences. Reference values were then established for these various parameters and the correlation between the various variables determined. When the subjects were stratified into four groups (underweight, normal, overweight, and obese) based on their BMI, significant differences (ANOVA, p < 0.05) were observed in LDL-C, Cr-CI, BP-I, as well as 10 out of the 13 anthropometric parameters. These differences could possibly provide diagnostic/prognostic insight for the four groups and the many important diseases associated with them. The hip circumference, in particular, has such a high correlation with both BMI and % BF that it is being suggested as a substitute for these two important parameters in Nigerian women of low socio-economic background.

Seroprevalence of hepatitis C virus infection in Nigerians with type 2 diabetes mellitus.

BACKGROUND: Several studies have suggested a strong epidemiologic association between Diabetes Mellitus (DM) and Hepatitis C Virus (HCV) infection in some populations. However, the reasons why chronic HCV infection is prevalent in DM remain unknown. Our aims were to determine the prevalence of HCV infection in a population of Nigerian diabetics compared with the general population as well as assess the influence of sex and age on HCV infection in the same diabetic population. DESIGN AND METHODS: A total of 115 diabetic patients were compared with 2,301 blood donors matched by recognized risk factors to acquire HCV infection. Serologic testing for anti HCV was done using a commercial enzyme-linked immunosorbent assay (ELISA) kits. RESULTS: Sixty (60) type 2 diabetic patients were males while fifty-five (55) were females. Their mean age was 55.4 +/- 9 years and mean blood glucose level was 8.5mmol/l. One subject tested positive for HCV infection. The control group consisted of 2,031 adults recruited from the blood donor's clinic. Forty five of them (2.2%) tested positive for HCV. CONCLUSION: Our preliminary results suggest a low sero-prevalence of HCV infection among our patients with type 2 diabetes. Presently, routine screening for HCV infection in persons with diabetes may not be necessary.

Stump ulcers and continued prosthetic limb use.

Stump ulcers are common problems in amputees. Temporary discontinuation of prosthetic limb use is frequently employed to facilitate healing. Inevitably, this limits activity and may, for instance, prevent an amputee from going to work. A survey of clinical practice was carried out based on the premise that controlled continued prosthetic limb use in patients with stump ulcers will not adversely affect the ulcer nor prevent healing. The survey would also form a basis for developing future guidelines in the management of stump ulcers. All consecutive patients attending the Chapel Allerton Hospital prosthetic clinic between January 2003 and May 2004 with stump ulcers were recruited into the study. Primary outcome measures were changes in the surface area of the ulcers and in clinical photographs taken on 2 occasions 6 weeks apart. Some 102 patients with a mean age 60 years (range 18 - 88 years) were recruited. Eight patients who were established prosthetic limb users did not complete the study and were excluded from the analysis. Of the patients 52 were newly referred patients with delayed surgical wound healing while 42 were established prosthetic limb users for at least 1 year. Continued prosthetic limb was associated with a significant reduction in ulcer size (p < 0.05). Mean sizes of the ulcers at first and second observations were 3.30 cm2 (range 0.06 - 81) and 0.70 cm2 (range 0.00 - 13.00) respectively. The ulcers improved in 83 cases while two were unchanged. Deterioration was observed in nine cases. The current clinical practice is to allow most of the patients to commence or continue prosthetic limb wearing despite the presence of stump ulceration. This observational study found that, despite prosthetic use, 60 (64%) cases healed completely within the six-week study period and 23 (25%) ulcers reduced in size. The ulcers were unchanged in 2% of the cases. Deterioration was observed in nine (9%) cases. This survey suggests that the current practice of allowing patients to use their prostheses is safe. A clinical trial is now needed to establish whether this practice alters healing rate or has any other disadvantages for new or established amputees.

Antinociceptive profile of the methanolic extract of Neorautanenia mitis root in rats and mice.

The antinociceptive activity of the methanolic extract of Neorautenania mitis was studied in mice and rats. Five experimental models of nociception employed were: acetic acid-induced abdominal constriction and hot-plate test in mice, formalin-induced pain, analgesy-meter and Randall-Selitto tests in rats. The antinociceptive action of the extract was tested against naloxone in the hot-plate test in a bid to further elucidate probable mechanisms of antinociception. Results showed that the extract at doses of 5, 10 and 20 mg/kg body weight caused significant (P<0.05) dose-dependent antinociceptive activity in all the nociceptive models. Naloxone (2 mg/kg), significantly (P<0.05) antagonised the antinociceptive activity at the highest dose of the extract (20 mg). The study showed that the methanolic extract of Neorautanenia mitis possesses both peripherally and centrally mediated antinociceptive activity. The peripherally mediated action may be linked partly to lipoxygenases and/or cyclo-oxygenases, while the central anti-nociception is likely to be mediated via opioid receptors in the CNS.