Body mass index, blood pressure, and cognitive impairment among type 2 diabetic patients in a primary care setting, North-Central Nigeria

The long-term effects of certain clinical factors on cognition cannot be overemphasized. The morbidity of Cognitive Impairment (CI) in patients with type 2 diabetes has been found to increase when associated with some clinical factors. The main objective of this study was to determine the relationship between CI and Body Mass Index (BMI) as well as CI and Blood Pressure (BP), among type 2 diabetic patients attending the primary care unit of a tertiary hospital. It was a descriptive hospital-based crosssectional study. Ethical approval was obtained from the Ethical Review Committee of the University of Ilorin Teaching Hospital (UITH) before the commencement of the study. Data was collected from 274 adult type 2 diabetic patients attending the Family Medicine clinics of the hospital, from March through May 2017. Interviewer-administered structured and semi-structured questionnaires were used to obtain information from the respondents. The Mini-Mental State Examination (MMSE) was used to assess CI among respondents. The BMI and BP of participants were obtained following standard procedure. Data was collated and analyzed using the Statistical Package for Social Sciences version 21 (SPSS- 21). The elderly constituted a higher proportion of participants 55.4%. Respondents were mainly females (70.8%), married (78.8%), and educated (78.1%). The clinical factor that had a statistically significant association with CI was the BMI of participants with a chi-square value (χ2) of 11.139 and a p-value of 0.048. Blood pressure had no statistically significant association with CI (χ2 of 5.181 and p-value of 0.159). CI is common in our clinics with a prevalence of 27% seen in this study. BMI had a statistically significant association with CI while BP was not. Hence, maintaining a normal weight may help in controlling CI. Physicians in primary care should routinely screen type 2 diabetic patients for CI as well as control risk factors for it.

Evaluation of CD4+ T cells in HIV patients presenting with malaria at the University of Ilorin Teaching Hospital Nigeria.

CD4 count is an important immunological marker of disease progression in HIV seropositive patients. This study was carried out to determine the effect of malaria or fever of unknown origin on the population of CD4+ T lymphocytes of HIV seropositive patients attending the highly active antiretroviral therapy (HAART) clinic of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. 36 subjects were selected for this study. Ongoing history of fever was used as a case definition for malaria and malaria was confirmed from microscopic examination of thick and thin film of blood sample obtained from the patients during presentation with fever. The CD4 count was evaluated during presentation of fever and post-fever using flow cytometry. There was significant decrease in CD4 count of the patients. However, upon classifying the patients into 2 groups - those that returned to the clinic after a week and those that returned after a month; a significant increase in CD4 count was noticed in the group that returned after a week, while a significant decrease was noticed in the group that returned after a month (at p value of 95 %). Further classification of the patients based on presence of malaria parasite, and body temperature resulted in varying effects on CD4 count post-fever (in the general group, 27 were positive for malaria parasites). Of these 27, there was an increase in CD4 count in 9 (33.3 %). However in the group that returned after a week, all 6 (100 %) that were positive for malaria parasites showed increase in CD4 count. Five (26.3 %) of the 19 patients that had body temperature within the range of 35.5-37.4 °C showed an increase in CD4 count, while 7 (41.2 %) of the 17 patients that had body temperature of 37.5 °C and above showed an increase in CD4 count. The results led to the conclusion that while some components of the immune response to malaria could strengthen the immune system of HIV seropositive patients by increasing their CD4 count, other components will suppress their immunity by decreasing their CD4 count, accelerating the progression to AIDS.