Stroke risk factors among participants of a world stroke day awareness program in South-Western Nigeria.

INTRODUCTION: Stroke is a major cause of death and disability in population across the world. Hypertension is the most common stroke risk factor globally as well as in the Nigerian population, however other modifiable risk factors such as obesity are becoming increasingly prevalent due to unhealthy diets and sedentary lifestyle. MATERIALS AND METHODS: We screened 224 volunteers from Ile-Ife during the 2011 and 2012 world stroke day commemorative activities. Blood pressures (BP) were measured and body mass index (BMI) was determined from weight and height measurements. The data from 40 (18%) were incomplete and were excluded from further analysis. RESULTS: The 184 subjects eligible for analysis comprised 85 males (46.2%) and 99 females (53.8%), with a male to female ratio of 0.85:1. Their ages ranged from 16 to 95 years (mean, 53±16 years). 25% of the study population had stage 1 or 2 hypertension (mean systolic blood pressure: 127±27 mmHg, mean diastolic blood pressure: 78±16 mmHg), while 34.8% and 14.7% were overweight and obese, respectively (mean BMI: 25.8±5.0 kg/m2). CONCLUSION: Stroke risk factors such as hypertension and obesity were common among the participants of the world stroke day awareness program in an urban area of Nigeria. Community screening and modification of these risk factors should be intensified in order to reduce stroke morbidity and mortality.

Effect of Gongronema latifolium ethanol leaf extract on gastric acid secretion and cytoprotection in streptozotocin-induced diabetic rats.

OBJECTIVES: Gongronema latifolium leaves have been used in folklore medicine to manage diabetes mellitus and alleviate dyspepsia. This study aimed to provide a pharmacological basis to the medicinal use ofGongronema latifolium as an antidiabetic and antiulcerogenic agent in diabetes mellitus. METHODS: Ethanol extract from the leaf (200 mg/kg bodyweight) of Gongronema latifolium was administered to both streptozotocin-induced diabetic and control groups orally for 14 days. Gastric acid secretion was measured and ulcer was induced using ethanol and four-hour pyloric ligation. RESULTS: The mean bodyweight was significantly lower (p < 0.01), while the mean weight of the stomach, liver and small intestine to bodyweight ratio was increased significantly (p < 0.05) in the two diabetic groups compared to control. Extract significantly (p < 0.01) reduced the blood glucose level similar to the non-diabetic control. Basal and stimulated acid secretion in diabetic control rats was significantly (p < 0.01) decreased when compared to control. Extract administration increased the stimulated gastric acid secretion to a level significantly (p < 0.05) higher than control while reduction in gastric secretion by ranitidine was similar compared with control. Gongronema latifolium treatment significantly (p < 0.05) reduced ulcer scores in both ulcer models and increased mucus weight in the diabetic group. CONCLUSION: These results suggest that Gongronema latifolium antiulcerative activity is due to its prevention of chemical-induced stomach injury.

Effects of ultraviolet radiation (type B) on wound exudates, appearance and depth description.

Purulent exudate is one of the clinical signs of decubitus ulcers; and it is indicative of infection. The greatest challenge is the decreasing sensitivity of infective micro-organisms to antibiotics. There appears to be paucity of data on the effect of Ultraviolet radiation on wound exudates and appearance. The main purpose of this study was to determine the effect of ultraviolet radiation (Type B) on wound exudates and appearance of decubitus ulcers. Ten (10) bed-ridden subjects with ascertained bilateral sore from unrelieved pressure in their lower extremities consented to participate in the study. The decubitus ulcers were treated with traditional saline-wet-to-moist (WM) wound dressing. The decubitus ulcers on the left lower extremities were the experimental limbs and were exposed to ultraviolet radiation as adjunct while the right lower limbs served as control and received only the saline-wet-to-moist (WM) wound dressing. The frequency of treatment was 3 times per week for 6 weeks. The type of exudates produced, amount of exudates, wound appearance and depth description were scored on a 5-point likert scale. The data was analyzed using descriptive statistics and non-parametric inferential statistics (Kruska-Wallis test). The result of the Kruskal Wallis test showed that there was significant improvement in the type of exudates produced by the decubitus ulcers of the experimental (left) limbs (X{2} = 33.71, p < 0.00) when compared with the control limbs. Similarly, there was significant reduction in the amount of exudates produced by the decubitus ulcers of the experimental limbs (X{2} = 30.58, p < 0.00) when compared with that of the control. Also, there was significant improvement in the appearance of the decubitus ulcers (X{2} = 33.01, p< 0.00) and depth description of the experimental (left) limbs compared to that of the control (right). This study concluded that Ultraviolet radiation (Type B) can significantly improve the appearance of decubitus ulcers. Also, it can significantly reduce the amount of purulent exudates and can hasten skin replacement of decubitus ulcers.

Aqueous leaf extract of Rothmannia longiflora improves basal metabolic rate and electrolyte parameters in alloxan-induced diabetic rats.

This study evaluated the action of aqueous leaf extract of Rothmannia longiflora on basal metabolic rate and electrolyte profile of alloxan-induced diabetic rats. Fifteen male Wistar rats weighing 135-140 g were assigned to 3 groups of 5 rats each. Group 1 which served as control received placebo treatment, group 2 namely the diabetic [untreated] group also received placebo treatment whereas group 3-the extract treated diabetic group was administered extract [15 g/kg body weight] by oral administration for 14 days. Results of BMR measurement showed a significant increase [P<0.01] in BMR level of Diabetic untreated group [1.03+/-0.02 ml/hr/g] compared to the control group [0.79+/-0.07 ml/hr/g]. Extract treatment significantly [P<0.05] decreased BMR in the diabetic rats. Results of analyses of serum electrolytes and glucose showed significant decreases [P<0.01] in sodium and chloride concentrations in the diabetic untreated group when compared to the control. However, sodium and chloride concentrations in the extract treated diabetic were not significantly different from that of their control values. There was no significant difference in potassium and urea concentrations in the extract-treated diabetic rats with respect to their control values. Extract treatment significantly [P<0.05] reduced serum glucose level of the extract treated group when compared to the diabetic untreated group. This suggests that oral administration of Rothmannia longiflora might be beneficial for the restoration of basal metabolic rate and improvement of electrolyte profile in diabetes mellitus.

Psychotropic drugs prescription at two regional psychiatric hospitals in northern Nigeria.

BACKGROUND: Studies on psychotropic drug prescription in Nigeria are few, limited to the south and over a decade old. With the recent advances in psychopharmacology an audit is desirable. OBJECTIVE: To describe the practice and pattern of psychotropic drugs prescription for new patients attending out-patient clinic in two Federal Neuro-Psychiatric Hospitals in Northern Nigeria and to identify extent of potential drug-drug interaction in the prescriptions. METHODS: A cross-sectional study, using charts review, on new patients seen over a month at the out-patient clinics of two regional psychiatric hospitals in Northern Nigeria. RESULTS: Two hundred and seventy-eight patients were seen. Conventional antipsychotics were the most prescribed (68%), anticholinergic (62%), tricyclic antidepressants (35%), anticonvulsants (25%), benzodiazepines (8%). SSRIs were given to 2% of patients, while no patient was given an atypical antipsychotic. Physicians did not inquire about patients medical and medication histories, nor perform physical examinations in most cases. Polypharmacy was high, giving rise to significant potential drug-drug interactions in 28% of patients. CONCLUSION: Prescription practices are far from ideal, and continuing education, as well as development of prescription practice guidelines is suggested. Government intervention and change in clinician attitudes may be needed to improve use of newer medications.

Effect of multiparity on electrolyte composition and blood pressure.

Pregnancy affects the physiology of the pregnant woman particularly the endocrine, cardiovascular and the renal systems. This work was therefore set to ascertain the state of electrolytes in pregnancy and how it affects blood pressure using multiparity as a factor. One hundred and twenty (120) women were used in this study. The non-pregnant groups were the nulliparous (control) and grand multiparous women who have stopped gestation (GMS) for at least five years. The pregnant groups were made up of 30 primigravidae (PG) and 30 grand multiparous (GMP). The pregnant groups (PG and GMP) were further divided into first, second and third trimesters. The subjects were aged matched with controls. Serum electrolytes (Na(+), K(+) and Cl(-)) were measured using standard methods. The results show that there was no significant difference in the electrolyte composition among the groups and between trimesters. There was also no significant difference in blood pressure among the groups and between trimesters in the pregnant groups irrespective of parity. Multiparity therefore may not pose any severe threat to health.

Intestinal motility and transit following chronic ingestion of different forms of palm oil diets.

This study was aimed at finding the effect of palm oil diets on the small intestinal motor activity and transit in rats. Adult albino Wistar rats were divided into three groups of ten rats each. The first group was fed on rat chow containing 15% (wt/wt) of fresh palm oil diets for fifteen weeks. The second was fed on rat chow containing 15% (wt/wt) thermally oxidized diet while the third group was the control and so was fed on rat chow only. Water and feed were allowed freely to all the groups. Intestinal motility and transit were measured after the feeding period. Results show that there was a significant increase (P < 0.05) in basal tone of the ileum from rats fed on thermally oxidized palm oil diet when compared with fresh palm oil fed and control diets respectively. Contraction to acetylcholine (10(-11) - 10(-5)M) showed a biphasic tone with highest contraction at lower doses of acetylcholine and lowest tone at 10(-7)M in both fresh palm oil-fed and thermally oxidized oil-fed groups when compared with control. There was a significant (P < 0.05) attenuation of inhibition of atropine effect in the oxidized oil fed group when compared with control while there was a significant (P < 0.01) increase in transit of food material in the intestine of oxidized oil-fed group when compared with control and fresh palm oil-fed groups. These results show that chronic ingestion of oxidized palm oil diet causes an increase in basal tone of ileum and enhances intestinal motility and transit in the rat.

Polypharmacy in psychiatric out-patient practice in northern Nigeria.

OBJECTIVE: To describe and analyze patterns of polypharmacy among psychiatric outpatients in northern Nigeria and identify predictors of psychotropic polypharmacy. METHOD: A cross-sectional study, using chart review of new patients at out-patient clinics of two regional psychiatric hospitals in northern Nigeria,measuring rates, patterns and predictors of psychotropic polypharmacy. RESULTS: A total of 278 patients were seen, of whom 92%were given two or more psychotropic agents.The pattern of psychotropic polypharmacy revealed that total, multi-class and adjunctive polypharmacy rates were high, while augmentation and same class polypharmacy rates were low. Age of respondent and diagnosis were the factors associated with total polypharmacy. CONCLUSION: The complex interplay of factors influencing physician prescription practices requires that a more pragmatic approach be adopted in efforts to curtail polypharmacy practice, rather than a wholesale, absolute condemnation of the practice.

Vitamin C improves basal metabolic rate and lipid profile in alloxan-induced diabetes mellitus in rats.

Diabetes mellitus (DM)is a multi-factorial disease which is characterized by hyperglycaemia, lipoprotein abnormalities and oxidative stress. This study evaluated effect of oral vitamin C administration on basal metabolic rate and lipid profile of alloxan-induced diabetic rats. Vitamin C was administered at 200 mg/kg body wt. by gavage for four weeks to diabetic rats after which the resting metabolic rate and plasma lipid profile was determined. The results showed that vitamin C administration significantly (p less than 0.01) reduced the resting metabolic rate in diabetic rats; and also lowered plasma triglyceride, total cholesterol and low-density lipoprotein cholesterol. These results suggest that the administration of vitamin C in this model of established diabetes mellitus might be beneficial for the restoration of basal metabolic rate and improvement of lipid profile. This may at least in part reduce the risk of cardiovascular events seen in diabetes mellitus.

Glucose tolerance in psychiatric patients.

The relationship between glucose tolerance and psychiatric disorders is controversial. Most of the reports which have emanated mostly from North America have found either increased prevalence of diabetes amongst psychiatric patients or no relationship between psychiatric disorders and diabetes. In this study, we screened psychiatric outpatients and performed a standard oral glucose tolerance test in 29 of them. Of 59 patients studied, one was diabetic and two were found to have impaired glucose tolerance. Amongst those subjected to OGTT indices of glucose disposal were either as good as in the controls or were better than in the control subjects even though the psychiatric patients were generally more obese. Results from this study do not support the suggestion that there is increased impairment of glucose tolerance in subjects with psychiatric disorders at least in the Nigerian Africans that were tested. The improved disposal of ingested glucose in the patients is likely to be related to some of the antipsychotic drugs particularly chlorpromazine. The number of subjects tested is however small and more subjects especially those yet to be started on antipsychotic drugs will need to be studied to define in greater detail the relationship between the prevalence of glucose intolerance and psychiatric disorders in the African.