Relationship between Lifestyle Indicators and Un-investigated Dyspepsia Among Adult Patients in a Primary Care Setting in Northern Nigeria.

BACKGROUND: Un-investigated dyspepsia has remained a common encounter among patients seen in primary care in sub-Saharan Africa. A preventive approach through counselling patients on modifications of lifestyle factors related to dyspepsia could be a cost-effective approach to dyspepsia management in primary care in low- and middle-income settings. OBJECTIVES: The objectives were to describe the sociodemographic patterns of adult patients with un-investigated dyspepsia in the Family Medicine Clinics, Federal Medical Centre, Gusau, Nigeria, to describe the pattern of lifestyle factors among adult patients with un-investigated dyspepsia, to determine the relationship between lifestyle patterns and un-investigated dyspepsia and to describe the specific food types that precipitate dyspepsia among the respondents. METHODS: A hospital-based cross-sectional study using the Short Form Leeds Dyspepsia Questionnaire to describe the presence and severity of dyspepsia and the Simple Lifestyle Indicator Questionnaire to describe the lifestyle patterns of participants. RESULTS: Most respondents (66.9%) have healthy dietary patterns however more respondents 66(52.4%) engaged in unhealthy levels of physical exercise. The Stress level was intermediate in majority of respondents (66.1%). There was no statistically significant association between lifestyle indicators and severity of dyspepsia among the respondents although the linear regression model with p-value < 0.01 and < 0.05, revealed stress as a predictor of dyspepsia in this study. CONCLUSION: There was no relationship between lifestyle indicators and Uninvestigated dyspepsia among the study participants. However, some specific local foods were identified as precipitants of dyspepsia. Primary care physicians may consider a targeted dietary modification counselling approach in managing patients with uninvestigated dyspepsia.

CONTEXTE: La dyspepsie non explorée reste une rencontre courante parmi les patients en soins primaires en Afrique subsaharienne. Une approche préventive consistant à conseiller les patients sur les modifications des facteurs de mode de vie liés à la dyspepsie pourrait être une approche rentable pour la gestion de la dyspepsie en soins primaires dans des environnements à revenus faibles et moyens. OBJECTIFS: Les objectifs étaient de décrire les tendances sociodémographiques des patients adultes atteints de dyspepsie non explorée dans les cliniques de médecine familiale du Centre médical fédéral de Gusau, au Nigéria, de décrire les schémas de mode de vie chez les patients adultes atteints de dyspepsie non explorée, de déterminer la relation entre les schémas de mode de vie et la dyspepsie non explorée, et de décrire les types spécifiques d'aliments qui déclenchent la dyspepsie chez les personnes interrogées. MÉTHODES: Une étude transversale menée à l'hôpital utilisant le questionnaire abrégé Leeds Dyspepsia pour décrire la présence et la gravité de la dyspepsie, et le questionnaire Simple Lifestyle Indicator pour décrire le schéma de mode de vie des participants. RÉSULTATS: La plupart des répondants (66,9 %) présentaient des schémas alimentaires sains, cependant un nombre plus élevé de répondants (52,4 %) s'engageaient dans des niveaux malsains d'exercice physique. Le niveau de stress était intermédiaire pour la majorité des répondants (66,1 %). Aucune association statistiquement significative n'a été trouvée entre les indicateurs de mode de vie et la gravité de la dyspepsie. Cependant, le modèle de régression linéaire avec une valeur de p < 0,01 et < 0,05 a révélé que le stress était un prédicteur de la dyspepsie dans cette étude. CONCLUSION: Il n'y avait pas de relation entre les indicateurs de mode de vie et la dyspepsie non explorée chez les participants à l'étude, cependant certains aliments locaux spécifiques ont été identifiés comme des déclencheurs de la dyspepsie. Les médecins de soins primaires pourraient envisager une approche ciblée de conseil en modification alimentaire pour la prise en charge des patients atteints de dyspepsie non explorée. MOTS-CLÉS: Dyspepsie non explorée, Indicateurs de mode de vie.

Oral findings in chronic kidney disease: implications for management in developing countries.

BACKGROUND: The importance of oral health care in the management of patients with systemic diseases including chronic kidney disease (CKD) has been affirmed. Many CKD patients have related oral lesions, however, attention to oral health care has been lacking, especially in the developing countries with higher burden of renal diseases. METHODS: One hundred and eighty patients, 90 cases and 90 controls were recruited, interviewed and examined. Oral mucosa assessment was based on the WHO Guide to Epidemiology and Diagnosis of Oral Mucosal Diseases. Urinalysis and blood creatinine levels were determined. Glomerular filtration rate (GFR) of each patient was calculated from the blood creatinine using Cockcroft and Gault formula. RESULTS: Oral lesions were present in 86 out of 90 (96.5%) CKD patients compared with 15 out of 90 (16.7%) controls (p < 0.001). Abnormal lip hyperpigmentation was the most frequently seen lesion in 81 out of 90 (90%) CKD patients. Other significant findings were gum bleeding, xerostomia, candidiasis, burning mouth and abnormal taste. In the controls (without CKD), the mean GFR was lower in subjects with oral lesions compared with those without oral lesions p < 0.001. CONCLUSIONS: CKD and reduced GFR in subjects without CKD are risk factors for oral lesions. The higher prevalence of oral lesions in CKD patients necessitates mandatory oral screening to identify patients with deteriorating renal function. The management of such lesions will enhance the overall well-being of CKD patients in developing countries.