Impact of the COVID-19 Pandemic on Elderly Medical Admissions and Outcomes in a Tertiary Hospital in Northeastern Nigeria: A Comparative Retrospective Study.

BACKGROUND: The coronavirus infectious disease 2019 (COVID-19) has been shown to be more lethal in the elderly (>65 years), especially those with co-morbidities. This study examined the impact of the pandemic lockdown period on trends in elderly medical admissions and deaths. METHODOLOGY: This is a retrospective study of elderly medical admissions and deaths in the medical wards of a Nigerian hospital. Data for the months of March, April, May, June, and July of 2020 was compared to the same months before (2019) and after (2021). Analysis was done using STATA version 15.0. RESULTS: During the study period, two hundred and seventy-six elderly patients were admitted, with a mean age (±SD) of 73.4 ± 7.4 years. The most common diagnoses at admission were chronic kidney disease (CKD) (26.85%, n=74) and hypertensive heart disease (HHD) (21.7%, n=60). The highest admission was in 2021, with a total of 99 (35.9%). Overall, 60 mortalities were recorded, with a proportional mortality rate of 21.7%, which was highest in 2020 (25.0%) and lowest in 2021 (17.1%). There was no difference between the mortality rates of 2019 versus 2020 (P=0.82) and 2020 versus 2021(P=0.18). Sepsis (35.0%) and CKD (25.0%) were the major contributors in 2019. CONCLUSION: CKD and HHD were the most common diagnoses at admission, whereas sepsis, CKD, and CVD were the commonest causes of death. The Covid-19 pandemic did not significantly alter the elderly admission pattern in our setting.

CONTEXTE: Il a été démontré que la maladie infectieuse à coronavirus 2019 (COVID-19) est plus mortelle chez les personnes âgées (>65 ans), en particulier celles qui présentent des comorbidités. Cette étude a examiné l'impact de la période de verrouillage pandémique sur les tendances des admissions médicales et des décès de personnes âgées. MÉTHODOLOGIE: Il s'agit d'une étude rétrospective des admissions et des décès de personnes âgées dans les services médicaux d'un hôpital nigérian. Les données relatives aux personnes âgées pour les mois de mars, avril, mai, juin et juillet 2020 ont été comparées aux mêmes mois avant (2019) et après (2021). L'analyse a été réalisée à l'aide de STATA version 15.0. RÉSULTATS: Au cours de la période, deux cent soixante-seize patients âgés ont été admis, avec un âge moyen et un écart-type (ET) de 73,4 7,4 ans. Les diagnostics les plus fréquents à l'admission étaient l'insuffisance rénale chronique (IRC) (26,85 %, n=74) et la cardiopathie hypertensive (HHD) (21,7 %, n=60). Le nombre d'admissions le plus élevé a été enregistré en 2021, avec un total de 99 (35,9 %). Au total, 60 décès ont été enregistrés, avec un taux de mortalité proportionnel de 21,7 %, qui était le plus élevé en 2020 (25,0 %) et le plus faible en 2021 (17,1 %). Les preuves étaient insuffisantes pour montrer une différence entre les taux de mortalité de 2019 par rapport à 2020 (P=0,82) et de 2020 par rapport à 2021 (P=0,18). Le sepsis (35,0 %) et l'IRC (25,0 %) étaient les principaux facteurs de mortalité en 2019. CONCLUSION: L'IRC et l'HHD étaient les diagnostics les plus courants à l'admission, tandis que la septicémie, l'IRC et les MCV étaient les causes les plus fréquentes de décès. La pandémie de Covid-19 n'a pas modifié de manière significative le schéma d'admission des personnes âgées dans notre contexte. Mots clés: COVID-19, Personnes âgées, Mode d'admission, Mortalité.

[Determination of the concentration of sex hormone-binding globulin in the clinical evaluation of women with secondary amenorrhea]. / Odredivanje koncentracije globulina koji vezuje seksualne hormone u klinickoj evaluaciji zena sa sekundarnom amenorejom.

The serum SHGB (sex-hormone-binding globulin) concentration was measured in patients with secondary amenorrhea in order to determine its role in the regulation of androgen and estrogen metabolism in the course of the normal and irregular menstrual cycle. SHBG concentration was lower than in the control group in 52% of amenorrheic patients, but this difference was not statistically significant due to great individual variations. If the patients were divided in 2 groups according to Prolactin (PRL) concentration, significant decrease in SHGB concentration was observed in the group with elevated PRL concentrations. Correlation of SHBG with estrogen (E2), testosterone (T), progesterone (PRG) and PRL was tested and results show the weak correlation (r = 0.4) between SHGB and T and more significant correlation between SHGB and E2 in the group with basal E2 concentration below 100 pmol/1. SHGB test should be included in the evaluation of alterations of androgen and estrogen metabolism.

Treatment of men with oligoasthenozoospermia and asthenozoospermia with kallikrein.

A randomised group of 75 men with idiopathic oligoasthenozoospermia and asthenozoospermia were subjected to control study with kallikrein. Kallikrein was given to 45 men 600 units daily in a period of 3-6 months. The other group of 30 infertile men was followed during the same period of time. Percentage of motile sperm was significantly improved after 3-6 months treatment with kallikrein. Sperm count and percentage of morphologically normal sperm showed improvement but was not statistically significant. Infertile men with sperm count below 20 X 10(6)/ml had greater improvement in sperm count than men with sperm count over 20 X 10(6)/ml. This study emphasizes that kallikrein is a relatively good drug for restoring sperm motility in idiopathic oligoasthenozoospermia and asthenozoospermia.

[Importance of determining gonadotropin levels in the serum in secondary amenorrhea]. / Znacaj odredivanja nivoa gonadotropina u serumu zena sa sekundarnom amenorejom.

On the basis of the results of the analysis of FSH, LH, and prolactin values in the serum of patients with secondary ammenorrhea, four groups of patients were formed: group 1 with low values of both gonadotropin hormones, group 2 with low FSH and high LH values, group 3 with high FSH and high LH values, and group 4 with the basdal gonadotropin values within normal. The use of functional tests proved helpful in the differentiation of the causes of amenorrhea. The use of the LH-RH test is of particular significance in the differentiation of the degree of changes in patients from group 1 and 4. To determine adequate therapy, the determination of estrogen in patients from group 1 and 3 is imperative. A successful treatment of secondary amenorrhea depends on its duration and a timely detection of its causes.