Prevalence of, and risk factors for erectile dysfunction in male type 2 diabetic outpatient attendees in Enugu, South East Nigeria.

Context: Erectile dysfunction (ED) is a strong predictor of poor quality of life in men with type 2 Diabetes mellitus (T2DM). Several studies evaluating ED in men with diabetes mellitus have been carried out, but few of these have been done in Nigeria. In Enugu, South East Nigeria, paucity of studies on this subject was observed. Aims: This study aims to determine the prevalence and predictors of ED in men with T2DM attending the diabetes clinics. Settings and Design: A descriptive cross-sectional study of men with T2DM in UNTH and Saint Mary's Hospital, Enugu, was carried out. The systematic sampling method was used to recruit participants. Subjects and Methods: Data collection from participants and their hospital records was done using semi-structured questionnaire. ED was assessed using the 5 items, international index of erectile function questionnaire. Statistical Analysis Used: Data analysis was done using SPSS version 20 and results presented as texts and tables. P value was set at <0.05. Results: A total of 325 participants with mean age of 57.8 ± 13.2 years were involved out of which 94.7% had ED. The proportion of participants with ED had increased with its severity. Predictors of ED included poor glycemic control, longer duration of diabetes, overweight/obesity, and older age. Poor ED health-seeking behavior and treatment were noted. Conclusions: The prevalence of ED is high. Lifestyle interventions targeted at improving glycemic control and weight loss may reduce the burden of this complication. We recommend objective ED screening using standard but brief instruments as part of routine evaluation of men with T2DM.

RésuméContexte: La dysfonction érectile (DE) est un puissant facteur prédictif de la qualité de vie médiocre chez les hommes atteints de diabète de type 2 (DT2). Plusieurs études L'évaluation de la dysfonction érectile chez les hommes atteints de diabète sucré a été réalisée, mais peu d'entre elles ont été réalisées au Nigéria. Enugu, sud-est du Nigeria, le manque d'études sur ce sujet a été observé. Objectifs: Cette étude vise à déterminer la prévalence et les prédicteurs de la dysfonction érectile chez les hommes atteints de DT2. assister aux cliniques de diabète. Paramètres et conception: Une étude transversale descriptive des hommes atteints de DT2 à l'UNTH et à l'Hôpital Saint Mary's, Enugu, a été réalisée. La méthode d'échantillonnage systématique a été utilisée pour recruter des participants. Sujets et méthodes: Collecte de données à partir de les participants et leurs dossiers d'hôpital ont été réalisés à l'aide d'un questionnaire semi-structuré. La DE a été évaluée en utilisant les 5 items, index international questionnaire sur la fonction érectile. Analyse statistique utilisée: L'analyse des données a été réalisée à l'aide de SPSS version 20 et les résultats présentés sous forme de texte et les tables. La valeur de p a été fixée à <0,05. Résultats: Au total, 325 participants âgés de 57,8 ± 13,2 ans ont été impliqués, dont 94,7% avaient ED. La proportion de participants atteints de dysfonction érectile avait augmenté avec sa gravité. Les prédicteurs de la dysfonction érectile comprenaient un contrôle glycémique médiocre, une durée plus longue du diabète, du surpoids / obésité et du troisième âge. Des comportements médiocres en matière de recherche de soins de santé et de traitement ont été notés. Conclusions: La prévalence de ED est élevé. Les interventions axées sur le mode de vie visant à améliorer le contrôle glycémique et la perte de poids peuvent réduire le fardeau de cette complication. nous recommander un dépistage objectif dans l'urgence à l'aide d'instruments standard mais brefs dans le cadre de l'évaluation de routine des hommes atteints de DT2. Mots-clés: Diabète, dysfonction érectile, Nigéria, prévalence, facteurs de risque.

Prostate Cancer Detected by Screening in a Semi Urban Community in Southeast Nigeria: Correlations and Associations between Anthropometric Measurements and Prostate-specific Antigen.

CONTEXT: Prostate cancer (PCa) is frequently diagnosed at advanced stages in Nigeria. AIMS: To determine the screen detected PCa prevalence in a suburban community and explore any relationships between prostate-specific antigen (PSA) and anthropometric measurements. SETTINGS AND DESIGN: Nsukka is a town and local government area (LGA) in Southeast Nigeria in Enugu State. Towns that share a common border with Nsukka are Edem Ani, Alor-uno, Opi, Orba, and Ede-Oballa. Nsukka LGA has an area of 1810 km2 and a population of 309,633 at the 2006 census. All consecutive responders who met the inclusion criteria were recruited. SUBJECTS AND METHODS: A screening outreach was conducted in one location in Nsukka. PSA testing and digital rectal examinations were performed. Height and weight were measured and body mass index (BMI) was calculated. STATISTICAL ANALYSIS USED: Results were subjected to statistical analysis using SPSS 20 (IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY, USA). Categorical data were analyzed using the Chi-square test, with significance level set at P < 0.05. Pearson's correlation was conducted for interval data (P < 0.05). RESULTS: One-hundred and sixty men met the inclusion criteria and were screened. Age range was 40-81 years; PSA range was 1.20-33.9 ng/ml. Digital rectal examinations (DREs) was abnormal in 17 men. Median BMI was 27.49. A Pearson's correlation coefficient showed a significant correlation between age and PSA, r = 0.127; P ≤ 0.05, and DRE findings and PSA, r = 0.178; P ≤ 0.05. There was no significant correlation between height and PSA, r = -0.99; P = 0.211; weight and PSA, r = -0. 81 P = 0.308; and BMI and PSA, r = -0.066; P = 0.407. 8/21 men consented to prostate biopsy with three positive, giving a screen detected PCa prevalence of 1.875%. CONCLUSIONS: Screen detected PCa prevalence in high this population and efforts to improve early detection may be of value in improving treatment outcomes.

Prostate cancer detected by screening in a semi urban community in Southeast Nigeria: Correlations and associations between anthropometric measurements and prostate-specific antigen

Context: Prostate cancer (PCa) is frequently diagnosed at advanced stages in Nigeria. Aims: To determine the screen detected PCa prevalence in a suburban community and explore any relationships between prostate-specific antigen (PSA) and anthropometric measurements. Settings and Design: Nsukka is a town and local government area (LGA) in Southeast Nigeria in Enugu State. Towns that share a common border with Nsukka are Edem Ani, Alor-uno, Opi, Orba, and Ede-Oballa. Nsukka LGA has an area of 1810 km2 and a population of 309,633 at the 2006 census. All consecutive responders who met the inclusion criteria were recruited. Subjects and Methods: A screening outreach was conducted in one location in Nsukka. PSA testing and digital rectal examinations were performed. Height and weight were measured and body mass index (BMI) was calculated. Statistical Analysis Used: Results were subjected to statistical analysis using SPSS 20 (IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY, USA). Categorical data were analyzed using the Chi-square test, with significance level set at P< 0.05. Pearson's correlation was conducted for interval data (P < 0.05). Results: One-hundred and sixty men met the inclusion criteria and were screened. Age range was 40­81 years; PSA range was 1.20­33.9 ng/ml. Digital rectal examinations (DREs) was abnormal in 17 men. Median BMI was 27.49. A Pearson's correlation coefficient showed a significant correlation between age and PSA, r = 0.127; P ≤ 0.05, and DRE findings and PSA, r = 0.178; P ≤ 0.05. There was no significant correlation between height and PSA, r = −0.99; P = 0.211; weight and PSA, r = −0. 81 P = 0.308; and BMI and PSA, r = −0.066; P = 0.407. 8/21 men consented to prostate biopsy with three positive, giving a screen detected PCa prevalence of 1.875%. Conclusions: Screen detected PCa prevalence in high this population and efforts to improve early detection may be of value in improving treatment outcomes

Prostate-specific antigen density values among patients with symptomatic prostatic enlargement in Nigeria.

BACKGROUND: This study aims to estimate the prostate-specific antigen density (PSAD) cutoff level for detecting prostate cancer (CAP) in Nigerian men with "grey zone PSA" (4-10 ng/ml) and normal digital rectal examination findings. We addressed this research question: Is the international PSAD cutoff of 0.15 ideal for detecting CAP in our symptomatic patients with "grey zone PSA?" AIM: To estimate the prostate-specific antigen density (PSAD) cutoff level for detecting CAP in Nigerian men with "grey zone PSA" (4-10 ng/ml) and normal digital rectal examination findings. DESIGN: Prospective. SETTING: A tertiary medical center in Enugu, Nigeria. PARTICIPANTS: Two hundred and fifty-four men with either benign prostatic hyperplasia (BPH) or CAP were recruited. INTERVENTION: Patients with PSA above 4 ng/ml or abnormal digital rectal examination or hypoechoic lesion in the prostate were biopsied. OUTCOME MEASURES: PSAD and histology report of BPH or CAP. RESULTS: Ninety-seven patients had CAP while 157 had benign prostatic hyperplasia (BPH). Seventy-two patients had their serum PSA value within the range of 4.0 and 10 ng/ml. PSAD cutoff level to detect CAP was 0.04 (sensitivity 95.88 %; specificity 28.7 %). CONCLUSIONS: The PSAD cutoff level generated for Nigerian men in this study is 0.04 which is relatively different from international consensus. This PSAD cutoff level has a positive correlation with histology and could detect patients with CAP who have "grey zone PSA."