Health behaviour and quality of life of patients with type 2 diabetes attending selected hospitals in south western Nigeria.

BACKGROUND: Type 2 diabetes is a chronic disease that affects patients' general health and well-being in various ways. Modification of lifestyle is essential in preventing Type 2 diabetes including its secondary complications. OBJECTIVE: This study assessed the profile, health behaviour and quality of life of patients presenting with Type 2 diabetes and attending the diabetic clinics of Lagos State University Teaching Hospital, Lagos State and the Ring Road State Hospital, Ibadan. SUBJECTS AND METHOD: A total of 100 diabetic patients aged between 40 and 85 years participated in this study. Their physical activity levels were determined by using the International Physical Activity Questionnaire (IPAQ); quality of life (QOL) was assessed using the Diabetes Quality of Life (DQOL) Inventory questionnaire and alcohol and smoking status as well as nutrition patterns were assessed using the Alcohol, Smoking and Nutrition Questionnaire (ASNQ). Age, gender, body mass index, waist circumference, waist-hip-ratio and blood pressure were also reported. Data were presented using descriptive statistics of mean, standard deviation, percentages and are presented in figures and tables. RESULTS: Results showed that most of the participants were overweight and/or obese with 62% having a body mass index greater than 25 kg/m2. About 78% of females showed a waist circumference of > 88 cm while 48% of the male participants had a > 92 cm waist circumference. Ninety-seven per cent of the female participants had a waist-hip ratio above 0.85 while 32% of the males had above 1.0 waist-hip ratio. Using the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) classification for hypertension, 49% of the participants were found to be at stages 1 and 2 hypertension by systolic blood pressure while 43% of the participants were at stages 1 and 2 hypertension by diastolic blood pressure. Sixty-two per cent of the participants revealed a low physical activity level, 34% had a moderate physical activity level while 4% had a high physical activity level. All the participants indicated that they neither consumed alcohol nor smoked at the time of the study. Thirty-four per cent of the participants had adequate quantities of fruit, 31% of them also consumed an adequate quantity of legumes and 73% of them ate an adequate quantity of fish per week. Fifty-eight per cent of the participants took less quantities of salt with their food as compared to their peers while 95% of the participants did not add sugar to their food; 79% of them preferred their food boiled. The mean score of the participants' QOL was 31.85 +/- 7.98 out of a total score of 75. The QOL as reported by the participants thus indicated a fairly good quality of life. CONCLUSION: Patients with Type 2 diabetes were generally found to be overweight, obese, sedentary and were frequently found to be hypertensive. It is, therefore, suggested that patients need to pay attention to their weight by participating in weight reduction programmes and also improve their physical activity levels in order to reduce their risk of developing the complications associated with Type 2 diabetes.

Cardiovascular effects of edible oils: a comparison between four popular edible oils.

Edible oils form an essential part of the modern diet. These oils play a role as an energy source, and provide the diet with many beneficial micronutrients. Although a popular conception may be that fat should be avoided, certain edible oils as a dietary supplement may play an important role in the improvement of cardiovascular health. CVD has become one of the leading causes of death worldwide. Dietary supplementation with different oils may have beneficial effects on cardiovascular health. While olive oil and sunflower-seed oil are known to reduce serum cholesterol, fish oil has become well known for reducing potentially fatal cardiac arrhythmias. Recently, red palm oil research has shown beneficial effects on cardiac recovery from ischaemia-reperfusion injury. It is clear that dietary supplementation with edible oils may play a vital role in reducing the mortality rate due to heart disease. The specific benefits and disadvantages of these oils should, however, be explored in greater depth. The present review will attempt to identify the benefits and shortcomings of four popular edible oils, namely olive oil, sunflower-seed oil, fish oil and palm oil. Additionally the present review will aim to reveal potential areas of research which could further enhance our understanding of the effects of edible oils on cardiovascular health.

The contributing role of tourism in the HIV/AIDS epidemic in the Caribbean.

The first confirmed case of HIV/AIDS in the Caribbean was reported in 1982, however a recent report by UNAIDS shows that the epidemic has risen to over 250,000 persons living with the virus with the highest prevalence rates shown to be in the Dominican Republic and Haiti. Various factors ranging from commercial sex trading to unsafe injection employed for drug abuse have been identified to play a contributing role in this increase. Also, the role and impact of tourism on the spread of HIV infection has been reported. Due to concerns shown by countries and territories who are dependent on tourism and that they rank amongst the most highly affected by HIV/AIDS in the region, this paper endeavours to examine the impact of HIV/AIDS and the contributing role of tourism to HIV/AIDS epidemic in the Caribbean.

Red palm oil: nutritional, physiological and therapeutic roles in improving human wellbeing and quality of life.

The link between dietary fats and cardiovascular disease has created a growing interest in dietary red palm oil research. Also, the link between nutrition and health, oxidative stress and the severity or progression of disease has stimulated further interest in the potential role of red palm oil (a natural antioxidant product) to improve oxidative status by reducing oxidative stress in patients with cardiovascular disease, cancer and other chronic diseases. In spite of its level of saturated fatty acid content (50%), red palm oil has not been found to promote atherosclerosis and/or arterial thrombosis. This is probably due to the ratio of its saturated fatty acid to unsaturated fatty acid content and its high concentration of antioxidants such as beta-carotene, tocotrienols, tocopherols and vitamin E. It has also been reported that the consumption of red palm oil reduces the level of endogenous cholesterol, and this seems to be due to the presence of the tocotrienols and the peculiar isomeric position of its fatty acids. The benefits of red palm oil to health include a reduction in the risk of arterial thrombosis and/or atherosclerosis, inhibition of endogenous cholesterol biosynthesis, platelet aggregation, a reduction in oxidative stress and a reduction in blood pressure. It has also been shown that dietary red palm oil, taken in moderation in animals and humans, promotes the efficient utilisation of nutrients, activates hepatic drug metabolising enzymes, facilitates the haemoglobinisation of red blood cells and improves immune function. This review provides a comprehensive overview of the nutritional, physiological and biochemical roles of red palm oil in improving wellbeing and quality of life.

Microbicides: a possible prevention approach to HIV transmission among African women.

Poverty, cultural belief and refusal to use condoms are some of the factors that contribute to the spread of HIV infection among African communities. There is a dire need to pursue research into the development, provision and the use of microbicides for African women. This review paper provides information and recommendations on the possible use of microbicides to prevent HIV infection among African women.

Assessment of the antitumour activity of targeted immunospecific albumin microspheres loaded with cisplatin and 5-fluorouracil: toxicity against a rodent ovarian carcinoma in vitro.

The 3-(4,5 dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide (MTT) assay is used successfully to estimate the number of viable cells in drug screening trials. We used the MTT assay to assess the viability of a rodent ovarian carcinoma cell line (DMBA-OC-1R) after exposure to combinations of cisplatin and 5-fluorouracil as free drug and in encapsulated (conjugated and unconjugated) forms. After 48 h of exposure to free drugs, a significant trend towards cell cytotoxicity could be observed and this was well established by 120 h. Cells treated with drug-containing immuno-microspheres showed a similar initial decrease in cell viability after 96 h, and this was maintained for 128 h. These results suggest that immuno-microspheres loaded with chemotherapeutic drugs have the potential to be successfully used in the treatment of ovarian cancer.

Adenylate kinase activity in the cerebrospinal fluid of children with tuberculous meningitis and its relationship to neurological outcome.

Cerebrospinal fluid (CSF) adenylate kinase activity was determined in 88 children (mean age 32.6 months) at stage II (n = 40) and stage III (n = 48) tuberculous meningitis (TBM) at, or shortly after, the initiation of treatment, and at weekly intervals thereafter for the first month of treatment, and in 60 children (mean age 40 months) investigated for, but later considered not to have meningitis. CSF adenylate kinase activity in this latter group ranged from 0 to 1.27 u/l (mean 0.59 u/l). Mean CSF adenylate kinase activity during the first week of therapy in children at stage II TBM (2.95 u/l; range 0-9.22 u/l) differed significantly (p = 0.03) from that in children at stage III TBM (5.62 u/l; range 0-18.93 u/l). CSF adenylate kinase activity did not differ between children at stage II and stage III TBM during any of the 3 subsequent weeks. CSF adenylate kinase activity was not related to CSF cell count, total protein or glucose concentration or intracranial pressure at any point during the first month of treatment, but was related to CSF lactate during the first week of therapy (p = 0.001). Consecutive determinations of CSF adenylate kinase activity were available in 34 children. Although CSF adenylate kinase activity tended to increase or decrease in keeping with changes in clinical condition this was not always the case. The close relationship of CSF adenylate kinase activity and lactate concentrations suggests that adenylate kinase activity reflects hypoxic cerebral metabolism and it was unusual for children with increased CSF adenylate kinase activity at the time of diagnosis to be clinically normal on completion of 6 months of antituberculosis treatment. Any treatment modality which significantly reduced CSF adenylate kinase activity in children early in the course of TBM would probably be of clinical benefit to the patients.

An aquatic toxicological evaluation of fenthion in the context of finch control in South Africa.

Queletox, containing fenthion as active ingredient, is the avicide formulation used in South Africa to control red-billed finches (Quelea quelea). Control measures involve night spraying of roosting areas with a light aircraft. Since roosting areas often include reedbeds along riversides and on islands, proper control is difficult without exposing the aquatic environment to some risk of contamination. This study tested the acute effects of fenthion, in association with the queletox formulation, on the cladocerans Daphnia pulex and Ceriodaphnia dubia and the fish species Poecilia reticulata, Tilapia rendalli, Cyprinus carpio, and Oreochromis mossambicus. The chronic effects of fenthion on D. pulex were evaluated in a 14-day reproduction test. Mean 48-hr LC50 values estimated for D. pulex and C. dubia were 1.30 and 1.72 micrograms liter-1 respectively. For the fish estimated 96-hr LC50 values were as follows: 2.12 (P. reticulata), 2.53 (C. carpio), 2.92 (T. rendalli) and 1.71 micrograms liter-1 (O. mossambicus). In the chronic test reproduction of the exposed population was stimulated at the lowest two fenthion concentrations (0.1 and 0.6 ng liter-1), while a reproductive impairment was recorded at concentrations varying from 1 to 10 ng liter-1. Concentrations of fenthion measured in dams after spraying are given to indicate the levels of contamination that may occur. QSAR was used to estimate the toxicity of some fenthion metabolites. The results of this study reveal that fenthion, at the concentrations occurring in the environment after aerial spraying, can have marked effects on the survival and reproduction of D. pulex for long periods after spraying.

Heat-stabilized albumin microspheres as a sustained drug delivery system for the antimetabolite, 5-fluorouracil.

The aim of this investigation was to study the release behaviour of heat-stabilized albumin microspheres with entrapped 5-Fluorouracil (5-FU) in vitro, and determine the organ distribution in vivo, for potential application in the treatment of ovarian cancer. Additionally, blood chemistry and haematological profiles were composed after intraperitoneal administration of 5-FU-loaded albumin microspheres into adult female Wistar rats. Microspheres with entrapped 5-FU was also added to 10(4) HeLa cells, cultured in Eagles Minimum Essential Medium, and the effects of drug leakage studied. It was found that cell division of the cells was halted before one cell cycle, as demonstrated by the absence of micronuclei and double nuclei. Blood chemistry and haematology indicated mild systemic toxic effects of the drug e.g. bone marrow suppression and liver involvement, reaching a maximum by Day 12 after intraperitoneal administration of 5-FU-microspheres. A return to normal however was observed within 4 weeks. The data suggest that 5-FU-loaded albumin microspheres may be beneficial in reducing the severe side-effects of this antimetabolite, whilst still maintaining therapeutic levels to cause tumour cell death.

Morphological classification by scanning electron microscopy of erythrocytes stored at 4 degrees C in citrate-phosphate-dextrose anticoagulant.

Scanning electron microscopy of human blood stored at 4 degrees C in CPD buffer shows a variation of red cell morphology over a period of 21 days. Our results show that at least 10 significantly different red cell shapes are present in stored whole blood.

Studies on the ultrastructure of blood cells and the microaggregate fraction in stored human blood.

Electron microscopy of citrate-phosphate-dextrose (CPD) buffered bank blood performed over 21 days shows that the normal architecture of erythrocytes, platelets and leucocytes disappears and that deformed organelles, leucocyte "ghosts", cell fragments and microaggregates accumulate. Leucocytes and platelets emerge as the most sensitive indicators of blood deterioration showing profound morphological changes from the first day. Microaggregates which passed through a 20-micrometer high capacity transfusion filter were identified as platelet conglomerates, leucocyte "ghost" and platelet-leucocyte "ghost" coaggregates with diameters of 6--20, 20--30 and 30--40 micrometers respectively. Of these aggregates present in the filtrate, 62% fell into the size range of 20--40 micrometers. The composition of microaggregates varies with storage time, the platelet conglomerates appear first during or after Day 1, leucocyte "ghosts" after Day 5 followed by platelet-leucocyte "ghost" coaggregate formation. At this stage the number of intact leucocytes and platelets is reduced and the filtrate shows an abundance of leucocyte debris. Microfiltration would thus appear to reduce but not eliminate the danger of microembolism and damage to capillary endothelium.