Psychological distress and health-related quality of life among stable patients with bronchiectasis.

BACKGROUND: Bronchiectasis is characterized by chronic symptoms and impaired physical activity. Anxiety and depression usually complicate chronic illness. Thus, underdiagnosis of psychological distress in bronchiectasis may lead to increased morbidity and mortality. AIMS: The aim of this study is to evaluate the impact of physical illness on psychological distress and its association with health-related quality of life (HRQOL). SUBJECTS AND METHODS: This is a cross-sectional study of adults with bronchiectasis. Patients completed a study questionnaire, the hospital anxiety and depression scale and the World Health Organization quality of life brief (WHOQOL-BREF) questionnaire. Physical examination was conducted on all participants. RESULTS: 103 patients were recruited for this study: 54 males (52.4%) and 49 females (47.6%). The average age of the patients was 49.12 ± 14.37 years. The most common predisposing factor for bronchiectasis amongst the patients was previous pulmonary tuberculosis (51 patients, 49.5%). Chronic productive cough, which was reported by 98 of the subjects (95.15%), was the most common symptom. 89 subjects (86.41%) reported episodes of shortness of breath, 82 (79.61%) reported at least one episode of exacerbation, while 52 subjects (50.49%) were hospitalized for bronchiectasis in the previous 12 months. 23 subjects (22.3%) had anxiety and 32 (31.1%) had depression. Anxiety and depression were significantly associated with indicators of severe disease. The subjects recorded low HRQOL scores across all domains. Psychological distress displayed a significant negative association with all the quality-of-life domains except between anxiety and social interaction. CONCLUSION: Symptoms of depression and anxiety are common among patients with bronchiectasis and these symptoms have a negative impact on HRQOL.

Association of microalbuminuria with left ventricular dysfunction in Nigerian normotensive type 2 diabetes patients.

BACKGROUND: Diabetes mellitus (DM) is a risk factor for left ventricular (LV) dysfunction, and microalbuminuria is frequently associated with DM. This study aimed to compare LV function among normotensive type 2 diabetes (T2DM) patients with normoalbuminuria, those with microalbuminuria, and healthy controls. METHODS: This was a cross-sectional study conducted at the diabetes and cardiology clinics of the University of Uyo Teaching Hospital, Uyo, Akwa-Ibom State, Nigeria, from January 2013 to March 2014. Microalbuminuria was tested for using Micral test strips, and echocardiography-derived indices of LV function were compared among the three groups. RESULTS: Sixty-three normoalbuminuric, 71 microalbuminuric T2DM patients and 59 healthy controls were recruited. Mean age of participants was 50 ± 8 years and the three groups were age and gender matched (p = 0.23, p = 0.36, respectively). LV diastolic dysfunction (LVDD) showed a stepwise increase from the healthy controls to the normoalbuminuric to the microalbuminuric T2DM patients (16.9 vs 61.9 vs 78.9%, respectively) (p < 0.001), while E/A ratio and fractional shortening showed a significant stepwise decrease (both p < 0.001). LV systolic dysfunction was rare among the three groups. Microalbuminuria showed a strong direct association with LVDD (OR 3.58, 95% CI: 1.99-6.82, p < 0.001). Age remained independently associated with LVDD (OR 1.10, 95% CI: 1.03-1.17, p = 0.003). CONCLUSION: LV diastolic function was altered in Nigerian normotensive T2DM patients, and the presence of microalbuminuria with DM had additional effects on this abnormality. Early screening for DM and microalbuminuria could identify individuals with high cardiovascular risk and possibly abnormal LV function.

Aqueous seed extract of Cola nitida rubra reduces serum reproductive hormone concentrations and sperm count in adult male albino Wistar rats.

BACKGROUND: Following the high rate of consumption of Cola nitida (cola nut) among the male population in Nigeria, this study seeks to determine the effects of consumption of Cola nitida on serum reproductive hormones and sperm count, which are major determinants of male fertility. MATERIALS AND METHODS: Thirty-two male albino wistar rats weighing 180-220 g were used for this study and were divided into 4 groups of eight animals each. Group 1 served as control, group 2 received 2 mg/kg Cola nitida extract (Test 1), group 3 received 6 mg/kg Cola nitida extract (Test 2) and group 4 received 10 mg/kg Cola nitida extract (Test 3). After 6 weeks of treatment, reproductive hormonal assay was carried out using the rat serum. Epididymal spermatozoa were collected and sperm count determined. RESULTS: Serum concentrations of luteinizing hormone (LH) and testosterone were significantly (P < 0.05) reduced in test 2 and 3, compared with control. Sperm count was significantly lower in test group 1 (P < 0.05), 2 (P < 0.001) and 3 (P < 0.001) compared with control, with test 3 significantly (P < 0.05) lower compared with test 1. There was no significant difference in testicular and epididymis weight in the different experimental groups studied. CONCLUSION: Aqueous seed extract of Cola nitida rubra resulted in reduced serum reproductive hormone concentrations and sperm count in male wistar rats, and may therefore be detrimental to reproductive health, hence the need for regulation of its consumption.