Oxidative stress among subjects with metabolic syndrome in Sokoto, North-Western Nigeria.

BACKGROUND: Oxidative stress is known to play a role in the pathophysiology of metabolic syndrome and its components. Racial differences may exist in the level of markers of oxidative stress and antioxidants in patients with metabolic syndrome. AIM: The aim of this study was to determine the oxidative stress and antioxidants status in subjects with metabolic syndrome in Sokoto, North-Western Nigeria. METHODS: A cross-sectional community-based study was carried out. Two hundred subjects (96 males and 104 females) were recruited for the study using a multi-stage sampling technique. Demographic data were obtained from the participants. Evaluation of anthropometric variables, blood pressure, blood glucose levels, lipid profiles, plasma insulin levels, total antioxidant status, and oxidative stress markers was performed. RESULTS: The subjects with metabolic syndrome had significantly higher malondialdehyde as compared to those without metabolic syndrome (236.4 [92.2] vs. 184 [63.2] nmol/l). The antioxidant enzymes (superoxide dismutase, glutathione peroxidase and catalase) were significantly lower in subjects with metabolic syndrome than in those without metabolic syndrome (11.3 [4.2] vs. 13.9 [4.1] U/ml, 160[42] vs. 220[32] U/ml, and 2.12 [0.2] vs. 2.42 [0.2] U/ml, respectively). Similarly, the antioxidant Vitamins (A, C, and E) levels were significantly lower in subjects with metabolic syndrome than in those without metabolic syndrome (7.1 [4.1] vs. 7.7 [4.2] µmol/L, 225 [55.3] vs. 227.6 [62.3] µmol/L, and 75.9 [13.9] vs. 82.8 [18.6] mg/dl, respectively). There was a positive correlation between components of metabolic syndrome and free radicals. CONCLUSION: Significantly increased oxidative stress and diminished antioxidant defenses were found among Nigerians with metabolic syndrome.

Lipoatrophy among patients on antiretroviral therapy in Lagos, Nigeria: Prevalence, pattern and association with cardiovascular risk factors.

CONTEXT: Antiretroviral therapy (ART) is linked with morphologic abnormalities such as lipoatrophy (LA), which may accompany metabolic alterations (dysglycemias, dyslipidemia and insulin resistance) that increase cardiovascular disease risk. LA and its association with metabolic alterations have been infrequently studied amongst Nigerians on ART. AIMS: To determine the prevalence, pattern and association of LA with metabolic abnormalities and hypertension among patients on ART attending an ambulatory human immunodeficiency virus clinic in Lagos, Nigeria. SUBJECTS AND METHODS: A cross-sectional study was carried out among patients on ART using a structured interviewer administered questionnaire. Data obtained included patients and physician's assessment of body fat changes, drug history, blood pressure, body composition assessment using bioelectrical impedance analysis and biochemical evaluation (glucose, lipids). LA was defined clinically. Data were analyzed using IBM SPSS statistical software version 21. RESULTS: A total of 48 (33.1%) of the 145 patients had LA. The face was the most frequently affected body region. Patients with LA with lower body circumferences, skin-fold thickness and body fat (P < 0.05). The frequencies of lipid abnormalities were: Reduced high density lipoprotein-cholesterol (47.1%), elevated total cholesterol (35.6%), reduced low density lipoprotein-cholesterol (19.2%), elevated triglycerides (14.4%). Fasting plasma glucose (FPG)≥6.1 mmol/l and hypertension were present among 9.6% and 40.7% respectively. LA was not significantly associated with the presence of glucose intolerance, dyslipidemia or hypertension (P > 0.05). CONCLUSIONS: Lipoatrophy, though commonly encountered in patients on ART in Nigeria was not associated with the presence of dyslipidemia, abnormal FPG or hypertension. Regular monitoring by the physician and increased patients awareness are necessary to reduce its prevalence and impact.

Self-reported physical activity among health care professionals in South-West Nigeria.

INTRODUCTION: Physical activity (PA) is a key requirement for maintaining good health. There is growing evidence of declining PA worldwide. Physical inactivity is linked with the global obesity pandemic and increasing burden of noncommunicable diseases (NCDs) in developing countries. A barrier to PA counseling by health care providers (HCPs) is personal PA habits. Information regarding PA among HCPs in Nigeria is limited. We aimed to determine the adequacy and predictors of PA among HCPs of a tertiary health care facility in Lagos, Nigeria. METHODS: A cross-sectional study was carried out with the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Using the World Health Organization (WHO) guideline, PA was categorized as adequate or inadequate. Predictors of PA were explored with multivariate logistic regression. RESULTS: A total of 300 HCPs were recruited, comprising 47.7% doctors and dentists, 43.3% nurses and 9.0% other HCPs. Mean age was 39.9 (9.0 years), 79.2%, 9.7% and 11.1% of the HCPs had low, moderate or high PA levels respectively. Thus, only 20.8% had adequate PA. 71.3% had body mass index (BMI) above the recommended value. BMI of ≥25 kg/m2 was associated with inadequate PA (Adjusted Odds Ratio-2.1,P=0.018). CONCLUSION: Majority of the HCPs had inadequate PA levels according to WHO guidelines. BMI≥25 kg/m2 was associated with inadequate physical inactivity. The low level of PA implies that these HCPs are at risk for NCDs. This will have a negative impact on availability of human resource for health. There is an urgent need to establish programs to increase PA among HCPs.

Epidemiology and patterns of hypertension in semi-urban communities, south-western Nigeria.

OBJECTIVE: To determine the prevalence and subtypes of hypertension among semi-urban residents in south-western Nigeria. METHODS: All adults aged 18 years or older in 10 semi-urban communities were recruited for the study. The blood pressure (BP) reading taken with a validated electronic BP monitor after at least 10 minutes of rest was used in the analysis. Hypertension was defined as BP ≥ 140/90 mmHg. RESULTS: Seven hundred and fifty subjects with a mean age of 61.7 ± 18.2 years participated in the study. The prevalence of hypertension was 55.5%. Stage 2 hypertension was the most common, present among 225 (54.1%) of the participants with hypertension, and 191 (45.9%) had stage 1 hypertension. Of those with hypertension, systolic-diastolic hypertension (SDH) was present among 198/416 (47.6%), while isolated systolic hypertension (ISH) and isolated diastolic hypertension (IDH) were present among 181/416 (43.6%) and 37/416 (8.9%), respectively. The prevalence of hypertension increased significantly with age. CONCLUSION: The prevalence of hypertension was high in these semi-urban communities. Hence, increased awareness and integrating hypertension care into primary healthcare and other community health services in these areas may prove beneficial in ameliorating its adverse effects.

PERIODONTAL SYSTEMIC INTERACTION: PERCEPTION, ATTITUDES AND PRACTICES AMONG MEDICAL DOCTORS IN NIGERIA.

BACKGROUND: Periodontal diseases (PD) impact the outcome of some systemic illnesses. Medical doctors' knowledge and practices regarding this association may influence the effective management of their patients. This has been understudied among Nigerian doctors. AIM: The study aimed to determine the knowledge, attitudes and practices regarding periodontal-systemic disease interactions among medical doctors in Nigeria. METHODOLOGY: This was a descriptive, cross sectional study by design, while the study setting was at the National Postgraduate Medical College of Nigeria (NPMCN), Ijanikin, Lagos. The study participants were senior resident doctors attending compulsory Research Methodology and Management courses organized by the NPMCN in 2014. Self-administered questionnaires were distributed among the participants to obtain information on their socio-demography, PD knowledge, association between PD and systemic illnesses, attitudes to periodontal health and oral hygiene practices questionnaires. Student t test and ANOVA were used to test associations between variables. The level of significance was set at p < 0.05. RESULTS: A total of 236 doctors participated in the study with a mean age of 35.8 (± 4.5) years, males being predominant (62.7%). Few doctors (42.1%) knew dental plaque as the main cause of PD, while 16.5% were aware of gum bleeding as earliest sign. Female doctors displayed better knowledge than males (p= 0.044). Majority were aware of an association between PD and chronic kidney disease (88.6%) and diabetes (86.5%). Knowledge of PD as a risk factor for stroke was 33.1%, poor glycemic control (25.4%), and pre-term low birthweight (14.8%). Most doctors had positive attitudes towards patients' periodontal health, while 33.5% assessed their patients' oral cavity regularly. All the doctors used tooth brush and paste to clean their teeth, while 43.2% cleaned twice daily. Only 16.5% used dental floss frequently and was associated with higher PD knowledge (p<0.001) and higher attitude scores (p=0.005). CONCLUSION: Senior resident doctors in Nigeria have positive attitudes regarding periodontal health. However, poor knowledge of PD and PD as risk factor for some systemic illnesses, coupled with unsatisfactory oral hygiene and dental examination practices are evident among the doctors.

PERIODONTAL SYSTEMIC INTERACTION: PERCEPTION, ATTITUDES AND PRACTICES AMONG MEDICAL DOCTORS IN NIGERIA.

BACKGROUND: Periodontal diseases (PD) impact the outcome of some systemic illnesses. Medical doctors' knowledge and practices regarding this association may influence the effective management of their patients. This has been understudied among Nigerian doctors. AIM AND OBJECTIVES: To determine the knowledge, attitudes and practices regarding periodontal-systemic disease interactions among medical doctors in Nigeria. METHODOLOGY: This was a descriptive, cross sectional study by design, while the study setting was at the National Postgraduate Medical College of Nigeria (NPMCN), Ijanikin, Lagos. The study participants were senior resident doctors attending compulsory Research Methodology and Management courses organized by the NPMCN in 2014. Self-administered questionnaires were distributed among the participants to obtain information on their socio-demography, PD knowledge, association between PD and systemic illnesses, attitudes to periodontal health and oral hygiene practices questionnaires. Student t test and ANOVA were used to test associations between variables. The level of significance was set at p < 0.05. RESULTS: A total of 236 doctors participated in the study with a mean age of 35.8 (± 4.5) years, males being predominant (62.7%). Few doctors (42.1%) knew dental plaque as the main cause of PD, while 16.5% were aware of gum bleeding as earliest sign. Female doctors displayed better knowledge than males (p= 0.044). Majority were aware of an association between PD and chronic kidney disease (88.6%) and diabetes (86.5%). Knowledge of PD as a risk factor for stroke was 33.1%, poor glycemic control (25.4%), and pre-term low birthweight (14.8%). Most doctors had positive attitudes towards patients' periodontal health, while 33.5% assessed their patients' oral cavity regularly. All the doctors used tooth brush and paste to clean their teeth, while 43.2% cleaned twice daily. Only 16.5% used dental floss frequently and was associated with higher PD knowledge (p<0.001) and higher attitude scores (p=0.005). CONCLUSION: Senior resident doctors in Nigeria have positive attitudes regarding periodontal health. However, poor knowledge of periodontal disease, and periodontal disease as risk factor for some systemic illnesses, coupled with unsatisfactory oral hygiene and dental examination practices are evident among the doctors.

Knowledge and attitude of some nigerian school teachers on the emergency management of avulsed permanent incisor.

BACKGROUND: Tooth avulsion has been known to be the most severe of all dental injuries. The immediate action taken at the accident site will determine the prognosis of the tooth. Replantation of an avulsed tooth is the treatment of choice. AIM & OBJECTIVES: To assess the knowledge and attitude of primary and secondary (Basic educational) school teachers on the emergency management of avulsed permanent incisors. SETTING: Twenty public and private basic educational schools were randomly selected from Lagos State. SUBJECTS & METHODS: Descriptive cross-sectional study. A 23 item self administered questionnaire was distributed to teachers to determine their knowledge and attitude on the emergency management of avulsed permanent incisors. Data was analysed using SPSS (Statistical Package for Social Sciences), Version 21.0. The responses obtained were tabulated and expressed as frequency distributions and then computed in percentages. Chi-square was used to test the association between knowledge of the schools teachers regarding the emergency management of avulsed permanent incisors and their socio-demographic variables. Multivariate analysis was used to adjust for confounding variables. The level of significance was set at P ≤0.05. RESULTS: A total of 320 teachers answered the questionnaires. Most of the teachers were female (63.1%). Only (30.9%) had received first aid training which included emergency management of dental trauma. Forty- two percent (134) didn't know that an avulsed permanent tooth could be replanted. Twenty teachers (44.4%) would clean an avulsed tooth with toothbrush and toothpaste. A greater proportion of the respondents 130 (40.6%) would transport an avulsed tooth using a clean white handkerchief. The overall knowledge of the school teachers was poor (84%).There was a statistically significant association between the knowledge of the school teachers and the inclusion of emergency management of dental trauma in the first aid training of the teachers P=0.05. Predictors of teachers' level of knowledge of emergency management of avulsed teeth were receipt of advise on management of traumatic dental injuries (OR= 2.5, CI=1.19-4.28) and type of school (OR=0.93, CI=0.206-0.750). CONCLUSION: The school teachers had insufficient knowledge about the emergency management of avulsed permanent teeth. School oral health campaigns with regards to emergency management of avulsed teeth will help improve teachers' knowledge and modify their behaviour.