The prevalence of metabolic syndrome and its components among overweight and obese Nigerian adolescents and young adults.

BACKGROUND: The incidence of metabolic syndrome (MetS), is rapidly increasing in developing countries. However, the epidemiology of MetS is not well reported in the pediatric and young adult population. We determined the prevalence of MetS and its components among overweight and obese Nigerian adolescents and young adults presenting for university admission. MATERIALS AND METHODS: A cross-sectional study of overweight and obese adolescents and young adults was performed. Blood pressure readings were taken while participants were seated. Anthropometric measures of waist circumference, weight and height were also taken using standard protocols and the body mass index was computed thereafter. Venous blood for fasting plasma glucose, triglycerides and high density lipoprotein cholesterol was collected and assayed using standard laboratory methods. Metabolic syndrome was defined by the International Diabetes Federation criteria. Statistical significance was set at 0.05. RESULTS: 91 individuals (18 males) aged 18.1 ± 4.85 years were studied. 13 (14.3%) of them had MetS and 11 (84.6%) of these were adolescents. Abdominal obesity was prevalent in 89 (97.8%) participants, hypertension was prevalent in 39 (42.9%) participants and hyperglycaemia was prevalent in 5 (5.5%) participants. Hypertriglyceridaemia was least prevalent in one (1.1%) participant who did not have MetS. All the participants who had hyperglycaemia (5.5%) had MetS. CONCLUSIONS: There is a high prevalence of MetS in obese and overweight Nigerian adolescents and young adults with the clustering of two components in half of the population. These findings have profound implications hence there is an urgent need to institute primary and secondary interventions in this population.

The Effectiveness of Clinician Education on the Adequate Completion of Laboratory Test Request Forms at a Tertiary Hospital.

BACKGROUND: Inadequately completed laboratory test request forms contribute to preanalytical errors and limit the advice of pathologists when interpreting laboratory test results. Educating clinicians about this has been proposed by several studies as a strategy to reduce the occurrence. AIM: We aimed to determine the effectiveness of such education on the prevalence of adequately completed laboratory test request forms. SUBJECTS AND METHODS: This was a quasi-experimental study conducted at the chemical pathology laboratory of the Lagos University Teaching Hospital, Nigeria. Incoming laboratory request forms were audited for a period of 1 month looking out for eight data variables. Subsequently, intensive clinician education was undertaken via seminars, publications, and orientation programs on 670 clinicians for 6 weeks duration. After that, a repeat audit for the same data variables was conducted for another period of 1 month. A Z-test of significance for the comparison of independent proportions was conducted for form errors pre- and post-intervention. RESULTS: Error rates for missing variables pre- and post-clinician education were: Name pre = 0 (0%), post = 0 (0%); age pre = 330 (21.6%), post = 28 (1.9%), P < 0.001; gender pre = 64 (4.2%), post = 53 (3.6%), P = 0.37; hospital number pre = 848 (55.6%), post = 524 (35.3%), P < 0.001; clinician name pre = 165 (10.8%), post = 64 (4.3%), P < 0.001; ward/clinic pre = 311 (20.4%), post = 235 (15.8%), P < 0.01; clinical diagnosis pre = 220 (14.4%), post = 33 (2.2%), P < 0.001; specimen type pre = 169 (11.1%), post = 116 (7.8%), P < 0.01, respectively. CONCLUSION: There was an improvement in the inadequate completion of laboratory request forms after clinicians were educated on proper completion using various interactive media, showing that it is an effective strategy. However, further studies are required to identify which educational strategy is most effective in reducing error rates in laboratory test request forms.

The effectiveness of clinician education on the adequate completion of laboratory test request forms at a tertiary hospital

Background: Inadequately completed laboratory test request forms contribute to preanalytical errors and limit the advice of pathologists when interpreting laboratory test results. Educating clinicians about this has been proposed by several studies as a strategy to reduce the occurrence. Aim: We aimed to determine the effectiveness of such education on the prevalence of adequately completed laboratory test request forms. Subjects and Methods: This was a quasi-experimental study conducted at the chemical pathology laboratory of the Lagos University Teaching Hospital; Nigeria. Incoming laboratory request forms were audited for a period of 1 month looking out for eight data variables. Subsequently; intensive clinician education was undertaken via seminars; publications; and orientation programs on 670 clinicians for 6 weeks duration. After that; a repeat audit for the same data variables was conducted for another period of 1 month. A Z-test of significance for the comparison of independent proportions was conducted for form errors pre- and post-intervention. Results: Error rates for missing variables pre- and post-clinician education were: Name pre = 0 (0%); post = 0 (0%); age pre = 330 (21.6%); post = 28 (1.9%); P 0.001; gender pre

High pleural fluid adenosine deaminase levels: a valuable tool for rapid diagnosis of pleural TB in a middle-income country with a high TB/HIV burden.

BACKGROUND: South Africa has the highest burden of tuberculosis (TB) in the World Health Organization (WHO) African region. Using traditional TB diagnostic tools, the diagnosis of pleural TB (PTB) is highly unrewarding. Elevated levels of pleural fluid adenosine deaminase (FADA) have been shown to be useful in the diagnosis of PTB; however, similar levels may be found in some other medical conditions leading to misdiagnosis. Following queries from clinicians concerning the likely high false-positive (FP) rate of FADA from our laboratory, we performed a retrospective audit of all high FADA results generated over a 12-month period. OBJECTIVES: To determine the positive predictive value (PPV) of FADA, the frequent causes of FPs in our laboratory and the demographic characteristics of tuberculous pleural effusions (TPEs) and non-tuberculous pleural effusions (NTPEs). METHODS: High FADA results generated in the past year were extracted with corresponding TB culture results, fluid cell count, cytology/ histology results, radiology reports and HIV results. Hospital records were reviewed for the final diagnosis in each case. Diagnosis of PTB was based on the WHO case definition of TB. RESULTS: A total of 159 results were reviewed: 133 (83.6%) were TPE, hence FADA had a PPV of 83.6%. Neoplasm was the most common cause of an FP in 13/26 (50%) NTPEs. While TPE was more common than NTPE in younger people, both groups had an equal gender distribution. CONCLUSION: FADA had a high PPV for PTB in our laboratory. We recommend its continued use as a rapid and reliable diagnostic tool for PTB.