Behavioural and anthropometric risk factors for diabetes mellitus among newly admitted undergraduates in a Nigerian University.

BACKGROUND: Type 2 diabetes mellitus (DM) is fast becoming a global epidemic, and its prevalence is increasing in children and young adults. The aim of the study was to identify young adults who had type 2 DM or impaired fasting glucose as well as those at risk of these conditions using anthropometric data and behavioral pattern. METHODOLOGY: Two hundred and twenty newly admitted undergraduates who were randomly selected during the registration process were involved in the study. Anthropometric parameters were measured while information on demographic details, medical history, and family history were obtained using a standard questionnaire. Fasting blood glucose was measured using the glucose oxidase method. RESULTS: Two hundred and seven (94%) participants had serum glucose within reference range, 10 (4.6%) had impaired fasting glucose, and 3 (1.4%) had serum glucose> 7.1 mmol/L, which is indicative of DM. A large number (91.4%) of individuals engaged in physical activity equivalent to a walk of at least 30 min/day. Most of them (93.2%) had body mass index <25.0 while 6.8% were overweight. One hundred and three participants (46.8%) indicated that they eat 3 or more servings of whole grain per day. CONCLUSION: Most of the participants are involved in healthy lifestyle. This has resulted in very low prevalence of impaired fasting glucose and type 2 DM among the group. It will be useful to follow up the group and note if they are able to maintain this trend since the risk of developing DM is known to increase with age.

The Causative Classification of Stroke system: an international reliability and optimization study.

BACKGROUND: Valid and reliable ischemic stroke subtype determination is crucial for well-powered multicenter studies. The Causative Classification of Stroke System (CCS, available at http://ccs.mgh.harvard.edu) is a computerized, evidence-based algorithm that provides both causative and phenotypic stroke subtypes in a rule-based manner. We determined whether CCS demonstrates high interrater reliability in order to be useful for international multicenter studies. METHODS: Twenty members of the International Stroke Genetics Consortium from 13 centers in 8 countries, who were not involved in the design and development of the CCS, independently assessed the same 50 consecutive patients with acute ischemic stroke through reviews of abstracted case summaries. Agreement among ratings was measured by kappa statistic. RESULTS: The κ value for causative classification was 0.80 (95% confidence interval [CI] 0.78-0.81) for the 5-subtype, 0.79 (95% CI 0.77-0.80) for the 8-subtype, and 0.70 (95% CI 0.69-0.71) for the 16-subtype CCS. Correction of a software-related factor that generated ambiguity improved agreement: κ = 0.81 (95% CI 0.79-0.82) for the 5-subtype, 0.79 (95% CI 0.77-0.80) for the 8-subtype, and 0.79 (95% CI 0.78-0.80) for the 16-subtype CCS. The κ value for phenotypic classification was 0.79 (95% CI 0.77-0.82) for supra-aortic large artery atherosclerosis, 0.95 (95% CI 0.93-0.98) for cardioembolism, 0.88 (95% CI 0.85-0.91) for small artery occlusion, and 0.79 (0.76-0.82) for other uncommon causes. CONCLUSIONS: CCS allows classification of stroke subtypes by multiple investigators with high reliability, supporting its potential for improving stroke classification in multicenter studies and ensuring accurate means of communication among different researchers, institutions, and eras.

Clinically diagnosed Guillain-Barre syndrome in Ile-Ife, Nigeria.

BACKGROUND: Guillain Barre Syndrome (GBS) is a neurological disorder that poses a great challenge to medical care. It affects all age groups, gender and socio-economic groups. OBJECTIVE: To determine the pattern of clinical presentation as well as the factors that determine morbidity and mortality in Guillain Barre Syndrome (GBS) patients. METHODS: The case records of all the patients with diagnosis of GBS from 1988-2005 were retrieved. Socio-demographic, clinical data and laboratory investigations were collated. RESULTS: There were a total of 14 patients managed during this period, which comprised seven males and seven females. The mean(SD) age was 23.6 (13.3) years. Nine (64.3%) patients were students, only one (8%) patient was a professional and the rest 4 (36%) were artisans. Five (36%) patients presented with weakness of both upper and lower limbs while another five (36%) patients presented with weakness of the lower limbs only and four (28%) patients had bulbar symptoms in addition to weakness of the upper and lower limbs. The most common prodromal symptoms were headache, fever and joint pains. The common symptoms at presentation were excessive sweating paraesthesia (43%), urinary hesitancy and retention (35%). Physical findings include Flaccid quadriparesis 13 (93%), autonomic dysfunction 9 (64.3%), sensory impairment (71.4%) and cranial neuropathies 6 (43.5%). Albuminocytological dissociation was present in the cerebrospinal fluid of five (56%) of nine patients who had lumbar puncture done and erythrocyte sedimentation rate (ESR) was elevated in five patients (38%). The sex, age presenting complaints and treatment given were found not to have correlation with clinical outcome. The pattern of motor paresis and the nature of discharge patient had were significantly correlated with clinical outcome. CONCLUSION: Guillain Barre syndrome present impotant challenge to medical care in Nigeria and it is hoped that this study would sensitize clinicians to the clinical burden of Guillain Barre syndrome among Nigerians.