Association between Height and Blood Pressure in Middle Age and Older Adults in Southeast Nigeria.

BACKGROUND: This study was carried out in Abia State, Southeast Nigeria, to determine the association between height and blood pressure in middle age and elderly adults. MATERIALS AND METHODS: This was a cross-sectional study carried out in Abia State, Southeast Nigeria, between August 2011 and March 2012. The participants were residents in the state and were recruited from the three senatorial zones of the state. The total number of participants that took part in the study was 2,487 adults. The World Health Organisation STEPwise approach to surveillance of chronic disease risk factors was used. Information collected included blood pressure and anthropometric measurements. The association between height and blood pressure was determined. RESULTS: A total of 1,363 participants that took part in the study were >40 years old. Six hundred and fifty-five participants (48.1%) were males and 708 participants (51.9%) were females. There was no significant inverse relationship between height and blood pressure components ( Systolic Blood Pressure Diastolic Blood Pressure, and Pulse Pressure ) among the males. Among the females there was a high inverse relationship between height and blood pressure components. However, this relationship was not statistically significant. In addition, among the males there was no relationship between height and hypertension. Among the females, there was some degree of inverse relationship between height and hypertension, although multivariate regression analysis showed that this was not significant. CONCLUSION: There was an inverse but non-significant relationship between height and blood pressure components/ hypertension among males and females in Southeast Nigeria in this study.

CONTEXTE: Cette étude a été menée dans l'État d'Abia, au sud-est du Nigeria, pour déterminer, pour déterminer l'association entre la taille et la pression artérielle chez les adultes d'âge moyen et les personnes âgées. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude transversale réalisée dans l'État d'Abia, au sud-est du Nigeria, entre août 2011 et mars 2012. Les participants étaient des résidents de l'État et ont été recrutés dans les trois zones sénatoriales de l'État. Le nombre total de participants ayant pris part à l'étude était de 2 487 adultes. L'approche STEPwise de l'Organisation mondiale de la santé pour la surveillance des facteurs de risque des maladies chroniques a été utilisée. Les informations recueillies comprenaient la pression artérielle et les mesures anthropométriques. L'association entre la taille et la pression artérielle a été déterminée. RÉSULTATS: Au total, 1 363 participants à l'étude étaient âgés de plus de 40 ans. Six cent cinquante-cinq participants (48,1%) étaient des hommes et 708 participants (51,9 %) étaient des femmes. Il n'y avait pas de relation inverse significative entre la taille et les composantes de la pression artérielle (pression artérielle systolique, pression artérielle diastolique et pression du pouls) chez les hommes. Chez les femmes, on a constaté une forte relation inverse entre la taille et les composantes de la pression artérielle. Cependant, cette relation n'était pas statistiquement significative. En outre, Chez les hommes, il n'y a pas de relation entre la taille et l'hypertension. Chez les femmes, on a constaté un certain degré de relation inverse entre la taille et l'hypertension, bien que l'analyse de régression multivariée a montré qu'elle n'était pas significative. CONCLUSION: Il existe une relation inverse, mais non significative, entre la taille et les composantes de la pression artérielle/ hypertension chez les hommes et les femmes du sud-est du Nigeria. Mots clés: Taille, Hypertension, Pression artérielle, Pression artérielle systolique.

The Impact of telemedicine during the COVID-19 pandemic in Nigeria: A review

Background: Telemedicine practice is a rapidly evolving aspect of medicine in developed countries, though resource-limited countries like Nigeria are yet to embrace it fully. Moreover, the COVID-19 pandemic has limited patients' visits to hospitals in addition to the social distancing measures deployed by the government. In addition, with the challenges of a limited number of doctors, among other difficulties, it has become important that a radical approach to patient care and treatment should be explored. Methods: A comprehensive literature review of original articles was done using an internet search. Words such as Telemedicine, COVID-19, Pandemic, Requirements, History, Benefits, and Challenges were searched on Google scholar, EMBASE, PubMed, Medline, Web MD, and Scopusto check for various articles published or any probable link. The references of the relevant articles were searched. Results: The practice of telemedicine has evolved over the years. Also, the global telemedicine market has grown exponentially and is expected to grow even further in the next five years. Unfortunately, this exciting narrative is not obtainable in developing countries like Nigeria. Indeed, some healthcare providers in Nigeria need to prepare for this new technological advancement, and consequently, they struggle to evolve their practice to adopt this new technology. Furthermore, there is disinterest from most of the end users, particularly the patients. Conclusion: Modifications must involve telemedicine services with a view of getting ready and well-organized in the event of any future pandemic such as COVID-19, in addition to harnessing the benefits of this service in the future.

Association between glycemic status and thyroid dysfunction in patients with type 2 diabetes mellitus.

BACKGROUND: Thyroid dysfunction has been widely reported to be more common in patients with type 2 diabetes mellitus (T2DM) in various parts of the world; however, there is paucity of data on this in our environment. OBJECTIVE: The aim of this study was to determine the possible relationship between glycemic status and thyroid dysfunction. METHODOLOGY: A total of 354 T2DM patients and 118 non-diabetic persons (controls) were recruited for the study. A pretested questionnaire was filled for each subject after due explanations. Their blood samples were tested for HbA1c, fT3, fT4, and TSH. Information retrieved from patient's medical records included age at diagnosis of diabetes (DM) and duration of DM. Testing statistics done included Student's t-test, chi square test, and regression analysis. P-value of less than 0.05 was taken to be statistically significant. RESULTS: The results show that 43.5% and 37.3% of T2DM and control subjects, respectively, were males. Mean HbA1c was significantly higher in T2DM patients than in the controls (7.8±2.0% vs 5.8±1.2%, p=0.001), while mean fT3 was significantly lower in T2DM patients than in the controls (2.3±1.5 pg/mL vs 2.7±2.2 pg/mL, p=0.03). Mean HbA1c was significantly higher in T2DM patients with thyroid dysfunction compared to their euthyroid counterparts (8.1±1.9% vs 5.1±1.2%, p=0.001). HbA1c had a positive linear relationship with the presence of thyroid dysfunction (regression coefficient=1.89, p=0.001). CONCLUSION: There was a positive linear relationship between HbA1c and the presence of thyroid dysfunction in the T2DM patients in this study. There was an inverse relationship between HbA1c and serum fT3.

Comparison of clinical and biochemical variables in type 2 diabetes mellitus patients and their first-degree relatives with metabolic syndrome in Benin City, Nigeria: A cross sectional case controlled study.

OBJECTIVE: Type 2 diabetes mellitus (T2DM) is characterized by a relative insulin deficiency or insulin resistance. It is also associated with a cluster of metabolic abnormalities, including hyper-tension and dyslipidemia. Although there are many studies that have studied the metabolic abnormalities in T2DM patients with metabolic syndrome (MetS), only few of them have assessed the metabolic abnormalities in their first-degree relatives (FDRs) who had MetS. The aim of this study is to compare the clinical and biochemical variables in T2DM subjects and their FDRs without diabetes in Benin City, Nigeria. METHODS: This is a cross sectional case control study including 124 T2DM patients, 96 FDR of T2DM subjects, and 96 controls recruited using convenience sampling. Data were collected using a questionnaire-administered technique. Variables of interest that were assessed included anthropometric indices like waist circumference (WC), hip circumference (HC), waist:hip ratio (WHR), body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum lipid profile, fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), proteinuria, and microalbuminuria. The 1999 World Health Organization (WHO) criteria were used to make a diagnosis of metabolic syndrome. The Chi-square test was used for comparison of proportions. P-value of less than 0.05 was taken as statistically significant. The student t-test was used to compare means and test for significant differences in the anthropometric and the metabolic indices. RESULTS: The prevalence of the MetS in T2DM persons was 87.1%, 16.7% in the FDR group, and 13.5% in the control group according to the WHO criteria. The mean value of HbA1c was significantly higher in T2DM subjects with MetS (p<0.05). The mean values of WC, FPG, total cholesterol, HDL cholesterol, and LDL cholesterol were higher in subjects with MetS in the T2DM group than in persons with MetS in the FDR group though not significant (p>0.05). The mean values of WHR, BMI, SBP, DBP, and triglyceride were higher in persons with the MetS in the FDR group than in persons with the MetS in the T2DM group. The difference in the BMI and SBP was significant (p<0.05). CONCLUSION: The prevalence of MetS in subjects with T2DM in Nigeria is very high. Though, all the biochemical and clinical indices were higher in T2DM subjects with MetS, the mean HbA1c, BMI, and SBP was significantly higher when compared to their FDR who also have MetS.

Hyperglycemic crisis precipitated by Lassa fever in a patient with previously undiagnosed type 2 diabetes mellitus.

Hyperglycemic crisis (HC) is an acute complication of diabetes mellitus (DM) that is commonly precipitated by infections and non-compliance with therapy. Viral precipitant of HC is uncommon. To report a rare case of HC unmasked by Lassa fever in a patient previously not known to have diabetes mellitus. A 54 year old lady presented with complaints of generalized body weakness, inability to pass stool, and fever. There was no abdominal pain, vomiting and nausea. There were no features of DM. She is not a known case of diabetes mellitus or hypertension. Patient does not drink alcoholic beverages. There was no history of bleeding from any orifices. She was acutely ill-looking, afebrile, not pale, anicteric, nil pedal oedema. Pulse rate was 110 beats per minute, regular, normal volume. Blood pressure was 110/80 mmHg. Respiratory rate was 26 cycles/minute, breath sound was vesicular. Abdomen was full and moved with respiration. There were no areas of tenderness, no organomegaly, no ascites, and bowel sounds were normoactive. Neurologic examination revealed a conscious patient who was restless. Casual blood glucose was 600mg/dl. Urinalysis: Glycosuria (+++), HbA1c was 12.4%. Lassa PCR done was positive. Patient was managed for hyperglycemic crisis with intravenous normal saline and soluble insulin. She was also commenced on Ribavirin but died of complications of lassa fever. Lassa fever should be included as a precipitant of hyperglycemic crisis in endemic countries.

Case series on tropical diabetic hand syndrome.

Tropical diabetic hand syndrome is a term used to describe diabetes complication of the hand affecting people in the tropics. It consists of localized cellulitis with variable swelling and ulceration of the hands, progressive, fulminant hand sepsis and gangrene in extreme cases. This syndrome is not well-recognized and is therefore less frequently reported. The authors describe three different female patients who were known diabetics of varying duration presenting with this syndrome at our tertiary health center and who were successfully managed by both the surgical and medical units. The need for early diagnosis and aggressive management is emphasized.