Health-Related Quality of Life and Its Determinants Among Hypertensive Patients in Rural Southwest Nigeria.

BACKGROUND: The health-related quality of life (HRQOL) of patients with hypertension is of particular concern to stakeholders because hypertension is a chronic disease. OBJECTIVES: To determine the pattern of HRQOL and its determinants among hypertensive patients in rural Southwestern Nigeria. SUBJECTS, MATERIALS AND METHODS: Ahospital-based crosssectional survey was conducted between June and October 2019 on 390 consented adult patients with hypertension on follow-up using systematic sampling technique. Respondents'blood pressure (BP), body mass index (BMI), waist circumference (WC), waist-hip ratio (W-HR) and other measurements were taken. Relevant data on socio-demographics and lifestyle behaviours were collected using an interviewer-administered questionnaire which incorporated validated instrument for assessment of HRQOL score using SF-12 survey. The data were analyzed using SPSS (version 21). Binary logistic regression was used to identify the determinants of HRQOL. RESULTS: The mean physical component summary (42.0 ± 8.44), mental component summary (40.6 ± 8.11), and mean overall quality of life score (41.3 ± 8.17) were all below the normal score of 50 ±10. However, of all the eight domains, the role emotional was the highest (47.61 ± 14.97). The odds of having overall good HRQOL were better with respondents with female gender (AOR=1.99, 95% CI: 1.05-3.88), tertiary education (AOR=3.22, 95% CI: 1.63-7.20), and controlled BP (AOR=3.01,95% CI: 1.04-15.79). CONCLUSION: The mean HRQOLscore of the respondents was below the mean score. The findings of this study would assist stakeholders in decision-making towards improved management of patients with hypertension.

CONTEXTE: La qualité de vie liée à la santé (HRQOL) des patients hypertendus est une préoccupation particulière pour les parties prenantes car l'hypertension est une maladie chronique. OBJECTIFS: Déterminer le modèle de la HRQOL et ses déterminants chez les patients hypertendus en milieu rural du sud-ouest du Nigéria. SUJETS, MATÉRIAUX ET MÉTHODES: Une enquête transversale hospitalière a été menée entre juin et octobre 2019 sur 390 patients adultes atteints d'hypertension en suivi, consentis, en utilisant une technique d'échantillonnage systématique. La pression artérielle (PA), l'indice de masse corporelle (IMC), la circonférence de la taille (CT), le rapport taillehanche (W-HR) et d'autres mesures ont été prises chez les répondants. Les données pertinentes sur les caractéristiques sociodémographiques et les comportements liés au mode de vie ont été collectées à l'aide d'un questionnaire administré par un enquêteur, intégrant un instrument validé pour l'évaluation du score HRQOL à l'aide de l'enquête SF-12. Les données ont été analysées à l'aide de SPSS (version 21). La régression logistique binaire a été utilisée pour identifier les déterminants de la HRQOL. RÉSULTATS: Le résumé de la composante physique (42,0 ± 8,44), la composante mentale (40,6 ± 8,11) et le score moyen de qualité de vie global (41,3 ± 8,17) étaient tous en dessous du score normal de 50 ± 10. Cependant, de tous les huit domaines, le rôle émotionnel était le plus élevé (47,61 ± 14,97). Les chances d'avoir une HRQOL globale satisfaisante étaient meilleures chez les répondants de sexe féminin (AOR=1,99, IC à 95 % : 1,05-3,88), ayant une éducation tertiaire (AOR=3,22, IC à 95 % : 1,63-7,20) et une PAcontrôlée (AOR=3,01, IC à 95 % : 1,04-15,79). CONCLUSION: Le score moyen de HRQOL des répondants était en dessous du score moyen. Les résultats de cette étude aideront les parties prenantes dans la prise de décision en vue d'une meilleure gestion des patients hypertendus. Mots-clés: Qualité de vie globale, Déterminants, Hypertension, Nigéria rural.

BARRIERS TO AN EFFECTIVE DIABETIC RETINOPATHY SERVICE IN IBADAN, NIGERIA (SUB -SAHARAN AFRICA) - A PILOT QUALITATIVE STUDY.

BACKGROUND: Diabetic retinopathy is an increasing cause of blindness. The prevalence of retinopathy in hospital attending diabetics in Ibadan is reported to be 42 %. This study assessed the barriers identified by patients and service providers to delivering good services for diabetic retinopathy in Ibadan, Nigeria, Sub-Saharan Africa. METHODS: A qualitative survey using non-participatory observation, in-depth interviews (patients and healthcare providers), and focus group discussion for diabetic patients in the eye clinic in University College Hospital, Ibadan was done. Semistructured interview and topic guides were used to evaluate the barriers to effective service. The participants were selected using a non-probability, purposive sampling strategy. Twenty participants were involved in the pilot study. There were ten in-depth interviews of patients and two focus group discussions of patients (3 in each group). Four healthcare providers were interviewed (a retinal surgeon, a senior registrar, an endocrinologist and a public health nurse). RESULTS: Lack of awareness that diabetes causes irreversible blindness was identified as a major barrier by both patients and providers. Cost of treatment of diabetes and treatment of retinopathy was also an important barrier. The long waiting time before consultation, staff attitudes to patients and appointment scheduling problems deterred patients from using the service. CONCLUSIONS: More diabetic patients can be encouraged to use eye service by providing more detailed information/counselling and making clinic attendance less costly and more convenient.

Use of cement dust in the manufacture of vitrified sewer pipes.

Waste by-pass cement dust was added in different percentages ranging from 2% to 10% to a standard mix for sewer pipes manufacture, as a substitute for expensive feldspar. It was found that a mix consisting of 45% kaolin, 36% ball clay, 9% grog and 10% by-pass dust and fired at a temperature of 1300 degrees C for 4 h yielded samples that meet the standards. It was possible to reach a water absorption of 4%, a modulus of rupture of 7.8 MPa and a resistance to acids and alkalis conforming with standard values. A test pipe was fabricated by vacuum extrusion using the suggested composition and was found to withstand a hydraulic pressure of 14 MPa for one minute without the appearance of any cracks.

Maternal and fetal serum nitric oxide (NO) concentrations in normal pregnancy, pre-eclampsia and eclampsia.

OBJECTIVES: To measure the maternal and fetal serum concentrations of total nitrites and nitrates (as an index of nitric oxide production) in normal pregnancy, pre-eclampsia and eclampsia. DESIGN: Three groups of women were studied cross-sectionally: late pregnant women with pre-eclampsia and eclampsia (n=31); normal late pregnant women (n=32); and age-matched healthy non-pregnant women (n=21). Venous blood samples were collected from all women and both maternal and umbilical venous samples were collected from pregnant women. METHODS: Blood samples were assayed for nitric oxide (NO) production by Greiss reaction which measures the combined oxidation products of NO (total nitrites and nitrates). RESULTS: There was a significant increase in serum total nitrites and nitrates concentrations in normal pregnant women than in the serum of age-matched normal non-pregnant women (P<0.0001). Significantly higher total nitrites and nitrates levels were found in the maternal sera of the pre-eclamptic and eclamptic women compared with those of normal pregnant women (P<0.0001). Also, fetal blood levels of total nitrites and nitrates were significantly increased in pre-eclampsia and eclampsia compared with those of normal pregnancy (P<0.0001). CONCLUSIONS: (1) Serum nitric oxide (NO) production is increased in normal pregnancy than in the normal non-pregnancy. (2) Maternal and fetal serum NO levels are increased significantly in pre-eclampsia and eclampsia, which possibly represents a compensatory/protective mechanism to maintain blood flow and limit platelets aggregation in the fetal-maternal circulations. (3) The increase in NO production is directly related to the severity of pre-eclampsia; this would be of diagnostic significance for the prediction of the severity of this syndrome.